伴有品行问题注意缺陷多动障碍儿童家庭环境与家长压力的关系

Relationship between family environment and parental stress in children with attention-deficit/hyperactivity disorder accompanied by behavior problems

目的:探讨伴有品行问题的注意缺陷多动障碍(ADHD)儿童的家庭环境与父母压力的关系。方法:根据DSM-5诊断标准纳入175例ADHD儿童,采用Conners儿童行为问卷评估品行问题,根据Conners行为量表品行因子是否超过该年龄组正常范围定义为ADHD伴品行问题(n=124)或不伴品行问题(n=51)。采用家庭环境量表中文版(FES-CV)、家长压力问卷(PSQ)评估家庭环境及家长压力。结果:ADHD伴品行问题儿童的家庭环境量表中文版中的亲密度、情感表达、娱乐性、组织性、知识性得分低于ADHD不伴品行问题儿童(P <0. 05)。Logistic回归分析显示FES-CV的娱乐性得分与ADHD儿童发生品行问题呈负向关联(OR=0. 89,95%CI:0. 80~1. 00)。ADHD伴品行问题儿童的父母PSQ得分高于ADHD不伴品行问题儿童的父母[(77. 6±23. 5) vs.(56. 6±13. 5),P <0. 05]。结论:伴有品行问题的注意缺陷多动障碍儿童的家庭环境常存在功能缺陷,家庭环境中的娱乐性可能是注意缺陷多动障碍儿童发生品行问题的保护因素,伴有品行问题的注意缺陷多动障碍儿童父母常可能有更大客观压力。

Objective: To explore the relationship between family environment and parental stress in children with attention-deficit/ hyperactivity disorder (ADHD) accompanied by behavior problems. Methods: According to the Diagnostic and Statistical Manual of Mental Disorder,Fifth Edition (DSM -5) diagnostic criteria,175 children with ADHD were included in this study. The Conners child behavior questionnaire was used to assess behavior problems. According to w hether the behavioral factors of Conners Behavior Scale exceed the normal range of the same age group,ADHD accompanying behavioral problems (n = 124) or non-accompanying behavioral problems (n = 51) are defined. Chinese version of Family Environment Scale (FES-CV) and parent stress questionnaire (PSQ) were used to assess family environment and parental stress. Results: The scores of intimacy,emotional expression,entertainment, organization and knowledge in the Chinese version of the family environment scale for ADHD children with behavior problems were lower than those of ADHD children without behavior problems ( P < 0. 05). Logistic regression analysis showed that FES-CV's entertainment score was negatively correlated with ADHD children' s behavioral problems[P = 0. 046,OR = 0. 89,95% CI: 0.80 ~ 1.00]. Parents of ADHD children with behavioral problems got higher PSQ scores than those whose children without behavioral problems [( 77. 6 ± 23. 5) vs.( 56. 6 ± 13. 5);P = 0. 012]. Conclusion: The family environment of ADHD children with behavior problems often has functional defects. The entertainment in family environment may be a protective factor for ADHD children with behavioral problems,and parents of ADHD children with behavioral problems often have more objective pressure.