目的 应用网络分析的方法探讨注意缺陷多动障碍(ADHD)儿童攻击性以及父母攻击性的相互影响。方法 2019年1—12月选择符合美国《精神障碍诊断与统计手册(第5版)》(DSM-5)诊断标准的ADHD儿童108人为ADHD组,正常儿童110人为对照组,两组儿童及其父母均完成攻击问卷。通过构建网络的方法对ADHD及对照组儿童攻击性行为与其父母的攻击性行为之间的相关性进行研究。结果 ADHD组儿童躯体攻击性、言语攻击性、易怒得分高于对照组儿童,差异有统计学意义(t=5.03、2.94、5.92,P<0.001)。ADHD父母的攻击性显著高于对照组,其分量表显示ADHD组父母易怒(t=3.83、3.70)、父母敌意(t=2.69、3.06)均高于对照组,差异有统计学意义(P<0.05)。相关分析显示父母的攻击性和ADHD儿童的攻击性有显著相关(P<0.01);网络分析显示ADHD儿童与正常对照组儿童存在不同的攻击性网络结构,其网络全局强度高于对照组(Z=2.06,P<0.05)。结论 ADHD儿童和其父母较正常儿童均具有较高水平的攻击行为,父母的攻击性和ADHD儿童的攻击性之间相互影响,ADHD儿童攻击性受到父母的影响显著大于对照组。
Abstract
Objective To analyze the interaction between aggression in children with attention deficit hyperactivity disorder(ADHD) and parental aggression by network analysis. Methods From January to December 2019,108 children diagnosed with ADHD according to Diagnostic and Statistical Manual of Mental Disorders(Fifth Edition)(DSM-5) were enrolled as ADHD group. Another 110 typical development children were included in control group. Children in two groups filled out Aggression Questionnaire(AQ) and their parents completed Vanderbilt ADHD Parent Rating Scale(VADPRS). The aggressive behaviors of children and parents between ADHD group and control group were compared and their correlation was analyzed. Results The scores of physical aggression,verbal aggression and irritability of children in ADHD group were significantly higher than those of control group(t=5.03,2.94,5.92, P<0.01). Parents of ADHD children were significantly more aggressive than the control group,and their scores of parental irritability(t=3.83,3.70) and parental hostility(t=2.69,3.06) were significantly higher(P<0.01). There was a significant correlation between parental aggression and ADHD children's aggression(P<0.05). Network analysis showed that there were different aggressive network structures between ADHD children and normal control children,and the global network intensity was significantly stronger in ADHD group(Z=2.06,P<0.05). Conclusions Both ADHD children and their parents have a higher level of aggressive behavior than normal children. Aggression of parents and ADHD children affect each other,and aggression of ADHD children is significantly more influenced by parents than controls.
关键词
注意缺陷多动障碍 /
父母 /
攻击性 /
网络比较分析
Key words
attention deficit hyperactivity disorder /
parents /
aggression /
network comparison test
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参考文献
[1] Wilens TE,Spencer TJ. Understanding attention-deficit/hyperactivity disorder from childhood to adulthood[J].Postgrad Med,2010,122(5):97-109.
[2] Lee CA,Milich R,Lorch EP,et al.Forming first impressions of children:The role of attention-deficit/hyperactivity disorder symptoms and emotion dysregulation[J].J Child Psychol Psyc,2018,59(5):556-564.
[3] Graziano PA,Garcia A. Attention-deficit hyperactivity disorder and children's emotion dysregulation:A meta analysis[J].Clin Psychol Rev,2016,46:106-123.
[4] Patel BD,Barzman DH,et al.Pharmacology and pharmacogenetics of pediatric ADHD with associated aggression:A review[J].Psychiatr Q,2013,84:407-415.
[5] Connor DF,Chartier KG,Preen EC,et al.Impulsive aggression in attention-deficit/hyperactivity disorder:Symptom severity,co-morbidity,and attention-deficit/hyperactivity disorder subtype[J].J Child Adolesc Psychopharmacol,2010,20(2):119-126.
[6] Borsboom D,Cramer AO. Network analysis:an integrative approach to the structure of psychopathology[J].Annu Rev Clin Psychol,2013,9:91-121.
[7] Borsboom D. A network theory of mental disorders[J].World Psychiatry,2017,16:5-13.
