注意缺陷多动障碍儿童心理行为特征和家庭环境因素的分析
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摘要
目的：探讨注意缺陷多动障碍(ADHD)儿童的心理行为特征和家庭环境因素特点及ADHD发病的相关因素,分析父母的个性特征与ADHD儿童的心理行为特征及家庭环境的相关性,为临床诊断和治疗提供理论依据。
方法：选取2009年3月-2009年10月首次在青岛市妇女儿童医疗保健中心心理科就诊的ADHD儿童60例及其父母120例作为ADHD组；按照整群抽样的方法抽取青岛市合江路小学学生60例及其父母120例作为对照组。两组儿童均填写艾森克个性问卷(EPQ)儿童版、Piers-Harris儿童自我意识量表(PHCSS),ADHD组儿童给予视听整合持续性操作测验(IVA-CPT);两组父母填写一般情况调查表、多动症状问卷、儿童行为评定量表(CBCL).EPQ成人版和家庭环境量表(FES-CV)。用SPSS12.0软件建立数据库,并进行统计分析。
结果：(1)ADHD组儿童EPQ神经质和精神质得分明显高于对照组(p<0.01)；ADHD组儿童自我意识明显低于对照组儿童(p<0.05)；ADHD组儿童抑郁、强迫性、社交退缩、多动、攻击性和违纪因子得分显著高于对照组(p<0.01)；ADHD组母亲神经质、精神质维度得分显著高于对照组(p<0.01)；ADHD组儿童家庭亲密度、知识性、娱乐性、道德宗教观和组织性得分显著低于对照组(p<0.05),矛盾性得分显著高于对照组(p<0.01)；ADHD组儿童与对照组儿童在母孕期父亲抽烟或喝酒、家庭月人均收入、教养方式、管教方法和亲子关系方面的差异有统计学意义(p<0.05)。(2)ADHD儿童父亲的神经质与患儿精神质呈正相关(p<0.01),父亲的精神质与患儿精神质呈正相关(p<0.05),母亲内外向与儿童内外向呈正相关(p<0.05)；母亲的内外向因子与自我意识中的合群因子呈正相关(p<0.01)；ADHD儿童母亲精神质因子得分与患儿行为因子抑郁和体诉均呈正相关(p<0.05)；ADHD儿童父亲内外向因子与家庭环境中的娱乐性、道德宗教观呈正相关(p<0.05),母亲内外向因子与矛盾性呈负相关(p<0.05),母亲精神质与情感表达呈负相关(p<0.05),与矛盾性、独立性呈正相关(p<0.05)。(3)多因素10gistic回归分析显示,ADHD儿童的多动、组织性、合群、违纪、母亲精神质进入回归方程,为ADHD发生的危险因素(p<0.05)。
结论：ADHD儿童情绪不稳定、敏感多疑,自我意识低下,呈现出外向型行为和内化行为；ADHD儿童母亲情绪不稳定、敏感多疑,家庭环境不健康；ADHD儿童的多动、组织性、合群、违纪、母亲精神质对ADHD发生影响最大；父母的个性特征与ADHD儿童的心理行为特征和家庭环境相关。
Objectives:to investigate the personality, self-concept, behavior and family environ-ment characteristics, parents'personality of children with attention deficit hyperactivity disorder(ADHD);to examine the the relationships between parents'personality of ADHD and the personality, self-concept, behavior and family environment characteristics of children with ADHD;to analyze risk factors of ADHD.
Methods:60 children with ADHD and their parents were selected and at the same time 60 healthy contols and their parents were randomly selected.All the cases were investigated using assessment scales as follows:general status questionaire,hyperactivity syptoms questionnaire,Integrated Visual and Auditory Continuous Performance Test(IVA-CPT), Eysenck Personality Questionnaire (EPQ),Piers-Harris Children's Self-concept Scale(PHCSCS),Child Behavior Checklist(CBCL), Family Environment Scale-Chinese Version(FES-CV).Statistical analyses were performed by discriptive statistics,t test, chi-square test,analysis of variance(ANOVA) and Binary logistic regression with SPSS.
Results:(1)Children with ADHD had higher scores in Neuroticism and Psychoticism (p<0.01);lower scores in self-concept(p<0.05);compared with the controls, the ADHD had higher scores in depression,obsession,social recession,hyperactivity,aggression and anti-discipline(p<0.01);the parents of children with ADHD had higher scores in Neuroticism and Psychoticism than the control group(p<0.01);the scores of the ADHD group were lower in cohesion,Intellectual-Cultural Orientation,Active-Recreational Orientation,Moral-Religious Emphasis,Organization and higher in Conflict than the control group(p<0.01);there were differences on smoking or drinking of father in the pregnance of mother,month family earning, rearing patterns, disciplining methods,parent child relationship between the ADHD and the controls(p<0.05).(2)There were significantly positive correlations between Neuroticism of father and Psychoticism of children with ADHD;Extrovision-lntrovision of mother and the Extrovision-lntrovision, affiliation of children;Psychoticism of mother and depression,physical complaints, conflict, independence; Extrovision-lntrovision of father and Active-Recreational Orientation,Moral-Religious Emphasis.There were negative correlations between Extrovision-lntrovision of mother and conflict, Psychoticism of mother and Expressiveness.(3)Logistic analysis showed that the hyperactivity,organization, affiliation,antidiscipline and the Psychoticism of mother were the risk factors of ADHD(p<0.05).
Conclusions:Children with ADHD showed more emotional instability,sensitive suspicious personality, inferior self-concept,more externalizing and internalizing behavior problems;mothers of children with ADHD showed more emotional instability,sensitive suspicious personality,and family environment were adverse;the most important risk factors to ADHD were the hyperactivity,organization,affiliation,antidiscipline and the Psychoticism of mother. Parents'personality was related with psychological and behavioral characteristics and the family environment of children with ADHD.
