【目的】 探讨孤独症患儿父母压力和情绪变化及其相关因素。 【方法】 采用父母压力指数量表(PSI)、孤独症行为量表(ABC)、孤独症评定量表(CARS)、抑郁自评量表(SDS)和焦虑自评量表(SAS)对孤独症患儿父母进行评定;采用PSI、SDS和SAS量表对正常儿童父母进行评定。 【结果】 1)孤独症患儿父母PSI总分及各分量表分均显著高于正常儿童父母(P=0.000);2)患儿父、母亲SDS和SAS分均显著高于正常儿童父母(P= 0.000)。患儿母亲SDS和SAS分均高于患儿父亲得分(P=0.000),患儿母亲抑郁发生率高于父亲(P=0.000);3)患儿父母的压力与患儿症状严重度正相关(P<0.01);4)多元回归结果表明孤独症患儿ABC量表分、孤独症患儿母亲的焦虑以及患儿年龄影响孤独症儿童父母压力,解释了总变异的54.9%。 【结论】 孤独症患儿父母承受着较高的压力、焦虑和抑郁水平,孤独症患儿母亲比患儿父亲及正常儿童父母更易发生抑郁,患儿行为问题是父母压力的主要影响因素。
Abstract
【Objectives】 To examine the parenting stress and mental health status and related factors associated with parenting stress in parents of children with autism. 【Methods】 Participants in this study were 196 parents of autistic children diagnosed with DSM-IV and 144 parents of normal children.The parents in two groups finished Parenting Stress Index(PSI),Self-rating Depression Scale(SDS) and Self-rating Anxiety Scale(SAS).Parents of autistic children also completed Autism Behavior Checklist(ABC) and the Children Autism Rating Scale (CARS). 【Results】 1)Parents of autistic children reported substantially higher scores of stress in the child domain,parent domain and total PSI than that of parents with normal children(P=0.000);2)Fathers and mothers of children with autism had higher SDS and SAS scores than those of parents of normal children (P=0.000).Mothers of children with autism reported higher scores in both SDS and SAS than those of the fathers(P=0.000);3)Elevated depression scores were more common in mothers of children with autism than those of fathers with autistic children and parents of normal children.There was no difference in elevated depression and anxiety scores between fathers of autistic children and parents of normal children;4)Parenting stress was positively correlated with severity of symptom of autistic children,children's behavior problems,SDS and SAS scores of parents of autistic children;5)Regression analysis indicated that ABC score,anxious level of mothers and age of autistic children were the related factors of parenting stress,accounting for 54.9% of the total variatio. 【Conclusions】 Parents with autistic children experienced higher level of stress,depression and anxiety than that of parents with normal children.Mothers of autistic children were more vulnerable to suffer from depression than fathers and parents of normal children.Behavior problems of autistic children was the major predictor of parenting stress.
关键词
孤独症儿童 /
父母压力 /
情绪障碍
Key words
autistic children /
parenting stress /
mental health
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Schieve LA,Blumberg SJ,Rice C,et al.The relationship between autism and parenting stress[J].Pediatrics,2007,119 (S):114-211.
[2] Fombonne E.Epidemiology of autistic disorder and other pervasive developmental disorders[J].J Clin Psychiatry,2005,66(10):3-8.
[3] Zaidman-Zait A,Mirenda P,Zumbo BD.An item response theory analysis of the Parenting Stress Index-Short Form with parents of children with autism spectrum disorders[J].J Child Psychol Psychiatry,2010,51(11):1269-1277.
[4] Hoffman CD.Parenting stress and closeness:mothers of typically developing children and mothers of children with autism[J].Focus Autism Other Dev Disabl,2009,24(3):178-188.
[5] Dumas JE,Wolf LC,Fishman SN,et al.Parenting stress,child behavior promblems,and dysphoria in parents of children with autism,Down syndrome,behavior disorders,and normal development[J].Exceptionality,1991,2(2):97-110.
[6] Olsson MB,Hwang CP.Depression in mothers and fathers of children with intellectual disability[J].J Intellect Disabil Res,2002,45(Pt 6):535-543.
[7] Boyd BA.Examining the relationship between stress and lack of social support in mothers of children with autism[J].Focus Autism Other Dev Disabl,2002,17(4):208-215.
[8] Abidin RR.Parenting Stress Index[M].3rd Ed.Odessa,FL:Psychological Assessment Resource,1995.
[9] Krug DA,Arick JR.Behavior chicklist for identifying severely handicapped individuals with high levels of autistic behavior[J].J Child Psychol Psychiatry,1980,21(3):221-229.
[10] Schopler E.Toward objective classification of childhood autism:childhood Autism Rating Scale(CARS)[J].J Autism Dev Disord,1980,10(1):91-103.
[11] Zung WW.A self-rating depression scale[J].Arch Gen Psychiatry,1965,12:63-70.
[12] Zung WW.A rating instrument for anxiety disorders[J].Psychosomatics,1971,12:371-379.
[13] Giarelli E,Wiggins LD,Rice CE,et al.Sex differences in the evaluation and diagnosis of autism spectrum disorders among children[J].Disabil Health J,2010,3(2):107-116.
[14] Lecavalier L,Leone S,Wiltz J.The impact of behaviour problems on caregiver stress in young people with autism spectrum disorders[J].J Intellect Disabil Res,2006,50(Pt 3):172-183.
[15] Donovon AM.Family stress and ways of coping with adolescents who have handicaps:Maternal perceptions[J].Am J Ment Retard,1988,92(6),502-509.
[16] Duarte CS,Bordin IA,Yazigi L.Factors associated with stress in mothers of children with autism[J].Autism,2005,9(4):416-427.
[17] Bristol MM,Gallagher JJ,Schopler E.Mothers and fathers of young developmentally disabled and non-disabled boys:Adaption and spouse support[J].Dev Psycho,1988,24(3):441-451.
[18] Orsmod GI,Lin LY,Seltzer MM.Mothers of adolescents and adults with autism:parenting multiple children with disabilities[J].Intellect Dev Disabi,2007,45(4):257-270.
[19] Hastings RP.Child behaviour problems and partner mental health as correlates of stress in mothers and fathers of children with autism[J].J Intellect Disabil Res,2003,47(Pt 4-5):231-237.
[20] Davis NO,Carter AS.Parenting stress in mothers and fathers of toddlers with autism spectrum disorders:Associations with child characteristics[J].J Autism Dev Disord,2008,38(7):1278-1291.
[21] Tobing LE,Glenwick DS.Relation of the childhood Austism Rating Scale-Parent version to diagnosis,stress,and age[J].Res Dev Disabil,2002,23(3):211-223.
基金
国家973项目(2010CB529602);国家973项目(2010CB529601);上海市基础研究重点项目(09JC1402400)
PDF(732 KB)
