抽动障碍患儿焦虑情绪特点及影响因素

Anxiety traits and influencing factors of children with tic disorders

目的探讨抽动障碍患儿的焦虑性情绪障碍特点及其影响因素。方法对31名抽动障碍患儿与32名正常儿童进行焦虑性情绪障碍筛查表、艾森克人格问卷（儿童版）、儿童依恋量表、父母教养方式问卷评估，用独立样本t检验比较两组儿童的焦虑性情绪障碍的差异，用Pearson相关与多元线性逐步回归分析儿童个性特点、亲子依恋关系及父母教育方式对焦虑情绪的影响。结果抽动障碍组患儿在躯体化／惊恐、分离性焦虑[分别为（6．20±5．33）分，（4．87±3．18）分]两个维度上均显著高于对照组[分别为（3．75±3．34）分，（3．06±2．61）分]，差异有统计学意义（P〈0．05）。抽动障碍患儿的躯体化／惊恐与儿童内外向、儿童精神质性格特点、母亲过分干涉、母亲拒绝否认、母亲严厉惩罚呈正相关（r分别为0．580，0．427，0．399，0．674，0．575，P〈0．05或P〈0．01），与母亲亲近度呈负相关（r=-0．365，P〈0．05）；广泛性焦虑与儿童内外向、精神质、掩饰性性格特点、母亲过分干涉、母亲拒绝否认、母亲严厉惩罚呈正相关（r分别为0．604，0．543，0．526，0．365，0．613，0．395，P〈0．05或P〈0．01）；分离性焦虑与儿童内外向、掩饰性性格特点、母亲拒绝否认呈正相关（r分别为0．440，0．401，0．365，P〈0．05）；社交恐怖与母亲过分干涉、母亲拒绝否认呈正相关（r分别为0．367，0．482，P〈0．05或P〈0．01）；学校恐怖与儿童内外向、儿童神经质、儿童精神质性格特点、母亲过分干涉、母亲拒绝否认、母亲严厉惩罚呈正相关（r分别为0．635，0．449，0．526，0．463，0．541，0．589，P〈0．05或P〈0．01），与母亲亲近度呈负相关（r=-0．394，P〈0．05）。躯体似惊恐、社交恐怖受母亲拒绝否认因子影响，其对方差的解释度分别为45．4％、23．2％；广泛性焦虑受母亲拒绝否认、儿童掩饰性因子的影响，对方差解释度为51．0％；分离件焦虑受儿童内外向因子的影响，其方差解释度为19．3％；学校恐怖受儿童内外向、母亲惩罚严厉因子的影响，方差解释度为50．0％，总体焦虑仍受母亲拒绝否认、儿童内外向因子的影响，方差解释度为49．4％。结论抽动障碍患儿的躯体化／惊恐与分离性焦虑水平高于正常儿童；焦虑性情绪障碍主要受母亲鼓励与宽容少、儿童外向性格的影响。

Objective To investigate the traits of anxiety characteristics and its influencing factors in children with tic disorders （TD）. Methods 31 children with tic disorders and 32 normal children were assessed by the screen for child anxiety related emotional disorders （SCARED）, eysenck personality ques- tionnaire （EPQ） for child, attachment security scale and egma minnen av bardndosnauppforstran （EMBU）. In- dependent sample t-test was used to compare the differences in anxiety disorders between the children of the two groups, and Pearson correlation and multivariate linear step-by-step regression analysis were used to ana- lyze the effects of personality traits,parent-child attachment and parental education on anxiety. Results So- matization/panic and separation anxiety in TD（ （6.20±5.33）, （4.87±3.18）） were higher than those in con- trol group（ （3.75±3.34）, （3.06±2.61） ;both P〈0.05）.There was positive correlation between somatization/ panic and children＇ s personality of introversion-extroversion （ E ）, psychoticism （ P ）, excessive interferencemother, the mother refusal and denial, mother severely punishment （ r= 0.580,0.427,0.399,0.674,0.575, P〈 0.05 or P〈0.01 ）, and negative correlation between somatization/panic and mother closeness（ r=-0.365 ,P〈 0.05） .Generalized anxiety was positively correlated with E, P, lie, excessive interference mother, the mother refusal and denial,mother severely punishment（r=0.604,0.543,0.526,0.365,0.613,0.395,P〈0.05 or P〈 0.01） .Separation anxiety was positively correlated with E, lie, the mother refusal and denial （r= 0.440, 0.401,0.365, P〈0.05）.Social phobia was positively correlated with excessive interference mother,the mother refusal and denial （ r= 0. 367,0.482, P〈 0.05 or P〈 0.01 ）. School phobia was not only positively associated with E, N, P, excessive interference mother, the mother refusal and denial, mother severely punished （ r = 0.635,0.449,0.526,0.463,0.541,0.589, P〈 0.05 or P〈 0.01 ）, but also negatively correlated with mother closeness （r=-0.394, P〈0.05）.The mother refusal and denial affected on somatization/panic and social pho- bia （accounted for 45.4%, 23.2% ） , the mother refusal and denial and lie affected on generalized anxiety （ac- counted for 51.0%）, E affected on separation anxiety（ accounted for 19.3% ） ,E and mother severely punish- ment affected on school phobia（ accounted for 50.0%）, the mother refusal and denial and E affected on total anxiety（ accounted for 49.4%）. Conclusions Somatization/panic and separation anxiety in children with tic disorder is higher than that in normal children.Anxiety disorder is mainly affected by fewer mother＇s encour- agement and tolerance,and children＇s extroversion.