注意缺陷多动障碍伴焦虑障碍患儿家庭环境因素对照研究  

A case-control study on family environment related factors in attention deficit hyperactivity disorder with anxiety disorder

作　　者：张跃兵[1] 罗学荣[1] 刘霞[2] 韦臻[1] 管冰清[3] 袁秀洪[3] 叶海森[1] 宁志军 杨伟 丁军[1] 邓云龙[3] 

机构地区：[1]中南大学湘雅二医院精神卫生研究所,湖南长沙410011 [2]济宁医学院公共卫生学院 [3]中南大学湘雅三医院心理科 [4]湖南省永州芝山精神病医院精神科 [5]湖南省娄底康复医院精神科

出　　处：《中华流行病学杂志》2009年第2期119-122,共4页Chinese Journal of Epidemiology

基　　金：基金项目：美国中华医学基金会资助项目（Small Grants Program#02-777）

摘　　要：目的探讨注意缺陷多动障碍（ADHD）伴或不伴焦虑障碍儿童家庭养育方式及相关因素。方法采用二阶段流行病学调查方法对湖南省9495名儿童及其家长进行问卷调查，对符合DSM-Ⅳ诊断标准的ADHD儿童和正常儿童采用父母教养方式评价量表及家庭亲密度和适应性量表做进一步调查。结果伴或不伴焦虑障碍的ADHD与正常儿童比较，主要在家庭实际亲密度、父母的惩罚、父母的拒绝、母亲的过干涉过保护和父亲的过度保护方面差异有统计学意义（P〈0.05）。ADHD伴焦虑障碍与单纯ADHD比较，父母的惩罚、父母的拒绝、父亲的过度保护、父亲的过度干涉、母亲的过干涉过保护方面差异有统计学意义（P〈0.05）；母亲拒绝是单纯ADHD儿童的影响因素，其OR值为1.122；ADHD伴焦虑障碍儿童的的影响因素分别为家庭理想亲密度、母亲拒绝和父亲惩罚，其OR值分别为0.966、1.215和1.089。结论ADHD伴或不伴焦虑障碍患儿的父母教养方式存在着诸多方面的问题，ADHD伴焦虑障碍患儿的发生受母亲拒绝、父亲惩罚和家庭理想亲密度的影响。Objective To study the family rearing pattern of attention deficlt hyperactivity disorder （ADHD） with or without anxiety disorder and to explore its risk factors. Methods 9495 children and their parents were sampled at random in Hunan province, using two-stage investigation. Those who were diagnosed ADHD and the normal control filled out Egna Minnen av Barndoms Uppfostran and family adaptability and cohesion scale by themselves. Results The comparison of factors as： actual family cohesion, parents＇ punishments, rejection, mother＇ s excessive protection, intervention and father＇ s excessive protection were significantly different between ADHD with or without anxiety disorder and normal children （P〈0.05）.The comparison of parents＇ punishments, rejection, excessive protection and intervention were obviously different between ADHD with anxiety disorder and simple ADHD （P〈0.05）. Mother＇s rejection was the influencing factor of simple ADHD, with OR as 1.122. Ideal family cohesion, mother＇s rejection and father＇s punishments were the influencing factors of ADHD with anxiety disorder, with OR as 0.966, 1.215 and 1.089 respectively. Conclusion There were some problems in the parental rearing pattern of ADHD with or without anxiety disorder. Mother＇s rejection, father＇s punishments and ideal family cohesion were suggested to be correlated with ADHD and anxiety disorder.

关 键 词：注意缺陷多动障碍 焦虑障碍 养育方式 亲密度和适应性 

分 类 号：R749.94[医药卫生—神经病学与精神病学] R179[医药卫生—临床医学]