儿童气质特点与ADHD共患行为问题的相关性
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摘要
目的:探讨儿童气质特点与注意缺陷多动障碍(ADHD)共患行为问题的关系。方法:选取103例符合DSM-Ⅳ诊断标准的ADHD儿童和32例年龄性别匹配的正常对照,并根据Rutter儿童行为问卷将ADHD儿童分为共患行为问题组(77例)及无行为问题组(26例),采用学龄儿童气质量表测查入组儿童气质特点。结果:ADHD共患行为问题儿童气质因子分在活动水平、节律性、适应性、反应强度、心境特点、持久性维度上得分明显高于无行为问题的ADHD儿童(P <0. 01)。ADHD儿童学龄儿童气质量表的心境特点、持久性及反应阈气质因子分与Rutter儿童行为问卷的神经症行为得分呈正相关性(r=0. 66、0. 52、0. 50,均P <0. 05)。结论:ADHD共患行为问题的儿童的气质特点主要表现为活动水平高,生活无节律,适应能力及持久性差,反应强烈、消极。ADHD儿童的气质因子分在心境特点、持久性及反应阈维度上与神经症行为问题可能存在正相关。
Objective: To explore the correlation between temperament characteristics and behavior problems in children with attention-deficit/hyperactivity disorder(ADHD). Methods: Totally 103 children with ADHD meeting the criterion of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition(DSM-Ⅳ) were selected, and 32 age-and gender-matched normal children were selected as control group. According to the Rutter Children's Behavior Questionnaire, ADHD children were divided into two groups, namely ADHD with behavior problems group(n =77) and ADHD without behavior problem group(n=26). All children were assessed with the Chinese School Children Temperament Scale( CSTS). Results: The ADHD children with behavior problems got higher CSTS scores in activity level, rhythm, adaptability, response intensity, mood characteristics and persistence dimensions than those without behavior problem(Ps <0. 01). The temperament factor scores of CSTS in mood,persistence and reaction dimensions were positively correlated with the scores of neurotic behavior of Rutter Children's Behavior Questionnaire in children with ADHD( r = 0. 66,0. 52,0. 50,Ps < 0. 05). Conclusion: The temperament characteristics of children with ADHD and comorbid behavioral problems are higher activity level, irregular life,poorer adaptability and persistence, stronger reaction and negative mood. The temperament factors of ADHD children may be related to neurobehavioral problems in dimensions of mood,persistence and reaction.
Objective: To explore the correlation between temperament characteristics and behavior problems in children with attention-deficit/hyperactivity disorder(ADHD). Methods: Totally 103 children with ADHD meeting the criterion of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition(DSM-Ⅳ) were selected, and 32 age-and gender-matched normal children were selected as control group. According to the Rutter Children's Behavior Questionnaire, ADHD children were divided into two groups, namely ADHD with behavior problems group(n =77) and ADHD without behavior problem group(n=26). All children were assessed with the Chinese School Children Temperament Scale( CSTS). Results: The ADHD children with behavior problems got higher CSTS scores in activity level, rhythm, adaptability, response intensity, mood characteristics and persistence dimensions than those without behavior problem(Ps <0. 01). The temperament factor scores of CSTS in mood,persistence and reaction dimensions were positively correlated with the scores of neurotic behavior of Rutter Children's Behavior Questionnaire in children with ADHD( r = 0. 66,0. 52,0. 50,Ps < 0. 05). Conclusion: The temperament characteristics of children with ADHD and comorbid behavioral problems are higher activity level, irregular life,poorer adaptability and persistence, stronger reaction and negative mood. The temperament factors of ADHD children may be related to neurobehavioral problems in dimensions of mood,persistence and reaction.
引文
[1]Wang T,Liu K,Li Z,et al. Prevalence of attention deficit/hyperactivity disorder among children and adolescents in China:a systematic review and meta-analysis[J]. BMC Psychiatry, 2017,17(1):32.
[2]李福轮,谢晴牧,赵乾龙,等.中国儿32童注意缺陷多动障碍患病率的Meta分析[J].临床荟萃,2017,(12):1079-1083.
[3] Thomas R, Sanders S,Doust J,et al. Prevalence of attention-deficit/hyperactivity disorder:a systematic review and meta-analysis[J]. Pediatrics,2015,135(4):994-1001.
[4] Gomez R,Corr PJ. ADHD and personality:a meta-analytic review[J]. Clin Psychol Rev,2014,34(5):376-388.
[5] Stoutjesdijk R, Scholte EM, Swaab H. Behavioral and academic progress of children displaying substantive ADHD behaviors in special education:a 1-year follow-up[J]. J Atten Disord, 2016,20(1):21-33.
