目的 比较孤独症谱系障碍(ASD)儿童与典型发育(TD)儿童母亲的焦虑状况,探索ASD儿童情绪行为问题与其母亲焦虑水平间的关系。方法 通过临床诊断招募55名6~12岁智商≥70的ASD儿童及74名TD儿童,采用状态-特质焦虑问卷(STAI)评估入组儿童母亲的焦虑情况,采用长处与困难问卷(SDQ)评估两组儿童情绪行为问题及表现。结果 ASD儿童组母亲状态焦虑得分与特质焦虑得分高于TD组母亲(t=5.272、4.484、P<0.05),ASD儿童SDQ困难总分及多动/注意力缺陷、情绪症状、同伴交往问题及品行问题因子得分高于TD组儿童(t=10.791、7.482、4.295、12.925、3.544),亲社会行为因子分(t=5.084)低于TD组儿童,差异均有统计学意义(P<0.01)。校正混杂因素后,ASD组母亲状态、特质焦虑得分与儿童困难总分 [S-AI: β=0.83 (95%CI: 0.19~1.46); T-AI: β=0.60 (95%CI: 0.05~1.14)]、情绪症状 [S-AI: β=2.28 (95%CI:0.72~3.84); T-AI: β=2.04 (95%CI: 0.74~3.33)]存在正相关关系(P<0.05)。TD组母亲状态焦虑得分与儿童困难总分 [β=0.50 (95%CI: 0.03~0.96)]、品行问题 [β=1.74 (95%CI: 0.19~3.30)]存在正相关关系;特质焦虑得分与品行问题 [β=1.54 (95%CI: 0.09~3.00)]存在正相关关系(P<0.05)。结论 ASD儿童母亲比TD儿童母亲更容易出现焦虑。其中ASD儿童母亲的焦虑水平与儿童情绪问题有关,TD儿童母亲的焦虑水平与儿童品行问题有关。
Abstract
Objective To compare maternal anxiety between children with autism spectrum disorder (ASD) and children with typical development (TD), and to explore the associations of maternal anxiety with emotional and behavioral problems in children with ASD. Methods A total of 55 ASD children and 74 TD children aged 6 to 12 years were recruited in this study. Station-Trait Anxiety Inventory (STAI) was used to evaluate maternal anxiety, and Strengths and Difficulties Questionnaire (SDQ) was used to assess children's emotional and behavioral problems. Results Mothers of ASD children had a higher level of maternal anxiety including state anxiety score and trait anxiety score (t=5.272, 4.484, P<0.05). In terms of SDQ, ASD children had higher scores of emotional and behavioral problems, hyperactivity/attention deficit, emotional symptoms, peer relationship problems and conduct problems(t=10.791, 7.482, 4.295, 12.925, 3.544, P＜0.05), and lower score of prosocial behaviors than TD children (t=5.084, P<0.01). In children with ASD, both maternal state anxiety and trait anxiety score were positively associated with total difficulties score [S-AI: β=0.83 (95%CI: 0.19 - 1.46), T-AI: β=0.60 (95%CI: 0.05 - 1.14), P<0.01] and emotional symptoms score [S-AI: β=2.28 (95%CI: 0.72 - 3.84), T-AI: β=2.04 (95%CI:0.74 - 3.33), P<0.01]. In TD children, maternal state anxiety score was positively associated with total SDQ score [β=0.50 (95%CI: 0.03 - 0.96), P<0.05] and conduct problem score [β=1.74 (95%CI:0.19 - 3.30), P<0.05], maternal trait anxiety score was positively related to conduct problem score [β=1.54 (95%CI: 0.09~3.00), P<0.05]. Conclusions Mothers of ASD children have higher levels of anxiety than those of TD children. Maternal anxiety is associated with emotional problems in ASD children, while it is associated with conduct behaviors in TD children.
关键词
孤独症谱系障碍 /
情绪行为问题 /
母亲 /
焦虑
Key words
autism spectrum disorder /
emotional and behavioral problems /
mother /
anxiety
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参考文献
[1] American Psychiatric Association. Diagnostic and statistical manual of mental disorders[M]. 5th ed.Washington DC: American Psychiatric Publishing, 2013.
[2] Vickerstaff S, Heriot S, Wong M, et al. Intellectual ability, self-perceived social competence, and depressive symptomatology in children with high-functioning autistic spectrum disorders[J]. J Autism Dev Disord, 2007, 37(9): 1647-1664.
[3] Maskey M, Warnell F, Parr JR, et al. Emotional and behavioural problems in children with autism spectrum disorder[J]. J Autism Dev Disord, 2013, 43(4): 851-859.
[4] Chandler S, Howlin P, Simonff E, et al. Emotional and behavioural problems in young children with autism spectrum disorder[J]. Dev Med Child Neurol, 2016, 58(2): 202-208.
[5] Gong Y, Du Y, Li H, et al. Parenting stress and affective symptoms in parents of autistic children[J]. Sci China Life Sci, 2015, 58(10): 1036-1043.
[6] Almansour MA, Alateeq MA, Alzahrani MK, et al. Depression and anxiety among parents and caregivers of autistic spectral disorder children[J]. Neurosciences, 2013, 18(1): 58-63.
[7] 刘霞. 学龄前儿童焦虑与行为问题和母亲焦虑的关系分析 [J/OL]. 临床医药文献电子杂志, 2018, 5(85): 95.
[8] 石秋霞, 吴国连, 魏晓娟,等. 学龄前儿童广泛性焦虑与行为问题和母亲焦虑的关系[J]. 中国妇幼健康研究, 2017, 28(1): 1-3.
