目的 探讨影响学龄期儿童注意缺陷多动障碍(ADHD)的家庭环境因素。方法 分别对ADHD患儿(ADHD组,103例)及一般情况匹配的正常儿童(对照组,103名)进行家庭环境量表(FES)、一般情况问卷及自制的严厉管教方式问卷调查;分析家庭环境与学龄期儿童ADHD的关系。结果 ADHD组FES亲密度、情感表达、知识性、娱乐性、组织性因子分低于对照组(P均<0.05);而矛盾性因子分显著高于对照组(P<0.01)。Logistic回归分析显示,FES亲密度(OR=0.55,P=0.004)、情感表达(OR=0.69,P=0.038)因子分高及儿童课外兴趣多(OR=0.51,P=0.000)是ADHD的保护性因素;母亲体罚孩子、家长陪同完成作业(OR=1.73,P=0.002)、儿童主要抚养人不是父母(OR=1.59,P=0.028)、与父母管教态度不一致(OR=1.55,P=0.047)是ADHD的危险因素。结论 ADHD儿童家庭存在亲密度低、儿童课外兴趣少、母亲体罚孩子等不良环境因素,这些环境因素与ADHD发展有关,也可能与ADHD的发生有关,但需要进一步研究。

Objective To explore the family environment influential factors of school-aged children with attention deficit hyperactivity disorder (ADHD). Methods The survey was made in 103 ADHD children (ADHD group) and 103 matched normal children (control group),children surveyed by Family Environment Scale (FES),general questionnaire and self-designed questionnaire of parental harsh discipline.The relations among family environment and ADHD were analyzed. Results The FES scores of cohesion,expressiveness,intellectual-cultural orientation,active-recreational orientation,organization in ADHD group were statistically lower than those in control group (all P<0.05),while the score of conflict in ADHD group was statistically significantly higher than that in control group (P<0.01).Logistic regression analysis indicated that the FES score of cohesion (OR=0.55,P=0.004),expressiveness (OR=0.69,P=0.038) and children having more hobbies (OR=0.51,P=0.000) were protective factors influencing ADHD.Mother spanking children (OR=1.73,P=0.002),children doing homework with their parents (OR=1.66,P=0.004),parental discipline being not consistent (OR=1.55,P=0.047),children being not raised by their parents (OR=1.59,P=0.028) were risk factors influencing ADHD. Conclusion Through the survey,it revealed the existence of non-favourable family circumstances including lower scores of cohesion children having less hobbies,mother spanking children etal in ADHD family maybe closely related with the progress or the cause of ADHD,but it requires further research.