学龄前儿童强迫症状与家庭养育环境关系的研究

Study on the correlation between family nurture environment and obsessive-compulsive symptoms of preschool children

目的研究学龄前儿童强迫症状的发生情况以及与家庭养育环境的关系,为早期发现及早期干预学龄前儿童强迫障碍提供科学依据。方法 2017年10-11月采用分层、整群抽样方法,选取太原市城区3所具有代表性的幼儿园共969例3～6岁儿童为研究对象。应用儿童基本情况调查表、家庭养育环境量表、Spence学前儿童焦虑量表、焦虑自测量表进行研究。数据处理采用t检验、χ~2检验、Logistic多元回归分析。结果强迫症状阳性检出60例(6.2%);其中男性32例(6.3%),女性28例(6.0%);小班19例(5.8%),中班29例(7.2%),大班12例(5.0%)。将阳性检出的60例作为强迫症状组,无任何焦虑的180例作为对照组。两组性别间比较(χ~2=0.200,P=0.655)和班级间比较(χ~2=2.065,P=0.356)差异均无统计学意义。在家庭养育环境量表中,两组在语言/认知、情感温暖/自我表达、社会适应/自我管理、忽视/干涉/惩罚、活动多样性/游戏参与和环境气氛6个因子差异均有统计学意义(P<0.05)。母亲学历(χ~2=14.356,P<0.01)和母亲焦虑得分(t=3.426,P<0.01)在两组间差异有统计学意义。多元Logistic回归分析中,忽视/干涉/惩罚(环境中等OR=0.241,95%CI为0.088～0.659)、母亲焦虑得分(OR=1.059,95%CI为1.009～1.111)以及母亲学历(中学OR=3.886,95%CI为1.554～9.716,大专及以上OR=2.695,95%CI为1.301～5.581)3个自变量与强迫症状发生有关。结论强迫症状在学龄前儿童较常见,强迫症状的发生与家庭养育方式、母亲情绪及母亲文化程度有关。对父母进行心理养育咨询可以早期干预学龄前儿童强迫障碍。

Objective To know about the prevalence of obsessive-compulsive symptoms in preschool children and its relationship with family rearing environment,in order to provide scientific basis for early intervention of obsessive-compulsive disorder. Methods Totally 969 children aged 3 to 6 years were selected in 3 representative kindergartens in Taiyuan city by stratification and cluster sampling from October to November 2017.Children′s general data questionnaire,the Family Rearing Environment Scale,Spence Preschool Anxiety Scale and Self-rating Anxiety Scale were used as investigation tools.The data were analyzed by means of t-test,χ^2 test and Logistic multiple regression analysis. Results Among 969 children,60 cases(6.2%) were positive for obsessive-compulsive symptoms,including 32 cases(6.3%) of males and 28(6.0%)of females,19 cases(5.8%) in the small classes,29(7.2%) in the middle classes and 12(5.0%) in the large classes.And 60 positive cases were defined as the obsessive-compulsive symptoms group,and 180 cases without anxiety were as control group.There was no significant differences on genders(χ^2=0.200,P =0.655) and grades(χ^2=2.065,P=0.356) between obsessive-compulsive symptoms group and control group.In the Family Nurture Environment Scale,there were significant differences on the subscales of language/cognitive,emotional warmth/self-expression,social adaptation/self-management,ignore/interference/punishment,participating in activity diversity/game and environment/atmosphere between obsessive-compulsive symptoms group and control group(P<0.05).Also,mother′s educational background and mother′s anxiety score were significantly different between the two groups(χ^2=14.356,t=3.426,P<0.01).Logistic regression analysis indicated that the neglect/intervention/punishment(medium enviroment OR=0.241,95%CI:0.088-0.659),mother′s anxiety score(OR=1.059,95%CI:1.009-1.111) and mother′s education level(high school OR=3.886,95%CI:1.554-9.716;college or above OR=2.695,95%CI:1.301-5.581) were associated with obsessive-compulsive symptoms of preschool children. Conclusions Obsessive-compulsive symptoms are common in preschool children,and are related to family rearing style,maternal mood and maternal education level.Psychological counseling of parents is essential to early interfere with obsessive-compulsive symptoms of preschool children.