儿童对立违抗性障碍的危险因素

The Risk Factors of Oppositional Defiant Disorder in Children

目的:探讨儿童对立违抗性障碍(Oppositionaldefiantdisorder,ODD)的有关危险因素及有效的预防干预措施。方法:在长沙市某小学416名全体在校学生中,以DSM-Ⅳ中的ODD诊断标准进行筛查。对其中34名ODD患儿和34名正常对照组儿童父母受教育程度、职业及卡特尔十六种人格测验(16PF)结果进行分析,入组儿童进行瑞文(CRT)智力测查。结果:父母受教育程度越高子女ODD的检出率越低。父亲受教育程度为“大学,高中,初中/小学”者,子女ODD的检出率分别为:6.6%,7.2%,12.0%。母亲受教育程度为“大学,高中,初中/小学”者,子女ODD的检出率分别为:5.3%,7.5%,10.6%。子女ODD的检出率与父母受教育程度负相关(r=-0.956,P<0.01)。父、母亲职业为“个体”者,子女ODD的检出率最高,分别为16.7%、16.5%,(χ2=12.67～12.68,P<0.01)。卡特尔十六种人格测验中,ODD儿童母亲怀疑性(5.1±1.4)及紧张性(5.1±1.3)分量表得分高于对照组儿童母亲(4.2±1.7)及(4.4±1.5),差异有统计学意义(t=2.06～2.29,P<0.05)。结论:父母受教育程度高及中高职业层次可能是儿童ODD的保护因素;父母人格方面的缺陷可能是儿童发生ODD的危险因素。

Objective： To research the risk factors of developing Oppositional Defiant Disorder （ODD） . Methods： Among 427 students in an elementary school in Changsha, we screened out thirty-four children with ODD by the criteria of DSM-Ⅳ. They and other thirty-four normal children from the same school were included in the casecontrol study. Education levels, jobs and Cartel 16 Personality Factors （16PF） were filled out by their parents. Combined Raven＇s Test （CRT） was used to evaluate childreng intelligence. Results： The prevalence rate of ODD in children increased with the decrease of their father＇s and mother＇s education level （for father＇s education level form advanced education, secondary education to primary, the rate increased from 6. 6%, 7.2% to 12.0% ） and （ for mother, 5.3%, 7. 5%, 10.6% ） . The rate of ODD was highest in children with father and mother doing small business （ 16. 7% and 16. 5%, X^2 = 12.67-12.68, P 〈 0. 01 ） . The suspicion and tension scores of 16PF of mothers of ODD children were significant higher （5.1±1.4） and （5.1 ±1.3 ） than those of mothers in controls （4.2 ±1.7 ） and （4. 4±1.5 ）, （ t=2.060- 2. 292, P 〈 0. 05 ） . Conclusions： The higher education and middle social economy status of parents were probably the protecting factors in ODD; the disabled personality characteristics of parents was probably the risk factors in children with ODD.