[6] Gallitto E. Temperament as a moderator of the effects of parenting on children's behavior[J]. Dev Psychopathol,2015,27(3):757-773.
[7]曹爱华,王玉玮,王贵菊.注意缺陷多动障碍儿童气质及行为问题的相关研究[J].中国行为医学科学,2007,16(3):220-223.
[8] American Psychiatric Association. Diagnostic and statistical manual of mental disorders(DSM-Ⅳ)[M]. Washington DC:American Psychiatric Associatio, 1994:100-105.
[9]龚耀先,蔡太生.中国修订韦氏儿童智力量表[J],中国临床心理学杂志,1994,2(1):1-6.
[10]杨玉凤.行为医学量表手册[M].北京:中华医学电子音像出版社,2001:431-432.
[11]张作记.行为医学量表手册[M].北京:中华医学电子音像出版社,2001:463-465.
[12]王玉凤.Rutter儿童行为问卷[J].中国心理卫生杂志,1991,12(增刊):55-58.
[13] Amihaesei IC, Zamfir CL. ADHD(attention defficit hyperactivity disorder)-a troubling entity, sometimes perpetuating during adult life[J]. Rev Med Chir Soc Med Nat Iasi,2016,120(1):10-14.
[14]黄春娟,潘顺英,孙玉燕,等.ADHD儿童气质类型及相关因素分析[J].浙江临床医学,2016,18(5):836-838.
[15]洪琦,张风,周胜利,等.儿童气质测查量表的修订和标准化[J].中华儿科杂志,1999,(3):6-9.
[16]阮世晓,刘晓,张文华.ADHD儿童的气质特点研究[J].健康必读(中旬刊),2012,11(3):43-44.
[17]欧阳林静,赵小玲,马静敏,等.广东省佛山市2~12岁儿童气质特点研究[J].海南医学,2008,19(8):160-162.
[18]傅晓燕,孟馥,梅竹,等.注意缺陷多动障碍儿童气质特征及家庭环境的研究[J].中国行为医学科学,2003,12(6):78-79.
[19]静进,吴丙辰,麦坚凝,等.注意缺陷多动障碍儿童的社会适应行为特征[J].中国实用儿科杂志,2007,22(7):502-505.
[20]Roy A,Hartman CA,Veenstra R,et al. Peer dislike and victimisation in pathways from ADHD symptoms to depression[J]. Eur Child Adolesc Psychiatry,2015,24(8):887-895.
[21]李杨,杨金伟,周郁秋,等.注意缺陷多动障碍儿童问题行为及其影响因素分析[J].中国全科医学,2017,20(29):3600-3605.
[22]编辑委员会中华儿科杂志,中华医学会儿科学分会神经学组,中华医学会儿科学分会儿童保健学组,等.儿童注意缺陷多动障碍诊疗建议[J].中华儿科杂志,2006,44(10):758-759.
[23]Wolraich M, Brown L, Brown RT, et al. ADHD:clinical practiceguideline for the diagnosis, evaluation, and treatment of attentiondeficit/hyperactivity disorder in children and adolescents[J]. Pediatrics,2011,128(5):1007-1022.
[24]万国斌.儿童心理行为及其发育障碍——第13讲儿童情绪障碍(一)[J].中国实用儿科杂志,2003,18(1):51-53.
[25]Jarrett MA,Ollendick TH. A conceptual review of the comorbidity of attention-deficit/hyperactivity disorder and anxiety:implications for future research and practice[J]. Clin Psychol Rev,2008,28(7):1266-1280.
[26]Tsang TW,Kohn MR,Efron D,et al. Anxiety in young people with ADHD:clinical and self-report outcomes[J]. J Atten Disord,2015,19(1):18-26.
[27] Shea C,Lee M,Lai K,et al. Prevalence of anxiety disorders in Hong Kong Chinese children with ADHD[J]. J Atten Disord,2018,22(5):403-413.
[28]任榕娜,陈新民,林茂英,等.情绪障碍患儿气质类型的临床研究[J].中国当代儿科杂志,2002,4(01):31-32,38.
[29]韦臻,何慧静,何曼玉,等.学龄前儿童情绪问题气质特征的研究[J].中国儿童保健杂志,2011,19(12):1122-1124.
[30]王美芳,张燕翎,于景凯,等.幼儿焦虑与气质、家庭环境的关系[J].中国临床心理学杂志,2012,20(3):371-373+397.
[2]李福轮,谢晴牧,赵乾龙,等.中国儿32童注意缺陷多动障碍患病率的Meta分析[J].临床荟萃,2017,(12):1079-1083.
[3] Thomas R, Sanders S,Doust J,et al. Prevalence of attention-deficit/hyperactivity disorder:a systematic review and meta-analysis[J]. Pediatrics,2015,135(4):994-1001.
