儿童注意缺陷多动障碍症状伴焦虑症状发生的调节中介因素研究

Moderated mediation analysis for symptoms of attention deficit/hyperactivity disorder with the symptoms of anxiety in children

目的探讨儿童注意缺陷多动障碍(ADHD)症状伴焦虑症状发生的调节中介因素。方法共纳入12?271名小学生,年龄8.9±1.9岁,其中男生6?743名,女生5?508名,性别缺失20名。采用心理创伤问卷(父母版)和Conners父母用量表收集学生相关资料,问卷由学生父母填写。采用单因素分析、多因素分析和调节中介分析法处理数据。结果单因素分析结果显示,总样本及男性和女性儿童的多动指数因子和儿童期创伤分别与焦虑因子呈正相关(P<0.01),ADHD和儿童期创伤正向预测焦虑障碍(P<0.001)。多因素分析结果显示,总样本、男性和女性儿童的多动指数因子(ADHD症状)和儿童期创伤正向预测焦虑因子得分(P<0.001),ADHD和儿童期创伤正向预测焦虑障碍(P<0.001)。调节中介分析结果显示,男性和女性的儿童期创伤是多动指数因子与焦虑因子间的中介因素(P<0.05),性别在多动指数因子与焦虑因子之间起调节作用(P<0.001)。结论ADHD症状/ADHD与焦虑症状/焦虑障碍关系密切。儿童期创伤在ADHD症状与焦虑症状间起中介作用,性别在ADHD症状与焦虑症状间起调节作用。

Objective To study the moderated mediation for attention deficit/hyperactivity disorder(ADHD)with the symptoms of anxiety in children.Methods A total of 12?271 students were included with an average age of 8.9±1.9 years,including 6?743 male students and 5?508 female students,and 20 students with missing data on gender.Child psychological trauma questionnaires(parents version)and Conners questionnaires(parent version)were completed by the parents of primary school students.The data was studied by univariate analysis,multivariate analysis and moderated mediation analysis.Results The results of the univariate analysis showed that in all subjects,boys,and girls,the scores of hyperactivity index and childhood trauma were positively correlated with the score of anxiety(P<0.01),and ADHD and childhood trauma positively predicted anxiety disorder(P<0.001).The results of the multivariate analysis showed that in all subjects,boys,and girls,the scores of hyperactivity index(ADHD symptoms)and childhood trauma positively predicted the score of anxiety(P<0.001),and both ADHD and childhood trauma positively predicted anxiety disorder(P<0.001).The results of the moderated mediation analysis showed that childhood trauma was a mediating factor for the relationship between hyperactivity index and anxiety index in boys and girls(P<0.05),and sex moderated the relationship between hyperactivity index and anxiety index(P<0.001).Conclusions ADHD symptoms/ADHD are closely associated with anxiety symptoms/anxiety disorder.Childhood trauma exerts a mediating effect on the relationship between ADHD symptoms and anxiety symptoms,and sex moderates the relationship between ADHD symptoms and anxiety symptoms.