伴品行行为问题的注意缺陷多动障碍患儿父母养育方式特点分析  

Parenting characteristics of children with attention deficit hyperactivity disorder and conduct problems

作　　者：李颖[1] 吴赵敏 操小兰 王鹏[2] 刘璐[2] 杨莉[2] 王玉凤[2] 杨斌让[1] Li Ying;Wu Zhaomin;Cao Xiaolan;Wang Peng;Liu Lu;Yang Li;Wang Yufeng;Yang Binrang(Children Health Care and Mental Health Center,Shenzhen Children′s Hospital,Shenzhen 518038,China;Peking University Mental Health Institute/Sixth Hospital,Key Laboratory of Mental Healthy,Ministry of Health,Beijing 100191,China)

机构地区：[1]深圳市儿童医院儿童保健与心理健康中心,深圳518038 [2]北京大学精神卫生研究所/第六医院,卫生部精神病学重点实验室,北京100191

出　　处：《中华实用儿科临床杂志》2022年第4期274-278,共5页Chinese Journal of Applied Clinical Pediatrics

基　　金：广东省基础与应用基础研究(2019A1515110700);深圳市医疗卫生三名工程项目(SZSM201612036)。

摘　　要：目的探讨伴品行行为问题的注意力缺陷多动障碍(ADHD)儿童父母养育方式特点。方法本研究采用横断面研究,研究对象为2017年9月至2019年12月就诊于深圳市儿童医院儿童保健与心理健康中心门诊,伴品行行为问题的ADHD患儿84例,不伴品行行为问题的ADHD患儿75例,及健康对照儿童(深圳市普通中小学的健康儿童)54例。采用父母养育方式评定量表(EMBU)分别评估父亲和母亲教育方式特点。使用协方差分析首先对EMBU各因子得分在3组间进行比较,对3组间差异有统计学意义的因子进一步采用Tukey法进行两两比较,相关检验均对年龄、性别进行校正。结果EMBU量表各因子得分中,伴品行行为问题的ADHD组患儿在父亲及母亲养育方式中的"惩罚、严厉"[父亲(22.10±4.92)分比(19.40±4.01)分比(17.40±2.51)分,母亲(15.10±3.54)分比(13.70±2.78)分比(12.40±1.97)分]和"拒绝、否认"[父亲(10.60±2.49)分比(9.40±2.06)分比(8.90±1.61)分,母亲(13.90±3.28)分比(12.40±2.64)分比(11.60±2.19)分]因子两个分量表的得分明显高于不伴品行行为问题的ADHD组及健康对照组(均P<0.001)。在父亲养育方式的"过度保护"因子上,2组ADHD患儿得分均高于健康对照组[(10.30±2.03)分比(9.80±2.13)分比(8.70±1.92)分,P<0.001];在母亲养育方式的"过分干涉"因子上,伴品行行为问题的ADHD患儿得分明显高于不伴品行行为问题的ADHD组和健康对照组[(36.00±4.64)分比(34.60±4.38)分比(33.30±4.92)分,P=0.009]。结论伴品行行为问题的ADHD患儿中,父母普遍对患儿采用过度严厉的教养方式,更多使用惩罚以及持否认和拒绝的态度。父母的养育方式在一定程度上导致了ADHD患儿品行行为问题的发生。Objective To explore the parenting characteristics of children with attention deficit hyperactivity disorder(ADHD)and conduct problems.Methods This was a cross-sectional study involving 84 ADHD children with conduct problems and 75 ADHD children without conduct problems treated in the Outpatient Department of Children′s Health and Mental Health Center,Shenzhen Children′s Hospital from September 2017 to December 2019,and 54 healthy control children(healthy children in ordinary primary and secondary schools in Shenzhen)were included.The Egna Minnen av Barndoms Uppfostran(EMBU)scale was used to access the parenting styles of participants.ANCOVA was used to compare the different score of all factors in EMBU among these 3 groups and Tukey′s post-hoc comparisons were also performed.All comparisons were corrected for age and sex.Results Among the factor scores of EMBU scale,ADHD children with conduct problems scored significantly higher on parental and maternal harsh/punishment[Parental(22.10±4.92)scores vs.(19.40±4.01)scores vs.(17.40±2.51)scores;Maternal(15.10±3.54)scores vs.(13.70±2.78)scores vs.(12.40±1.97)scores]and the reject/deny factors[Parental(10.60±2.49)scores vs.(9.40±2.06)scores vs.(8.90±1.61)scores,Maternal(13.90±3.28)scores vs.(12.40±2.64)scores vs.(11.60±2.19)scores]than ADHD children without conduct problems and the healthy control group(all P<0.001).On parental overprotection factors,both ADHD groups scored higher than the healthy control group[(10.30±2.03)scores vs.(9.80±2.13)scores vs.(8.70±1.92)scores,P<0.001],while on maternal over-interference factor,ADHD children with conduct problem scored significantly higher than ADHD children without conduct problems and the healthy controls[(36.00±4.64)scores vs.(34.60±4.38)scores vs.(33.30±4.92)scores,P=0.009].Conclusions Parents of ADHD children with conduct problems tend to use more negative parenting skills like punishment,over-interference,rejection and denial.This kind of negative parenting style,to some extent,causes the conduc

关 键 词：注意缺陷多动障碍 父母养育方式 行为问题 

分 类 号：R749.94[医药卫生—神经病学与精神病学]