方法：选取2009年3月-2009年10月首次在青岛市妇女儿童医疗保健中心心理科就诊的ADHD儿童60例及其父母120例作为ADHD组；按照整群抽样的方法抽取青岛市合江路小学学生60例及其父母120例作为对照组。两组儿童均填写艾森克个性问卷(EPQ)儿童版、Piers-Harris儿童自我意识量表(PHCSS),ADHD组儿童给予视听整合持续性操作测验(IVA-CPT);两组父母填写一般情况调查表、多动症状问卷、儿童行为评定量表(CBCL).EPQ成人版和家庭环境量表(FES-CV)。用SPSS12.0软件建立数据库,并进行统计分析。
结果：(1)ADHD组儿童EPQ神经质和精神质得分明显高于对照组(p<0.01)；ADHD组儿童自我意识明显低于对照组儿童(p<0.05)；ADHD组儿童抑郁、强迫性、社交退缩、多动、攻击性和违纪因子得分显著高于对照组(p<0.01)；ADHD组母亲神经质、精神质维度得分显著高于对照组(p<0.01)；ADHD组儿童家庭亲密度、知识性、娱乐性、道德宗教观和组织性得分显著低于对照组(p<0.05),矛盾性得分显著高于对照组(p<0.01)；ADHD组儿童与对照组儿童在母孕期父亲抽烟或喝酒、家庭月人均收入、教养方式、管教方法和亲子关系方面的差异有统计学意义(p<0.05)。(2)ADHD儿童父亲的神经质与患儿精神质呈正相关(p<0.01),父亲的精神质与患儿精神质呈正相关(p<0.05),母亲内外向与儿童内外向呈正相关(p<0.05)；母亲的内外向因子与自我意识中的合群因子呈正相关(p<0.01)；ADHD儿童母亲精神质因子得分与患儿行为因子抑郁和体诉均呈正相关(p<0.05)；ADHD儿童父亲内外向因子与家庭环境中的娱乐性、道德宗教观呈正相关(p<0.05),母亲内外向因子与矛盾性呈负相关(p<0.05),母亲精神质与情感表达呈负相关(p<0.05),与矛盾性、独立性呈正相关(p<0.05)。(3)多因素10gistic回归分析显示,ADHD儿童的多动、组织性、合群、违纪、母亲精神质进入回归方程,为ADHD发生的危险因素(p<0.05)。
结论：ADHD儿童情绪不稳定、敏感多疑,自我意识低下,呈现出外向型行为和内化行为；ADHD儿童母亲情绪不稳定、敏感多疑,家庭环境不健康；ADHD儿童的多动、组织性、合群、违纪、母亲精神质对ADHD发生影响最大；父母的个性特征与ADHD儿童的心理行为特征和家庭环境相关。
Objectives:to investigate the personality, self-concept, behavior and family environ-ment characteristics, parents'personality of children with attention deficit hyperactivity disorder(ADHD);to examine the the relationships between parents'personality of ADHD and the personality, self-concept, behavior and family environment characteristics of children with ADHD;to analyze risk factors of ADHD.
Methods:60 children with ADHD and their parents were selected and at the same time 60 healthy contols and their parents were randomly selected.All the cases were investigated using assessment scales as follows:general status questionaire,hyperactivity syptoms questionnaire,Integrated Visual and Auditory Continuous Performance Test(IVA-CPT), Eysenck Personality Questionnaire (EPQ),Piers-Harris Children's Self-concept Scale(PHCSCS),Child Behavior Checklist(CBCL), Family Environment Scale-Chinese Version(FES-CV).Statistical analyses were performed by discriptive statistics,t test, chi-square test,analysis of variance(ANOVA) and Binary logistic regression with SPSS.
Results:(1)Children with ADHD had higher scores in Neuroticism and Psychoticism (p<0.01);lower scores in self-concept(p<0.05);compared with the controls, the ADHD had higher scores in depression,obsession,social recession,hyperactivity,aggression and anti-discipline(p<0.01);the parents of children with ADHD had higher scores in Neuroticism and Psychoticism than the control group(p<0.01);the scores of the ADHD group were lower in cohesion,Intellectual-Cultural Orientation,Active-Recreational Orientation,Moral-Religious Emphasis,Organization and higher in Conflict than the control group(p<0.01);there were differences on smoking or drinking of father in the pregnance of mother,month family earning, rearing patterns, disciplining methods,parent child relationship between the ADHD and the controls(p<0.05).(2)There were significantly positive correlations between Neuroticism of father and Psychoticism of children with ADHD;Extrovision-lntrovision of mother and the Extrovision-lntrovision, affiliation of children;Psychoticism of mother and depression,physical complaints, conflict, independence; Extrovision-lntrovision of father and Active-Recreational Orientation,Moral-Religious Emphasis.There were negative correlations between Extrovision-lntrovision of mother and conflict, Psychoticism of mother and Expressiveness.(3)Logistic analysis showed that the hyperactivity,organization, affiliation,antidiscipline and the Psychoticism of mother were the risk factors of ADHD(p<0.05).
Conclusions:Children with ADHD showed more emotional instability,sensitive suspicious personality, inferior self-concept,more externalizing and internalizing behavior problems;mothers of children with ADHD showed more emotional instability,sensitive suspicious personality,and family environment were adverse;the most important risk factors to ADHD were the hyperactivity,organization,affiliation,antidiscipline and the Psychoticism of mother. Parents'personality was related with psychological and behavioral characteristics and the family environment of children with ADHD.
引文
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