ODD儿童的亲子关系、师生关系及同伴关系特点

Parent-child Relationship, Teacher-child Relationship and Peer Relationship in Children with Oppositional Defiant Disorder

目的:探讨单纯对立违抗障碍(Oppositional Defiant Disorder,ODD)儿童、ODD伴ADHD儿童、ODD伴ADHD及CD儿童的亲子关系、师生关系及同伴关系的特点。方法:选取符合DSM-IV中ODD诊断标准的儿童260名(含单纯ODD 70名,ODD+ADHD 134名,ODD+ADHD+CD 54名)及正常对照组儿童269名;家长填写亲子关系问卷,教师填写师生关系问卷,儿童填写孤独感问卷。结果:①与对照组相比,ODD组的师生亲密度较低,亲子和师生冲突较高,同伴关系较差(均P<0.01);②ODD内部3组相比,单纯ODD组在亲子冲突、师生冲突、同伴关系上显著低于ODD+ADHD和ODD+ADHD+CD,在亲子亲密性上显著高于ODD+ADHD+CD,在师生亲密上显著高于ODD+ADHD和ODD+ADHD+CD组(P<0.01或P<0.05);ODD+ADHD组在师生冲突上低于ODD+ADHD+CD组(P<0.05)。结论:ODD儿童比正常儿童的师生亲密度低,亲子和师生冲突高,同伴关系差;ODD儿童中,单纯的ODD儿童亲子、师生、同伴关系要好于其他两个组,共患ADHD会恶化亲子冲突、师生亲密度和冲突、同伴关系;共患ADHD+CD会加剧师生冲突。

Objective To compare the difference of parent-child relationship, teacher-child relationship and peer rela-tionship between oppositianal defiant disorder（ODD） children and normal control children Methods： 260 children who metthe DSM-IV diagnosis of ODD（70 patients with pure ODD, 134 patients with ODD＋ADHD and 54 patients with ODD＋AD-HD＋CD） and 269 normal controls participated in this study. Parent-child Relationship Scale, Student-Teacher Relation-ships Scale, and Children＇s Loneliness Scale were assessed by parents, teachers and children respectively. Results： ①Compared with control group, ODD group scored significantly lower in teacher--child closeness, but higher in parent-childconflict, teacher-child conflict and loneliness（all P〈0.01）; ②Compared with ODD＋ADHD group and ODD＋ADHD＋CDgroup, pure ODD group scored significantly lower in parent-child conflict, teacher--child conflict loneliness,but significant-ly higher in parent-child closeness, teacher-child closeness（P〈0.01 or P〈0.05）; Compared with ODD＋CD＋ADHD group,ODD＋ADHD group scored significant lower in teacher-child conflict（P〈0.05）. Conclusion： The ODD children had moreconflict with parent, less closeness and more conflict with teachers, more feelings of loneliness compared with normal chil-dren; Furthermore, relative to pure ODD children, ODD children with ADHD comorbidity may have more parent-child andteacher-child conflict and peer-relationship problems, and reduced teacher-child closeness, while the ODD children co-morbided with ADHD and CD also have more teacher-child conflict and reduced parent-child closeness.