发育性阅读障碍和注意缺陷多动可疑儿童的情绪行为问题
|
摘要
目的比较发育性阅读障碍(developmental dyslexia,DD)儿童、注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)可疑儿童、DD合并ADHD儿童在情绪、行为问题方面的异同,为开展针对性干预提供参考。方法采用《长处与困难量表》(Strengths and Difficulties Questionnaire,SDQ)对DD组(32名),ADHD组(32名),合并组(14名),正常对照组(32名)4组儿童的情绪、行为问题进行评估,同时采用多层回归分析探讨识字量和多动行为对儿童情绪、行为问题的介导作用。结果 DD组、ADHD组、合并组、正常对照组儿童除同伴交往问题的差异无统计学意义外(P值均>0.05),亲社会行为(6.41±2.75,5.53±2.49,7.07±2.37,7.72±2.19)、情绪问题(1.81±1.94,3.66±1.66,3.21±2.33,2.03±1.99)、品行问题(2.31±1.23,3.66±1.77,2.64±1.98,1.97±1.31)、困难总分(6.94±2.96,10.28±3.90,9.07±3.17,6.06±3.94)的差异均有统计学意义(F值分别为4.42,6.36,7.24,8.82,P值均<0.05)。其中ADHD组的所有情绪、行为问题表现最严重。多层回归分析表明,被试儿童在情绪问题、品行问题、同伴问题及困难总分等方面的表现主要由多动症状所介导。结论多动症状较阅读障碍更易引起儿童的情绪和行为问题。在对DD儿童的治疗中,需要重视ADHD对其情绪、行为问题的影响。
Objective To compare the differences and similarities in emotional and behavioral problems among children with developmental dyslexia(DD), attention deficit hyperactivity disorder(ADHD) or both, aiming to provide basis for targeted intervention. Methods Strengths and Difficulties Questionnaire(SDQ) was used to investigate emotional and behavioral problems among four groups of children(DD=32, ADHD=32, DD+ADHD=14, TD=32). Hierarchical regression analysis was recruited to investigate the associations of emotional and behavioral problems with spelling impairment or ADHD symptoms. Results Except for peer problems, emotional and behavioral problems varied in the four groups [prosocial DD:(6.41±2.75), ADHD:(5.53±2.49), combined:(7.07±2.37), control:(7.72±2.19), F=4.42, P<0.05; emotional problems DD:(1.81±1.94), ADHD:(3.66±1.66), combined:(3.21±2.33), control:(2.03±1.99), F=6.36, P<0.05; conduct problems DD:(2.31±1.23), ADHD:(3.66±1.77), combined:(2.64±1.98), control:(1.97±1.31), F=7.24, P<0.05; difficulties score DD:(6.94±2.96), ADHD:(10.28±3.90), combined:(9.07±3.17), control:(6.06±3.94), F=8.82, P<0.05 ], most serious in ADHD group. In addition, children in DD group scored higher than those in normal group in terms of prosocial behavior. Children in the combined group showed higher total scores of peer problems and difficult score than those in the normal group. Emotional symptoms were more serious among children in combined group than those in the DD group. Compared with the combined group, behavioral problems in ADHD group were more common. Hierarchical regression analysis indicated that occurrence of emotional and behavioral problems in combined group was mostly mediated by hyperactivity symptoms. Conclusion Compared with DD group, children with ADHD combined or not combined with DD show more emotional and behavioral problems. Emotional and behavioral problems are notably observed among those with hyperactivity symptoms than DD.
Objective To compare the differences and similarities in emotional and behavioral problems among children with developmental dyslexia(DD), attention deficit hyperactivity disorder(ADHD) or both, aiming to provide basis for targeted intervention. Methods Strengths and Difficulties Questionnaire(SDQ) was used to investigate emotional and behavioral problems among four groups of children(DD=32, ADHD=32, DD+ADHD=14, TD=32). Hierarchical regression analysis was recruited to investigate the associations of emotional and behavioral problems with spelling impairment or ADHD symptoms. Results Except for peer problems, emotional and behavioral problems varied in the four groups [prosocial DD:(6.41±2.75), ADHD:(5.53±2.49), combined:(7.07±2.37), control:(7.72±2.19), F=4.42, P<0.05; emotional problems DD:(1.81±1.94), ADHD:(3.66±1.66), combined:(3.21±2.33), control:(2.03±1.99), F=6.36, P<0.05; conduct problems DD:(2.31±1.23), ADHD:(3.66±1.77), combined:(2.64±1.98), control:(1.97±1.31), F=7.24, P<0.05; difficulties score DD:(6.94±2.96), ADHD:(10.28±3.90), combined:(9.07±3.17), control:(6.06±3.94), F=8.82, P<0.05 ], most serious in ADHD group. In addition, children in DD group scored higher than those in normal group in terms of prosocial behavior. Children in the combined group showed higher total scores of peer problems and difficult score than those in the normal group. Emotional symptoms were more serious among children in combined group than those in the DD group. Compared with the combined group, behavioral problems in ADHD group were more common. Hierarchical regression analysis indicated that occurrence of emotional and behavioral problems in combined group was mostly mediated by hyperactivity symptoms. Conclusion Compared with DD group, children with ADHD combined or not combined with DD show more emotional and behavioral problems. Emotional and behavioral problems are notably observed among those with hyperactivity symptoms than DD.
