注意缺陷多动障碍不同亚型男性患儿家庭亲密度及适应性与养育方式调查

The family cohesion, adaptability and parental rearing pattern characteristics among boys with different subtypes of attention deficit hyperactivity disorder

目的了解不同亚型注意缺陷多动障碍（ADHD）患儿的家庭亲密度及适应性与养育方式特点。方法对湖南省9495名儿童及其家长采用二阶段流行病学调查方法进行问卷调查，对其中部分符合美国精神障碍诊断与统计手册第4版ADHD诊断标准的患儿采用家庭亲密度及适应性量表（注意缺陷型40例，多动冲动型52例，混合型39例；对照组58例）和父母教养方式评价量表（注意缺陷型48例，多动冲动型42例，混合型56例；对照组6例）进行调查。结果（1）ADHD3个亚型的现实亲密度、亲密满意度、适应满意度评分与对照组的差异均无统计学意义（F检验，P均〉0．05）；理想亲密度、现实适应性和理想适应性各分项与对照组的差异均有统计学意义[事后（Post Hoc）检验，P均〈0．05]，尤以多动冲动型更为明显。（2）ADHD 3个亚型父亲情感温暖评分与对照组的差异均有统计学意义（Post Hoc检验，P均〈0．05）；注意缺陷型父亲惩罚评分与对照组的差异有统计学意义（Post Hoc检验，P=0．011）；ADHD3个亚型母亲惩罚评分与对照组的差异均有统计学意义（Post Hoc检验，P均〈0．05）；注意缺陷型和混合型母亲情感温暖评分与对照组的差异有统计学意义（Post Hoc检验，P均〈0．05）。结论ADHD男性患儿不同亚型在家庭亲密度及适应性和养育方式特点不尽一致，应针对性地进行家庭干预。

Objective To explore family cohesion, adaptability and parental rearing pattern characteristics among boys with different subtypes of attention deficit hyperactivity disorder （ADHD）. Methods A total of 9495 children were sampled out in Hunan Province using the second-phase-interview approach. The children with positive screening were re-interviewed and diagnosed as ADHD according to the DSM-Ⅳ criteria. The 131 boys with different ADHD subtypes and 58 healthy boys matched with age as control group then filled the FACESII-CV . 146 boys with different ADHD subtypes and 61 healthy boys matched with age as control group then filled the EMBU. Results （ 1 ） There were no significant differences in the FACESII-CV fact cohesion, cohesion satisfaction and adaptability satisfaction between boys with 3 different subtypes of ADHD and the controls （ Fisher Test; P 〉 0. 05 ）, but significant differences in ideal cohesion, fact and ideal adaptability, especially between boys with hyperactive/impulsive ADHD type and controls （Post Hoc test;P 〈0. 05）. （2） As to EMBU score, the ADHD boys with 3 subtypes had different ‘ warmth of father＇ and ‘ punishment of mother＇ score to the controls （ Post Hoe test; P 〈 0. 05 ）. There were significant differences in ＇ punishment of father＇ between the boys with inattentive type and controls （ Post Hoe test ;P = 0. 011 ） , and in ‘warmth of mother＇ between the boys inattentive type with the combined type and the controls（ Post Hoe test;P 〈 0. 05 ）. Conclusion The ADHD boys with different subtypes may have incongruent characteristics in family cohesion, adaptability and parental rearing pattern.