[9] 仇晓静, 丁小兵. 孤独症儿童家长与普通儿童家长的心理特征比较分析[J]. 世界最新医学信息文摘, 2019, 19(A5): 214-220.
[10] Bennett T, Boyle M, Georgiades K, et al. Influence of reporting effects on the association between maternal depression and child autism spectrum disorder behaviors[J]. J Child Psychol Psychiatry, 2012, 53(1): 89-96.
[11] 郑晓华, 李延知. 状态-特质焦虑问卷[J]. 中国心理卫生杂志, 1997, 11(4): 28-29.
[12] 刘书君. 长处和困难问卷(SDQ)中文版的信度和效度研究 [D]. 成都:四川大学, 2006.
[13] Gao X, Shi W, Zhai Y, et al. Results of the parent-rated Strengths and Difficulties Questionnaire in 22,108 primary school students from 8 provinces of China[J]. Shanghai Arch Psychiatry, 2013, 25(6): 364-374.
[14] 张厚粲. 韦氏儿童智力量表第四版(WISC-Ⅳ)中文版的修订[J]. 心理科学, 2009, 32(5): 1177-1179.
[15] 章丽丽, 刘毅梅, 吴燕玲,等. 孤独症谱系障碍儿童干预成效与父母焦虑抑郁状态变化的关系[J]. 中国妇幼保健, 2017, 32(9): 1895-1897.
[16] 杜慧婷. 小班幼儿父母的育儿焦虑及其受状态焦虑影响的研究 [D]. 上海:上海师范大学, 2011.
[17] 徐云, 李诗涵. 孤独症儿童家长压力的影响因素探究[J]. 浙江工业大学学报(社会科学版), 2018, 17(3): 346-350.
[18] Minichil W, Getinet W, Derajew H, et al. Depression and associated factors among primary caregivers of children and adolescents with mental illness in Addis Ababa, Ethiopia[J]. BMC Psychiatry, 2019, 19(1): 249.
[19] Zainal H, Magiati I. A comparison between caregiver-reported anxiety and other emotional and behavioral difficulties in children and adolescents with autism spectrum disorders attending specialist or mainstream schools[J]. J Autism Dev Disord, 2019, 49(7): 2653-2563.
[20] Ang KQP, Loh PR. Mental health and coping in parents of children with autism spectrum disorder (ASD) in Singapore:An examination of gender role in caring[J]. J Autism Dev Disord, 2019, 49(5): 2129-2145.
[21] Lau JY, Eley TC, Stevenson J. Examining the state-trait anxiety relationship:A behavioural genetic approach[J]. J Abnorm Child Psychol, 2006, 34(1): 19-27.
[22] 于永菊. 焦虑和抑郁对正负性注意偏向的影响:注意控制的中介作用[J]. 心理与行为研究, 2020, 18(1): 121-127.
[23] 毋嫘, 林冰心. 高特质焦虑个体对负性情绪信息注意偏向的机制探讨[J]. 中国临床心理学杂志, 2016, 24(6): 992-995,1028.
[24] Iizuka C, Yamashita Y, Nagamitsu S, et al. Comparison of the strengths and difficulties questionnaire (SDQ) scores between children with high-functioning autism spectrum disorder (HFASD) and attention-deficit/hyperactivity disorder (AD/HD)[J]. Brain Dev, 2010, 32(8): 609-612.
[25] 栾风焕, 杜亚松, 江文庆,等. 上海市区学龄期儿童情绪和行为问题及其影响因素研究[J]. 中国儿童保健杂志, 2018, 26(2): 137-140.
[26] 邓延峰, 季建林, 范建红, 等. 上海市23325名学龄前儿童行为、情绪问题调查分析[J]. 中国社区医师, 2019, 35(11): 159-160,163.
[27] 黄明金, 宫晓鸿, 杨涛,等. 父母效能成长团体训练对儿童情绪行为问题及家长情绪改善的效果[J]. 四川精神卫生, 2020, 33(5): 467-470.
[28] Mackler JS, Kelleher RT, Shanahan L, et al. Parenting stress, parental reactions, and externalizing behavior from ages 4 to 10[J]. J Marriage Fam, 2015, 77(2): 388-406.
[29] 邢晓沛, 李苗苗, 阴桐桐. 母亲负性情绪与儿童外化问题行为的关系:家庭嘈杂度的调节作用[J]. 心理科学, 2018, 41(4): 842-848.
[30] Bohnert A, Lieb R, Arilan N. More than leisure: organized activity participation and socio-emotional adjustment among adolescents with autism spectrum disorder[J]. J Autism Dev Disord, 2019, 49(7): 2637-2652.
[31] Hodges A, Joosten A, Bourke-Taylor H, et al. School participation: The shared perspectives of parents and educators of primary school students on the autism spectrum[J]. Res Dev Disabil, 2020, 97: 103550.
[32] Rieffe C, Osterveld P, Terwogt MM, et al. Emotion regulation and internalizing symptoms in children with autism spectrum disorders[J]. Autism, 2011, 15(6): 655-670.
[33] Burstein M, Ginsburg GS, Tein JY. Parental anxiety and child symptomatology:An examinzation of additive and interactive effects of parent psychopathology[J]. J Abnormal Child Psych, 2010, 38(7): 897-909.
[34] 王玥媛. 母亲特质焦虑对学龄前儿童焦虑的影响 [D]. 哈尔滨:哈尔滨工程大学, 2020.
基金
国家自然科学基金项目(81872639);广东省重点领域研发计划项目(2019B030335001)
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