引文
[1] 胡晓云,王琦,陈玉霞,等.汉语发育性阅读障碍儿童多种认知加工缺陷初探[J].中国儿童保健杂志,2018,26(4):357-360,364.
[2] CHENG D,XIAO Q,CHEN Q,et al.Dyslexia and dyscalculia are characterized by common visual perception deficits[J].Dev Neuropsychol,2018,43(6):497-507.
[3] ZHOU Y,MCBRIDE C C,LAW A B,et al.Development of reading related skill in Chinese and English among Hong Kong Chinese children with and without dyslexia[J].J Exp Child Psychol,2014,6(122):75-91.
[4] BATNINI S,UNO A.Investigation of basic cognitive predictors of reading and spelling abilities in Tunisian third-grade primary school children[J].Brain Dev,2015,37(6):579-591.
[5] 童连,史慧静,臧嘉捷.中国儿童ADHD流行状况Meta分析[J].中国公共卫生,2013,29(9):1279-1283.
[6] POLANCZYK G V,SALUM G A,SUGAYA L S,et al.Annual research review:A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents[J].J Child Psychol Psychiatry.2015,56(3):345-65.
[7] 张荣,聂绍发.儿童注意缺陷多动障碍的流行病学特征及病因研究进展[J].海南医学报,2015,21(1):140-144.
[8] CHEUNG C H,FRAZIER-WOOD A C,ASHERSON P,et al.Shared cognitive impairments and aetiology in ADHD symptoms and reading difficulties[J].PLoS One,2014,9(6):e98590.
[9] CEDERLF M,MAUGHAN B,LARSSON H,et al.Reading problems and major mental disorders-co-occurrences and familial overlaps in a Swedish nationwide cohort[J].J Psychiatry Res,2017,8(91):124-129.
[10] CARROLL J M,MAUGHAN B,GOODMAN R,et al.Literacy difficulties and psychiatric disorders:evidence for comorbidity[J].J Child Psychol Psychiatry,2005,46(5):524-532.
[11] 熊莉,张玉,朱慧玲,等.学龄期注意缺陷多动障碍儿童情绪和行为问题分析[J].中国妇幼保健,2019,34(10):2352-2354.
[12] ARNOLD E M,GOLDSTON D B,WALSH A K,et al.Severity of emotional and behavioral problems among poor and typical readers[J].J Abnormal Child Psychol,2005,33(2):205-217.
[13] 苏林雁,李雪荣,黄春香,等.Conners父母症状问卷的中国城市常模[J].中国临床心理学杂志,2001,9(4):241-243.
[14] 静进,海燕,邓桂芬,等.学习障碍筛查量表的修订与评价[J].中国儿童保健杂志,1998,6(3):197-200.
[15] 陶保平,王孝玲.小学生识字量评价量表[M].上海:上海教育出版社,1993.
[16] 王立伟,范娟,杜亚松.Conners父母用症状问卷的中国城市常模和信度研究[J].上海精神医学,2005,17(6):321-323.
[17] 王栋,狄敏,钱明.联合型瑞文测验中国儿童常模第三次修订[J].中国临床心理学杂志,2007,15(6):559-568.
[18] RUSSELL G,RYDER D,NORWICH B,et al.Behavioural difficulties that co-occur with specific word reading difficulties:a UK population-based cohort study[J].Dyslexia,2015,21(2):123-141.
[19] BISSET M,RINEHART N,SCIBERRAS E.Body dissatisfaction and weight control behaviour in children with ADHD:a population-based study[J].Eur Child Adolesc Psychiatry,2019.DOI:10.1007/s00787-019-01314-8.
[20] 武宇琦,杨斌让,王鹏,等.伴有品行问题注意缺陷多动障碍儿童家庭环境与家长压力的关系[J].中国心理卫生杂志,2019,33(6):443-446.
[21] CARBALLO J J,RODRíGUEZ-BLANCO L,GARCíA-NIETO R,et al.Screening for the ADHD phenotype using the strengths and difficulties questionnaire in a clinical sample of newly referred children and adolescents[J].J Atten Disord,2018,22(11):1032-1039.
[22] 钱丽竹.5～6年级汉语阅读障碍儿童自尊、孤独感和社交焦虑的关系研究[D].兰州:西北师范大学,2017.
[23] NELSON J M,LIEBEL S W.Socially Desirable responding and college students with dyslexia:implications for the assessment of anxiety and depression[J].Dyslexia,2018,24(1):44-58.
[24] GHISI M,BOTTESI G,RE AM,et al.Socioemotional features and resilience in italian university students with and without dyslexia[J].Fron Psychol,2016,3(7):478.
[25] BURKE M D,BOON R T,HATTON H,et al.Reading interventions for middle and secondary students with emotional and behavioral disorders:a quantitative review of single-case studies[J].Behav Modif,2015,39(1):43-68.