[8] 李献云,费立鹏,张亚利,等. Buss和Perry攻击问卷中文版的修订和信效度[J].中国神经精神疾病杂志,2011,37(10):607-613.
[9] 段宝军,张学芳,李艳子. 父母教养方式与儿童攻击性行为的关系研究[J].卫生职业教育,2015,33(22):102-104.
[10] 肖朝华,王庆红,罗甜甜,等.Vanderbilt父母评定量表在注意缺陷多动障碍诊断中的应用[J].中国当代儿科杂志,2013,15(5):348-352。
[11] Epskamp S,Borsboom D,Fried EI. Estimating psychological networks and their accuracy:a tutorial paper[J].Behav Res Methods,2018,50:195-212.
[12] Rooijen G,Isvoranu AM,Meijer CJ,et al.Asymptom network structure of the psychosis spectrum[J].Schizophr Res,2017,189:75-83.
[13] Borkulo CD,Boschloo L,Kossakowski JJ,et al.Comparing network structures on three aspects:A permutation test[J].Psychol Methods,2022.doi:10.1037/met0000476.
[14] Borkulo CD,Borsboom D,Schroevers RA. Group-level symptom networks in depression[J].JAMA Psychiatry,2016,73(4):411.
[15] Bubenzer BS,Herpertz DB,Kuzmanovic B,et al.Neural correlates of reactive aggression in children with attention-deficit/hyperactivity disorder and comorbid disruptive behaviour disorders[J].Acta Psychiatr Scand,2016,133:310-323.
[16] Van MA,Youngstrom E,Freeman A,et al.Impact of irritability and impulsive aggressive behavior on impairment and social functioning in youth with cyclothymic disorder[J].J Child Adolesc Psychopharmacol,2016,26:26-37.
[17] Coccaro EF,Lee R,Gozal D. Elevated plasma oxidative stress markers in individuals with intermittent explosive disorder and correlation with aggression in humans[J].Biol Psychiatry, 2016,79:127-135.
[18] Brotman MA,Kircanski K,Leibenluft E, et al.Irritability in children and adolescents[J].Annu Rev Clin Psychol,2017,13:317-341.
[19] Nora B,Steven WE,Frances W. ADHD and emotion dysregulation among children and adolescents[J].Clin Child Fam Psych,2015,18:185-217.
[20] Bunford N,Evans SW,Wymbs F. ADHD and emotion dysregulation among children and adolescents[J].Clin Child Fam Psychol Rev,2015,18(3):185-217.
[21] Lugo CC,Flegenheimer C,McDermott JM,et al.Emotional understanding,reactivity,and regulation in young children with ADHD symptoms[J].J Abnorm Child Psych,2017,45(7):1297-1310.
[22] Azeredo A,Moreira D,Barbosa F,et al.ADHD,CD,and ODD:Systematic review of genetic and environmental risk factors[J].Res Dev Disabil,2018,82:10-19
[23] Verena DS,Angélique OJ,CramerLourens JW,et al.Deconstructing the construct:A network perspective on psychological phenomena[J].New Ideas Psychol,2013,31(1):43-53.
[24] Robinaugh DJ,Ria HH,Emma RT,et al.The network approach to psychopathology:A review of the literature 2008-2018 and an agenda for future research[J].Psychol Med,2020,50(3):353-366.
[25] Cramer AO,Claudia DV,Erik JG,et al.Major depression as a complex dynamic system[J].PLoS One,2016,11(12):e0167490.
[26] Schweren L,Borkulo CD,Fried E,et al.Assessment of symptom network density as a prognostic marker of treatment response in adolescent depression[J].J Am Med Assoc Psychiatry, 2018,75(1):98-100.
[27] Isvoranu,AM,Borkulo CD,Boyette LL,et al.A network approach to psychosis:Pathways between childhood trauma and psychotic symptoms[J].Schizophr Bull,2017(43):187-196.
[28] Fritz EI,Fried IM,Goodyer PO,et al.A network model of resilience factors for adolescents with and without exposure to childhood adversity[J].Sci Rep,2018,8(1):15774.
[29] Anne W,Christiane O,Robert S,et al.Risk and protective factors for the development of ADHD symptoms in children and adolescents:Results of the longitudinal BELLA study[J].PLoS One, 2019,14(3):e0214412.
基金
山东大学青年团队创新项目(IFYT18037):山东省自然科学基金(ZR2020MH162)
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