对立违抗障碍患儿家庭社会经济状态与心理特征关系的研究

Study on socioeconomic status and psychological characteristics of children with oppositional defiant disorder

目的探讨对立违抗障碍(ODD)患儿的家庭社会经济状态和心理特征,为揭示ODD的发病机制提供依据。方法对2016年8月至2017年1月在郑州市第八人民医院首次就诊的44例8~14岁ODD患儿(ODD组)及按年级随机抽取郑州市某小学的50名健康儿童(健康对照组)进行一般情况调查表和Achenbach儿童行为评定量表(CBCL)评估,采用χ2检验、独立样本t检验进行数据分析。结果ODD组患儿父亲文化程度、母亲文化程度、家庭人均收入均显著低于健康对照组,学习成绩差于健康对照组,差异均有统计学意义(均P=0.000)。ODD患儿CBCL量表的分裂样[(2.32±2.73)分]、抑郁[(4.48±6.12)分]、交往不良[(3.09±3.34)分]、强迫性[(4.05±5.60)分]、社交退缩[(2.39±3.20)分]、多动[(4.95±4.37)分]、攻击性[(7.59±7.62)分]、违纪[(2.91±3.85)分]得分均高于健康对照组[(1.04±1.37)分、(1.48±2.06)分、(0.68±1.13)分、(0.78±1.46)分、(0.60±1.16)分、(1.70±1.98)分、(2.48±3.28)分、(0.62±1.58)分],差异均有统计学意义(均P<0.05)。ODD组男童交往不良[(2.85±3.33)分]、强迫性[(3.96±5.11)分]、社交退缩[(2.63±3.16)分]、多动[(5.44±4.50)分]因子得分均高于健康对照组男童[(0.80±1.05)分、(1.30±1.92)分、(0.95±1.50)分、(2.15±1.56)分],差异均有统计学意义(均P<0.05);ODD组女童的分裂样[(2.24±2.64)分、抑郁[(4.65±4.93)分]、交往不良[(3.47±3.37)分]、强迫性[(4.18±6.38)分]、体诉[(2.12±3.65)分]、社交退缩[(2.00±3.26)分]、多动[(4.18±4.12)分]、攻击性[(8.24±7.26)分]、违纪[(3.76±4.85)分]因子得分均高于健康对照组女童[(0.83±1.22)分、(1.10±1.84)分、(0.60±1.18)分、(0.43±0.92)分、(0.53±1.09)分、(0.37±0.80)分、(1.40±2.17)分、(1.87±2.14)分、(0.30±0.78)分],差异均有统计学意义(均P<0.05);男女童ODD的CBCL得分差异均无统计学意义(均P>0.05)。结论ODD患儿的家庭社会经济状态低,有明显的情绪和行为问题;性别不同,心理特征有所不同。

Objective To explore the socioeconomic status and psychological characteristics of the children with oppositional defiant disorder(ODD), and to provide evidence for revealing the pathogenesis of ODD. Methods General Conditions Questionnaire and Achenbach Children′s Behavior Checklist Scale (CBCL) were used to evaluate 44 cases of ODD children aged 8 to 14 years old who were first referred to the Eighth People′s Hospital of Zhengzhou City from August 2016 to January 2017, and 50 healthy children were randomly selected according to their grades from a primary school in Zhengzhou.Chi-square test and independent sample t test were used to analyze data. Results The father′s and mother′s education levels and family per capita income in ODD group were lower than those in healthy control group, and their academic achievements in ODD group were worse than those in healthy control group, and the diffe-rences were statistically significant(all P=0.000). The scores of schizoid (2.32±2.73), depression(4.48±6.12), social problems(3.09±3.34), compulsion(4.05±5.60), social withdrawal(2.39±3.20), hyperactivity(4.95±4.37), aggressive behavior(7.59±7.62) and rule-breaking(2.91±3.85) in ODD children were higher than those of the healthy control group(1.04±1.37, 1.48±2.06, 0.68±1.13, 0.78±1.46, 0.60±1.16, 1.70±1.98, 2.48±3.28, 0.62±1.58), and the differences were statistically significant(all P<0.05). The scores of social problems(2.85±3.33), compulsion(3.96±5.11), social withdrawal(2.63±3.16), hyperactivity(5.44±4.50) in male ODD children were higher than those in the male healthy children(0.80±1.05, 1.30±1.92, 0.95±1.50, 2.15±1.56), and the differences were statistically significant(all P<0.05). Compared with the female children(0.83±1.22, 1.10±1.84, 0.60±1.18, 0.43±0.92, 0.53±1.09, 0.37±0.80, 1.40±2.17, 1.87±2.14, 0.30±0.78), the scores of schizoid(2.24±2.64), depression(4.65±4.93), social problems(3.47±3.37), compulsion(4.18±6.38), somatic complaints(2.12±3.65), social withdrawal (2.00±3.26), hyperactivity(4.18±4.12), aggressive behavior (8.24±7.26) and rule-breaking(3.76±4.85) in female ODD children were significantly higher, and the differences were statistically significant(all P<0.05). There was no significant gender difference in the score of CBCL scale in ODD group(all P>0.05). Conclusions There are significant emotional and behavioral problems in ODD children whose family socioeconomic status is lower, and their psychological characteristics vary with gender differences.