注意缺陷多动障碍儿童问题行为及其影响因素分析  

Analysis on the Problem Behaviors and Influencing Factors in Children with Attention-deficit Hyperactivity Disorder

作　　者：李杨[1] 杨金伟[1] 周郁秋[1] 曹建琴[1] 杨军[1] 贾祥瑞[1] LI Yang YANG Jin -wei ZHOU Yu -qiu CAO Jian -qin YANG Jun JIA Xiang -rui(Harbin Medical University （ Daqing ） , Daqing 163319, China)

机构地区：[1]哈尔滨医科大学大庆校区,黑龙江省大庆市163319

出　　处：《中国全科医学》2017年第29期3600-3605,共6页Chinese General Practice

基　　金：教育部人文社会科学项目青年基金课题(13YJCZH093);黑龙江省卫生厅科研课题(2011-229);哈尔滨医科大学(大庆)种子基金

摘　　要：目的研究注意缺陷多动障碍(ADHD)儿童问题行为及其影响因素。方法于2013年10月—2014年6月,采用便利抽取法对黑龙江省某市选取5所公立小学1~4年级儿童进行问卷调查。采用一般情况调查表、Conners父母问卷(PSQ)、儿童气质问卷、Ruteer儿童行为问卷(父母问卷)、中文版儿童睡眠习惯问卷(CSHQ)、父母养育方式量表进行调查。根据PSQ多动指数得分≥1.5分,判断为ADHD初筛阳性,并经由ICD-10确诊ADHD 132例,作为试验组,按照同质性原则进行匹配132例作为对照组。采用多因素Logistic回归分析ADHD的影响因素。结果共发放问卷6 280份,回收有效问卷5 742份,有效回收率为91.4%。352例ADHD初筛阳性,初筛阳性率为6.1%,确诊132例,患病率为2.3%。两组气质问卷中趋避性、情绪本质得分比较,差异均无统计学意义(P>0.05);试验组气质问卷中活动度、规律性、适应性、反应强度、坚持性、注意分散度、反应阈得分高于对照组(P<0.05)。对照组Ruteer儿童行为问卷得分低于试验组(t=47.98,P<0.001)。两组CSHQ中睡眠焦虑、夜醒、异态睡眠、睡眠呼吸障碍、日间困倦、总分比较,差异均无统计学意义(P>0.05);试验组CSHQ中睡眠习惯、入睡潜伏期、睡眠持续时间得分低于对照组(P<0.05)。对照组父亲惩罚严厉、拒绝否认、过度保护及母亲过分干涉、拒绝否认、惩罚严厉得分均低于试验组,母亲情感温暖得分高于试验组(P<0.05)。多因素Logistic回归分析结果显示,出生体质量、活动度、趋避性、反应强度、注意分散度、父亲惩罚严厉、母亲情感温暖、母亲惩罚严厉为ADHD的影响因素(P<0.05)。结论 ADHD患儿存在较多的问题行为,且存在家庭教养方式方面的危险因素。Objective To study the problem behaviors and their influencing factors in children with attention deficit hyperactivity disorder（ ADHD）. Methods From October 2013 to June 2014,a questionnaire survey was conducted to the children of Grade 1 to 4 from five public primary schools in a city of Heilongjiang Province by means of the convenient extraction method. The general situation questionnaire, Conners parents questionnaire（ PSQ）, children＇ s temperament questionnaire,Ruteer children＇s behavior questionnaire（ parental questionnaire）,Chinese version of the children＇ s sleep habits questionnaire（ CSHQ）,and parental rearing scale were used to investigate. It was judged positive for ADHD screening according to the score of PSQ hyperactivity index ≥1. 5 points. And ADHD was diagnosed by ICD-10 as experimental group. 132 cases were matched as control group according to the principle of homogeneity. Multivariate Logistic regression was used to analyze the influencing factors of ADHD. Results A total of 6 280 questionnaires were distributed and 5 742 valid questionnaires were collected. The recovery efficiency was 91. 4%. 352 cases were positive for ADHD screening,and the screening positive rate was 6. 1%. 132 cases were diagnosed as ADHD and the prevalence rate was 2. 3%. There were no statistically significant differences in the avoidance and emotional nature scores between the two groups（ P〈0. 05）; the scores of activity, regularity, adaptability,reaction intensity,persistence,attention dispersion and reaction threshold in the temperament questionnaire of the experimental group were higher than those in the control group（ P〈0. 05）. The score of Ruteer children＇ s behavior questionnaire in the control group was lower than that in the experimental group（ t = 47. 98,P〈0. 001）. There were no statistically significant differences in sleep anxiety,night wakening,abnormal sleep,sleep apnea,daytime sleepiness and total scores between the two groups CSHQ（ P〈0. 05）; the sleep habi

关 键 词：注意力缺陷障碍伴多动 儿童行为 影响因素分析 

分 类 号：R742.89[医药卫生—神经病学与精神病学]