儿童注意缺陷多动障碍行为问题与自我意识的相关分析

Relationships between self-concept and behavior in children with ADHD

目的探讨不同样本来源的注意缺陷多动障碍（ADHD）儿童的行为特点和自我意识水平及两者间的关系。方法2013年9月～2014年4月在汕头市中心市区进行学龄期ADHD流行病学调查，严格按照美国精神障碍诊断与统计手册第4版（DSM-Ⅳ）诊断标准筛查出来的126例ADHD作为学校组，按照年龄和性别相匹配，在调查学校中随机抽取126例学生作为对照组；临床组为同期到精神科门诊首诊的ADHD儿童50例，年龄8～12岁。儿童及其家长分别完成自我意识量表（PHCSS）和行为量表（CBCL）。结果ADHD组PHCSS的总分和行为、焦虑、合群、幸福与满足感的分值均明显低于对照组（P〈0．01），且临床组显著低于学校组（P〈0．01）；CBCL社会功能分值呈现对照组〉学校组〉临床组（P〈0．01），而行为总分分值呈现对照组〈学校组〈临床组（P〈0．01）；PHCSS与CBCL的社交能力呈正相关，而与行为总分呈负相关（P〈0．05）。结论ADHD儿童自我意识水平低于正常儿童，其中临床组更为明显。ADHD儿童的行为问题与自我意识水平密切相关。

Objective The aim of this study was to examine the relationship between behavior problems and self- concept in children with ADHD came from different populations. Methods The school sample, 126 ADHD children,were screened from the public primary schools in the urban area of Shantou from September 2013 to April 2014, with psy- chiatrists to make a definite diagnosis on the basis of Diagnostic and Statistical Manual of Mental Disorders （DSM- 1V ）. The control group consisted of 126 students matched in gender and age and chosen following the same schools were random choosen into the group. 50 children in the clinical group came from outpatient clinic. All children completed the Piers-Harris Self-Concept Scale （ PHCSS ） and the parents were asked to complete Child Behavior Checklist（CBCL）. Results The children with ADHD had lower scores on the behavior,anxiety,intimate relationship,happiness and the to- tal score in the PHCSS （P〈 0.01 ） . Moreover, the scores in the clinical group had significant lower than the children of the school sample （P〈O.01） . The scores of social function in CBCL were also significant lower than the school sample （P 〈 0.01 ） . The results of behavioral scores showed that the highest scores in the clinical group, while there were least score in the control group （P〈 0.01 ） . In ADHD children, the level of self-concept correlated positively with the social acceptability,while correlated negatively with the behavior problems （P〈0.05） . Conclusion There were lower self- concept in the children with ADHD than the normal children,especially in the clinical group. Further research has found that the levels of children＇ s self-concept were correlated with CBCL scale.