伴过敏性疾病ADHD儿童自我意识与家庭环境分析

Self-concept and family environment of ADHD children with allergic diseases

目的：探讨注意缺陷多动障碍（ ADHD）儿童伴与不伴哮喘等过敏性疾病的家庭环境与自我意识特点，为治疗方法提供依据。方法对在广州医学院荔湾医院心理科就诊的8～12岁ADHD儿童144例及广州市一间小学8～12岁的正常儿童126例进行调查，儿童填写自我意识量表，家长填写哮喘和过敏性疾病调查表和家庭环境量表，3组均数比较用协方差分析，均数两两比较采用LSD检验。结果单纯ADHD组在量表总分方面明显低于对照组（ F＝12．238，P＜0．05），主要表现在行为、智力与学校、躯体外貌与属性、焦虑、合群、幸福与满足分因子方面；ADHD合并过敏性疾病组在量表总分上与对照组无差异（ F＝12．238， P＜0．05），行为得分显著性高于ADHD组（F＝12．851，P＜0．05），但焦虑量表分显著低于正常组和ADHD组（F＝3．857，P＜0．05）。 ADHD在亲密度、组织性方面显著性低于正常组，家庭矛盾性高于正常组（ F值分别为2．876、2．721和3．78，均 P＜0．05）。 ADHD合并过敏性疾病组矛盾性量表分低于ADHD组（F＝3．78，P＜0．05），娱乐性量表分高于ADHD组（F＝2．204，P＜0．05），而控制性高于对照组（F＝2．295，P＜0．05）。结论 ADHD患儿的自我意识明显比正常儿童差，伴过敏性疾病的ADHD患儿的行为自我评价优于ADHD患儿，但更焦虑。加强家长健康教育，改善家庭环境有助于提高ADHD患儿的自我意识水平。

Objective To explore the characteristics of the family environment and self-concept of attention deficit hyperactivity disorder （ ADHD） children with or without allergic diseases, so as to provide evidence for treatment.Methods Investigation was conducted among 144 ADHD children visiting psychology department of Liwan Hospital of Guangzhou Medical University and 126 healthy children （ control group） in a primary school in Guangzhou.They were 8-12 years old.Piers-Harris children’ s self-concept scale （ P-HCSS） was filled by children, and the questionnaire survey of International Study of Asthma and Allergies in Childhood（ ISAAC） and family environment scale-Chinese version （ FES-CV） was finished by their parents.Covariance analysis was used for comparison among three groups, and LSD testing for comparison between groups.Results The total scores of PHCSS of ADHD group were significantly lower than those of the control group （F=12.238, P 〈0.05）, and the minor factors included behavior, intelligence and school, body shape and characteristics, anxiety, grouping, happiness and satisfaction.The total scores of PHCSS of the ADHD group with allergic diseases were not significantly different from those of the control group （F=12.238,P〈0.05）, but the score of behavior was significantly higher than that of the ADHD group （F=12.851,P〈0.05） and the score of anxiety was significantly lower than that of the control group and that of the ADHD group （F=3.857,P〈0.05）.In the ADHD group the scores of intimacy and organization were obviously lower than the control group, and the score of family conflict was higher （F value was 2.876, 2.721 and 3.78, respectively, all P〈0.05）.Compared with the ADHD group, the score of conflict was lower and that of amusement was higher in the ADHD group with allergic disease （F value was 3.78 and 2.204, respectively, both P〈0.05）.However, the score of control of the ADHD group with allergic diseases was higher than the control group （F=2.295, P〈0.05）.Conclusion The self-concept of ADHD children is significantly poorer than that of the normal children.The ADHD children with allergic diseases have higher self-evaluation on behavior than ADHD children, but they are more anxious.Enhancing family education and improving family environment can improve the self-concept of ADHD children.