学龄前注意缺陷多动障碍儿童主要照养父母的执行功能

Executive function of primary caregivers in preschool children with attention-deficit hyperactivity disorder

目的探讨学龄前注意缺陷多动障碍(attention-deficit hyperactivity disorder,ADHD)儿童及其主要照养父母的ADHD症状和执行功能特点,并分析儿童执行功能与父母执行功能之间的相关性。方法研究对象为225例符合《美国精神障碍诊断与统计手册(第5版)》(Diagnostic and Statistical Manual of Mental Disorders,fifth edition,DSM-5)诊断标准的学龄前ADHD儿童,另选115例同年龄正常对照儿童。两组儿童主要照养父母均分别填写成人ADHD症状自评量表(adult ADHD self-rating scale,ASRS)、中文版学龄前儿童执行功能行为评定量表(父母版)(behavior rating inventory of executive function-preschool version,BRIEF-P)及执行功能行为评定量表(成人版)(behavior rating inventory of executive function-adult version,BRIEF-A),然后分别对儿童的执行功能和父母的执行功能进行组间比较,并且对ADHD组儿童与父母之间的执行功能进行相关性分析。结果 (1)ADHD组与正常组儿童主要照养父母在注意缺陷和多动/冲动症状得分及总分差异均无统计学意义(均P>0. 05),但两组间父母的注意缺陷阳性条目数和症状总阳性条目数差异有统计学意义(均P <0. 05)。(2) ADHD组与正常组儿童执行功能比较各因子得分及总分差异有统计学意义(均P <0. 05),ADHD组儿童父母BRIEF-A中的情感控制、组织条理、行为管理指数因子得分及总分与正常组儿童父母比较差异有统计学意义(均P <0. 05)。(3) ADHD组儿童的执行功能与其主要照养父母的BRIEF-A情感控制、组织条理、行为管理指数因子分及总分呈低至中度正相关(r=0. 20～0. 45,P <0. 01),多重线性回归分析结果显示:ADHD儿童主要照养父母的执行功能总分对儿童的执行功能总分的影响达20. 1%。结论学龄前ADHD儿童主要照养父母的执行功能低于正常对照儿童父母,ADHD儿童的执行功能与其父母的执行功能存在正相关关系,父母可能通过遗传和环境因素影响其子女。

Objective To explore the symptoms and executive function of preschool children with attention-deficit hyperactivity disorder (ADHD) and their primary caregivers, and to analyze the correlation between children s and parents executive function. Methods Research subjects were 225 ADHD preschool children diagnosed by Diagnostic and Statistical Manual of Mental Disorders,fifth edition(DSM-5) and 115 normal preschool children. The executive functions of preschool children with ADHD and their primary caregivers were evaluated using behavior rating scale of executive function-preschool version (BRIEF-P), adult ADHD self-rating scale(ASRS), and behavior rating inventory of executive function-adult version (BRIEF-A). The results of the two groups were compared. Results ① The differences of symptom scores between the parents of children in ADHD group and normal group had no statistical significance ( P >0.05), but the numbers of items of inattention and sum had statistical significance( P <0.05).② The scores of the children s ecological executive function in the ADHD group were significantly higher than those in the control group ( P <0.05), and the scores of emotional control, organization orderliness, behavior management index factor and total scores in parents of children with ADHD were statistically significant compared with those of parents in the control group ( P <0.05).③ BRIEF-P scores of children in the ADHD group were low to moderate positive correlated with their parents BRIEF-A scores ( r =0.189 - 0.453, P <0.01). The results of multiple linear regression analysis showed that the total scores of executive function of primary caregivers of ADHD children affected the total scores of executive function of children by 20.1%. Conclusion Executive function of some parents of preschool children with ADHD is impaired. Executive function of children with ADHD and their parents executive function have certain relevance. Parents may affect their children through genetic or environmental factors.