摘要
目的:分析注意力缺陷障碍伴多动儿童的行为和个性特点及其与家庭环境的关系。方法:于2004/05按照DSM-Ⅳ的注意力缺陷障碍伴多动诊断标准调查长沙市某学校小学三年级到初中一年级共1320名学生,筛查出由儿童精神病学主治医师组确诊的51名注意力缺陷障碍伴多动儿童作为注,对照组为其同班级、同性别、同年龄段(相差<1岁)的正常儿童51名。采用Achenbach儿童行为量表和艾森克儿童个性问卷调查儿童的行为与个性特点,采用家庭环境量表中文版调查儿童家庭环境特征。Achenbach儿童行为量表分为社会能力和行为问题两部分。社会能力由活动情况、社交情况、学校情况3个分量表组成;行为问题分为退缩、躯体主诉、焦虑抑郁、社交问题、思维问题、注意问题、违纪行为、攻击性行为8个分量表,并分别计算社会能力和行为问题总分。其中退缩、躯体主诉、焦虑抑郁、注意问题4个分量表构成了内化性行为问题;违纪行为、攻击性行为两个分量表构成外化性行为问题。艾森克儿童个性问卷有内外倾向、情绪稳定性、精神质和掩饰倾向4个分量表。采用家庭环境量表中文版,包括亲密度、情感表达、矛盾性、独立性、成功性、知识性、娱乐性、道德宗教观、组织性、控制性等10个维度。Achenbach儿童行为量表和家庭环境量表由同学带回家由父母填写,1周后收回,艾森克儿童个性问卷由儿童仔细填写。结果:102名儿童完成全部测评,进入结果分析。①注意力缺陷障碍伴多动组儿童社交情况、学校情况、焦虑抑郁、社交、思维及注意问题评分和社会能力总分和行为总分明显高于对照组(t=-3.966～8.253,P<0.001)。②注意力缺陷障碍伴多动儿童个性在内外倾向得分较对照组低(34.61±5.66,42.31±6.42,t=-6.429,P<0.001),而情绪稳定性及精神质得分较对照组高(34.31±6.29,30.90±5.11,t=3.008,P<0.05);(27.27±3.19,22.88±4.02,t=6.111,P<0.001)。③注意力缺陷障碍伴多动儿童的家庭环境中其亲密度程度、情感表达、独立性、成功性、组织性得分低于正常组(t=-7.801～-2.139,P<0.05或0.001),而矛盾性、控制性得分高于正常组(t=3.099,3.246,P<0.05)。④注意力缺陷障碍伴多动儿童的行为和个性特征与家庭环境无明显相关,取Achenbach儿童行为量表中的思维问题、社交问题、注意问题、内外向性行为问题与家庭环境各因子分做典型相关分析,并得到第一典型相关系数(λ1=0.679,P>0.05);取艾森克儿童个性问卷内外倾向、情绪稳定性和精神质3个维度与家庭环境各因子分做典型相关分析,求得典型相关系数(λ1=0.610,P>0.05)。结论:注意力缺陷障碍伴多动儿童具有突出的行为问题和不同程度社会功能损害。家庭环境对其未产生明显的影响。与正常儿童相比,注意力缺陷障碍伴多动儿童呈现了注意缺陷、攻击和违纪行为的独特个性特征和异常的家庭结构。
AIM： To analyze the behavior, personality characteristics, and the relations with family in children with attention deficit hyperactivity disorder （ADHD）. METHODS：1320 students from the third grades to the seventh grades were investigated in a school of Changsha city with ADHD diagnosis standard of DSM-Ⅳ during May 2004. Fifty-one of them diagnosed by child psychiatry attending physician were considered as ADHD group. Fifty-one normal children with same class, same sex and same age period （no more than 1 year difference） were as control group. Children behavior and personality characteristics were detected with Achenbach Children Behavior Checklist （CBCL） and Eysenck personality Questionnaire （EPQ）. Family feature of children was investigated with family environment scale-Chinese version （FES-CV）. CBCL included social competencies that composed of activities, social relations, and school performance and behavioral problems composed of 8 sub-scales： withdrawal, somatic complaints, and anxiety and depression, social problems, thinking problems, attentiveness problems, oppositional behavior and aggressive behavior.General scores of social competencies and behavioral problems were calculated, respectively. Internalizing behavior problems were composed of withdrawal, somatic complaints, anxiety and depression with attentiveness problems; Externalizing behavior problems were composed of oppositional behavior and aggressive behavior. EPQ included 4 sub-scales： Extraversion （E）, Neuroticism （N）, Psychoticism （P）, and Social Desirability （L）. FES-CV had cohesion, expressiveness, conflict, independence, achievement orientation, intellectual-cultural orientation, active-recreational orientation, moral-religious emphasis, organization and control measures, etc. The CBCL and FES-CV were brought to home by students and filled out by parents, one week later taken back. Children filled out the EPQ carefully. RESULTS：102 children finished the whole tests and were all involved in the result analysis. ①Scores on social condition, school condition, anxiety and depression, social intercourse, thinking and attentiveness problems, general score of social competencies with general score of behavior in the ADHD group were higher significantly than those in the control group （t =-3.966 to 8.253,P 〈 0.001）. ②Scores on E in ADHD children were lower than those in the control group （34.61±5.66,42.31±6.42,t =-6.429, P 〈 0.001）, while scores on N and P were higher than those in the control group （34.31±6.29,30.90±5.11 ,t=3.008,P 〈 0.05）; （27.27±3.19,22.88±4.02,t=6.111,P 〈 0.001 ）. ③Scores on cohesion, expressiveness, independence, achievement orientation and organization in children with ADHD were lower than those in the control group （t =-7.801 to -2.139,P 〈 0.05 or 0.001）, while scores on conflict and control were higher than those in the control group （t=3.099,3.246,P 〈 0.05）. ④The behavior and personality characteristics in ADHD children had insignificant relation with family. The thinking problems, social problems, attentiveness problems, E and every factor of family condition in CBCL were gained to perform canonical correlation analysis, and the first canonical correlation coefficient （λ1=0.679,P 〉 0.05） was obtained; The E, N and P with every factor of family were gained to perform canonical correlation analysis, and canonical correlation coefficient was got （λ1=0.610,P 〉 0.05）. CONCLUSION：There are special behavioral problems and social functional lesion in different degree in children with ADHD. Home environment has insignificant effects to them. Compared with normal children, ADHD children have unique personality characteristics, such as attentiveness defection, oppositional and aggressive behavior with abnormal family structure.
出处
《中国临床康复》
CSCD
北大核心
2005年第44期72-74,共3页
Chinese Journal of Clinical Rehabilitation