[4] Gomez R,Corr PJ. ADHD and personality:a meta-analytic review[J]. Clin Psychol Rev,2014,34(5):376-388.
[5] Stoutjesdijk R, Scholte EM, Swaab H. Behavioral and academic progress of children displaying substantive ADHD behaviors in special education:a 1-year follow-up[J]. J Atten Disord, 2016,20(1):21-33.
[6] Gallitto E. Temperament as a moderator of the effects of parenting on children's behavior[J]. Dev Psychopathol,2015,27(3):757-773.
[7]曹爱华,王玉玮,王贵菊.注意缺陷多动障碍儿童气质及行为问题的相关研究[J].中国行为医学科学,2007,16(3):220-223.
[8] American Psychiatric Association. Diagnostic and statistical manual of mental disorders(DSM-Ⅳ)[M]. Washington DC:American Psychiatric Associatio, 1994:100-105.
[9]龚耀先,蔡太生.中国修订韦氏儿童智力量表[J],中国临床心理学杂志,1994,2(1):1-6.
[10]杨玉凤.行为医学量表手册[M].北京:中华医学电子音像出版社,2001:431-432.
[11]张作记.行为医学量表手册[M].北京:中华医学电子音像出版社,2001:463-465.
[12]王玉凤.Rutter儿童行为问卷[J].中国心理卫生杂志,1991,12(增刊):55-58.
[13] Amihaesei IC, Zamfir CL. ADHD(attention defficit hyperactivity disorder)-a troubling entity, sometimes perpetuating during adult life[J]. Rev Med Chir Soc Med Nat Iasi,2016,120(1):10-14.
[14]黄春娟,潘顺英,孙玉燕,等.ADHD儿童气质类型及相关因素分析[J].浙江临床医学,2016,18(5):836-838.
[15]洪琦,张风,周胜利,等.儿童气质测查量表的修订和标准化[J].中华儿科杂志,1999,(3):6-9.
[16]阮世晓,刘晓,张文华.ADHD儿童的气质特点研究[J].健康必读(中旬刊),2012,11(3):43-44.
[17]欧阳林静,赵小玲,马静敏,等.广东省佛山市2~12岁儿童气质特点研究[J].海南医学,2008,19(8):160-162.
[18]傅晓燕,孟馥,梅竹,等.注意缺陷多动障碍儿童气质特征及家庭环境的研究[J].中国行为医学科学,2003,12(6):78-79.
[19]静进,吴丙辰,麦坚凝,等.注意缺陷多动障碍儿童的社会适应行为特征[J].中国实用儿科杂志,2007,22(7):502-505.
[20]Roy A,Hartman CA,Veenstra R,et al. Peer dislike and victimisation in pathways from ADHD symptoms to depression[J]. Eur Child Adolesc Psychiatry,2015,24(8):887-895.
[21]李杨,杨金伟,周郁秋,等.注意缺陷多动障碍儿童问题行为及其影响因素分析[J].中国全科医学,2017,20(29):3600-3605.
[22]编辑委员会中华儿科杂志,中华医学会儿科学分会神经学组,中华医学会儿科学分会儿童保健学组,等.儿童注意缺陷多动障碍诊疗建议[J].中华儿科杂志,2006,44(10):758-759.
[23]Wolraich M, Brown L, Brown RT, et al. ADHD:clinical practiceguideline for the diagnosis, evaluation, and treatment of attentiondeficit/hyperactivity disorder in children and adolescents[J]. Pediatrics,2011,128(5):1007-1022.
[24]万国斌.儿童心理行为及其发育障碍——第13讲儿童情绪障碍(一)[J].中国实用儿科杂志,2003,18(1):51-53.
[25]Jarrett MA,Ollendick TH. A conceptual review of the comorbidity of attention-deficit/hyperactivity disorder and anxiety:implications for future research and practice[J]. Clin Psychol Rev,2008,28(7):1266-1280.
[26]Tsang TW,Kohn MR,Efron D,et al. Anxiety in young people with ADHD:clinical and self-report outcomes[J]. J Atten Disord,2015,19(1):18-26.
[27] Shea C,Lee M,Lai K,et al. Prevalence of anxiety disorders in Hong Kong Chinese children with ADHD[J]. J Atten Disord,2018,22(5):403-413.
[28]任榕娜,陈新民,林茂英,等.情绪障碍患儿气质类型的临床研究[J].中国当代儿科杂志,2002,4(01):31-32,38.
[29]韦臻,何慧静,何曼玉,等.学龄前儿童情绪问题气质特征的研究[J].中国儿童保健杂志,2011,19(12):1122-1124.
[30]王美芳,张燕翎,于景凯,等.幼儿焦虑与气质、家庭环境的关系[J].中国临床心理学杂志,2012,20(3):371-373+397.