注意缺陷多动障碍患儿父母冲突、依恋安全性与患儿社交焦虑的关系

Relationships among interparental conflict,security and social anxiety in children with attention deficit hyperactivity disorder

目的:探讨注意缺陷多动障碍(ADHD)患儿父母冲突、依恋安全性与患儿社交焦虑的关系。方法:采取整群抽样的方法,以上海市普陀区2所普通小学1 405名儿童为调查对象,对经斯诺佩评估量表(SNAP-IV)筛查为阳性的儿童由精神科医师问诊,按《美国精神障碍诊断与统计手册》第4版为标准确诊的103例ADHD患儿(ADHD组)及性别、年龄等相匹配的103名正常儿童(对照组)采用依恋安全性量表(KSS)、儿童知觉父母冲突量表(CPIC)和儿童社交焦虑量表(SASC)调查、比较和分析。结果:ADHD组SASC总分及其中害怕否定评价因子分明显高于对照组(P均<0.01);CPIC中冲突强度、冲突频率、冲突解决、自我归因、冲突内容维度评分明显高于对照组(P<0.05或P<0.01);父子KSS评分、母子KSS评分明显低于对照组(P均<0.01);ADHD组CPIC中父母冲突频率、冲突强度、冲突解决、威胁、应对效能因子分与SASC分呈正相关(P<0.05或P<0.01),父子KSS评分、母子KSS评分与SASC分负相关(P均<0.01);多元线性回归分析显示CPIC中威胁因子和父亲KSS评分与患儿SASC评分相关(P均<0.01)。结论:父母冲突及亲子依恋可能是ADHD患儿社交焦虑的影响因素。

Objective: To explore the correlation of interparental conflict and security with social anxiety in children with attention deficit hyperactivity disorder (ADHD). Method: A cluster sampling method was used to study all the children from two primary schools in the Shanghai Putuo district.After screening by SNAP-IV,positive children were consulted by psychiatrists and 103 children with ADHD were diagnosed according to the 4th edition of American Manual of Diagnosis and Statistics of Mental Diseases.The survey was made in 103 ADHD children(ADHD group) and 103 normal children matched by sex and age(control group) by kerns security scale(KSS),children's perception of interparental conflict scale( CPIC ) and social anxiety scale for children(SASC).The relationships between interparental conflict,security and social anxiety in children with ADHD were analyzed. Results: Compared with the control group,the scores of fear of negative evaluation dimensions and SASC were statistically higher in ADHD group( P <0.01).The CPIC scores of frequency,strength,solution,self-blame and content in ADHD group were statistically higher than those in control group( P <0.01).The KSS scores of father-child and mother-child in ADHD group were statistically lower than those in control group( P <0.01).The CPIC scores of frequency,strength,solution,threats and coping efficacy in ADHD group were positively correlated with the scores of SASC( P <0.05 or P <0.01 ).The KSS scores of mother-child and father-child in ADHD group were negatively correlated with the total scores of SASC( P < 0.01 ).Multiple linear regression analysis showed that CPIC threats and father-child attachment security were correlated with the total scores of SASC( P <0.01). Conclusion: Parental conflict and security may be the influencing factors of social anxiety in children with attention deficit hyperactivity disorder.