伴焦虑障碍注意缺陷多动障碍儿童的行为问题和自我意识特点

Behavior Problems and Self-Consciousness in ADHD Children Comorbid with Anxiety Disorder

目的:探讨伴焦虑障碍的注意缺陷多动障碍(attention defici thyperactivity disorder,ADHD)儿童的行为问题和自我意识水平的特点。方法:对湖南省6个地区5～17岁中小学生采用分层随机的抽样方法,共抽取9495名儿童,采用二阶段流行病学调查方法,最后选出符合标准的三组儿童(对照组214人、单纯ADHD组219人、伴焦虑障碍ADHD组111人)。入组儿童由家长填写儿童行为量表(Achenbach Child Behavior Checklist,CBCL),儿童自己填写儿童自我意识量表(children'sself-conceptscale,CSCS)。结果:(1)单纯ADHD组儿童行为问题评分均大于对照组[如行为问题总分(30.35±24.32)vs.(16.97±14.86),P<0.01],而儿童自我意识量表评分均小于对照组[如总分(50.85±9.98)vs.(57.46±10.80),P<0.05];(2)伴焦虑障碍ADHD组行为问题评分[如总分(41.66±28.07)]均大于对照组(P<0.01),而儿童自我意识量表中除躯体情况外,其他评分均小于对照组(Ps<0.05);(3)伴焦虑障碍ADHD组行为问题评分均大于单纯ADHD组(P<0.05),而儿童自我意识量表中的行为分、焦虑分、合群分及总分均小于单纯ADHD组[(10.44±3.17)vs.(11.55±2.80),(8.06±2.61)vs.(9.21±2.61),(7.42±2.22)vs.(8.16±1.89),(47.25±9.93)vs.(50.85±9.98);均P<0.05]。结论:ADHD儿童与正常儿童相比其行为问题多,自我意识差,而伴焦虑障碍ADHD儿童比单纯ADHD儿童的行为问题更突出,自我意识更差。

Objective： To explore the characteristics of behavioral problems and self-concept level in children with attention deficit hyperactivity disorder （ADHD ） accompanying anxiety disorder. Methods： With stratified random sampling method, a sampling survey was made in 9495 children（ aged 5 -17 years） from 6 regions of Hunan province together. Using the two stage epidemiologic research method, three groups, including control group （214 cases） , pure ADHD （219 cases） and ADHD accompanying anxiety disorder （ 111 cases） were determined as the subjects. All the subjects completed the Children＇s Self-Concept Scale （ CSCS ）, and the Achenbach Child Behavior Checklist （CBCL） was completed by their parents. Results： （ 1 ） Compared to the control group, the pure ADHD group scored higher in CBCL [e. g. , the total score： （30. 35 ±24. 32） vs. （ 16.97 ± 14. 86） ], and scored lower in CSCS [ e. g. , total score： （50. 85 ±9. 98 ） vs. （57. 46± 10. 80 ）, P 〈 0. 05 ] . （2） Compared to the control group, children with ADHD accompanying anxiety disorder scored higher in CBCL [ e. g. , total score ： （41.66 ± 28.07 ）, P 〈 0. 01 ], and in CSCS except physical activities （ Ps 〈 0. 05 ） . （ 3 ） Compared to the pure ADHD group, ADHD accompanying anxiety disorder group scored higher in CBCL and lower in CSCS [behavior： （10.44±3.17） vs. （11.55±2.80）; anxiety： （8.06±2.61） vs. （9.21±2.61）, gregariousness： （7.42±2.22） vs. （8.16±1.89）; total score ： （47.25±9.93） vs. （50.85±9.98）; Ps〈0.05] .Conclusion： ADHD children have more behavioral problems and lower level of self-concept than normal children, and children with ADHD accompanying anxiety disorder have more prominent presence of behavioral problems and lower self-concept rating than children with pure ADHD.