目的 分析注意缺陷多动障碍(ADHD)儿童家庭环境特征和行为问题与社会功能损害之间的关系,为ADHD的临床诊断和治疗提供科学依据。 方法 选取2017年9月-2018年11月徐州市儿童医院140名ADHD儿童作为观察组,同时招募120名健康儿童作为对照组。采用自行设计的问卷、中文版家庭环境量表(FES-CV)、Conners父母评定量表(CPRS)、Conners教师评定量表(CTRS)和Weiss功能缺陷量表父母版(WFIRS-P)、现场行为观察法对儿童进行评估。采用Logistic回归模型预测ADHD风险因素。 结果 随着母亲受教育程度(OR=1.16,8.80,9.20)、职业地位(OR=0.89,2.24,2.35,5.90)和情绪稳定程度(OR=1.74)的降低,儿童ADHD风险呈上升趋势;父亲职业和教育水平、情绪状态与上述结果相似。ADHD儿童中文版家庭环境量表(FES-CV)中仅矛盾性分量表差异具有统计学意义(t=4.342,P<0.001)。ADHD儿童在所有6个Weiss功能缺陷量表父母版(WFIRS-P)的分量表测试中均表现出损伤[最低维度得分(0.19±0.22)分,健康儿童最高维度得分为(0.19±0.20)分,P<0.001)]。Conners父母评定量表(CPRS)和Conners教师评定量表(CTRS)除心身障碍维度外,其余差异均有统计学意义(P<0.001)。 结论 ADHD儿童与健康儿童相比,较差家庭环境、父母较低教育水平、更糟的职业状况和父母情绪不稳定可能会增加儿童的ADHD风险,且与儿童行为问题和社会功能损害相互作用。因此,早期以折中因素为重点的干预有助于改善ADHD儿童的社会行为功能。
Abstract
Objective To explore the relationship between family environmental characteristics, behavioral problems and social function impairment in children with attention deficit hyperactivity disorder(ADHD), and to provide scientific evidence for clinical diagnosis and treatment of ADHD. Methods A total of 140 children with ADHD in Xuzhou Children′s Hospital from September 2017 to November 2018 were enrolled as the observation group, and 120 healthy children were recruited as the control group.Self-designed questionnaire, Chinese version of Family Environment Scale (FES-CV), Conners Parent Rating Scale (CPRS), Conners Teacher Rating Scale (CTRS) and Weiss Functional Deficit Scale Parental Edition (WFIRS-P), on-site Behavioral observations were used to assess children.Logistic regression model was used to predict risk factors for attention deficit hyperactivity disorder. Results The risk of ADHD in children increased with the decrease in education (OR=1.16,8.80,9.20), occupational status (OR=0.89,2.24,2.35,5.90)and emotional stability (OR=1.74); The level of occupational and educational levels, emotional state were similar to the above results.The difference in contradiction only in the ADHD Children′s Chinese Family Environment Scale (FES-CV) was statistically significant (t=4.342, P＜0.001).ADHD children showed impairment in all six Weiss Functional Deficit Scale Parental Edition (WFIRS-P) subscale tests [lowest dimension score (0.19 ± 0.22) points, healthy children highest dimension score (0.19 ± 0.20) points, P<0.001].The Conners Parental Rating Scale (CPRS) and the Conners Teacher Rating Scale (CTRS) had statistically significant differences except the dimensions of the psychosomatic disorder (P＜0.001). Conclusions Children with ADHD have a worse family environment, lower education levels, worse occupational status, and emotional instability in their parents than healthy children, which may increase children′s risk of ADHD and interact with child behavioral problems and social dysfunction.Therefore, early interventions focused on compromise factors can help improve the social behavioral function of children with ADHD.
关键词
注意缺陷多动障碍 /
儿童 /
家庭特征 /
社会功能损害 /
行为问题
Key words
attention deficit hyperactivity disorder /
children /
family characteristics /
social function impairment /
behavioral problems
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