[26] RIETZ C S,HASSELHORN M,LABUHN A S.Are externalizing and internalizing difficulties of young children with spelling impairment related to their ADHD symptoms?[J].Dyslexia,2012,18(3):174-185.
[2] CHENG D,XIAO Q,CHEN Q,et al.Dyslexia and dyscalculia are characterized by common visual perception deficits[J].Dev Neuropsychol,2018,43(6):497-507.
[3] ZHOU Y,MCBRIDE C C,LAW A B,et al.Development of reading related skill in Chinese and English among Hong Kong Chinese children with and without dyslexia[J].J Exp Child Psychol,2014,6(122):75-91.
[4] BATNINI S,UNO A.Investigation of basic cognitive predictors of reading and spelling abilities in Tunisian third-grade primary school children[J].Brain Dev,2015,37(6):579-591.
[5] 童连,史慧静,臧嘉捷.中国儿童ADHD流行状况Meta分析[J].中国公共卫生,2013,29(9):1279-1283.
[6] POLANCZYK G V,SALUM G A,SUGAYA L S,et al.Annual research review:A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents[J].J Child Psychol Psychiatry.2015,56(3):345-65.
[7] 张荣,聂绍发.儿童注意缺陷多动障碍的流行病学特征及病因研究进展[J].海南医学报,2015,21(1):140-144.
[8] CHEUNG C H,FRAZIER-WOOD A C,ASHERSON P,et al.Shared cognitive impairments and aetiology in ADHD symptoms and reading difficulties[J].PLoS One,2014,9(6):e98590.
[9] CEDERLF M,MAUGHAN B,LARSSON H,et al.Reading problems and major mental disorders-co-occurrences and familial overlaps in a Swedish nationwide cohort[J].J Psychiatry Res,2017,8(91):124-129.
[10] CARROLL J M,MAUGHAN B,GOODMAN R,et al.Literacy difficulties and psychiatric disorders:evidence for comorbidity[J].J Child Psychol Psychiatry,2005,46(5):524-532.
[11] 熊莉,张玉,朱慧玲,等.学龄期注意缺陷多动障碍儿童情绪和行为问题分析[J].中国妇幼保健,2019,34(10):2352-2354.
[12] ARNOLD E M,GOLDSTON D B,WALSH A K,et al.Severity of emotional and behavioral problems among poor and typical readers[J].J Abnormal Child Psychol,2005,33(2):205-217.
[13] 苏林雁,李雪荣,黄春香,等.Conners父母症状问卷的中国城市常模[J].中国临床心理学杂志,2001,9(4):241-243.
[14] 静进,海燕,邓桂芬,等.学习障碍筛查量表的修订与评价[J].中国儿童保健杂志,1998,6(3):197-200.
[15] 陶保平,王孝玲.小学生识字量评价量表[M].上海:上海教育出版社,1993.
[16] 王立伟,范娟,杜亚松.Conners父母用症状问卷的中国城市常模和信度研究[J].上海精神医学,2005,17(6):321-323.
[17] 王栋,狄敏,钱明.联合型瑞文测验中国儿童常模第三次修订[J].中国临床心理学杂志,2007,15(6):559-568.
[18] RUSSELL G,RYDER D,NORWICH B,et al.Behavioural difficulties that co-occur with specific word reading difficulties:a UK population-based cohort study[J].Dyslexia,2015,21(2):123-141.
[19] BISSET M,RINEHART N,SCIBERRAS E.Body dissatisfaction and weight control behaviour in children with ADHD:a population-based study[J].Eur Child Adolesc Psychiatry,2019.DOI:10.1007/s00787-019-01314-8.
[20] 武宇琦,杨斌让,王鹏,等.伴有品行问题注意缺陷多动障碍儿童家庭环境与家长压力的关系[J].中国心理卫生杂志,2019,33(6):443-446.
[21] CARBALLO J J,RODRíGUEZ-BLANCO L,GARCíA-NIETO R,et al.Screening for the ADHD phenotype using the strengths and difficulties questionnaire in a clinical sample of newly referred children and adolescents[J].J Atten Disord,2018,22(11):1032-1039.
[22] 钱丽竹.5～6年级汉语阅读障碍儿童自尊、孤独感和社交焦虑的关系研究[D].兰州:西北师范大学,2017.
[23] NELSON J M,LIEBEL S W.Socially Desirable responding and college students with dyslexia:implications for the assessment of anxiety and depression[J].Dyslexia,2018,24(1):44-58.
[24] GHISI M,BOTTESI G,RE AM,et al.Socioemotional features and resilience in italian university students with and without dyslexia[J].Fron Psychol,2016,3(7):478.
[25] BURKE M D,BOON R T,HATTON H,et al.Reading interventions for middle and secondary students with emotional and behavioral disorders:a quantitative review of single-case studies[J].Behav Modif,2015,39(1):43-68.
[26] RIETZ C S,HASSELHORN M,LABUHN A S.Are externalizing and internalizing difficulties of young children with spelling impairment related to their ADHD symptoms?[J].Dyslexia,2012,18(3):174-185.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |