学龄前孤独症谱系障碍儿童父母心理健康状况的调查  

Mental Health of Parents of Preschool Children with Autism Spectrum Disorder

作　　者：尹培培 汪芳 梁凤晶 邢艺沛 汪瑜 岑超群 邹娥 IN Pei-Pei;WANG Fang;LIANG Feng-jing;XING Yi-pei;WANG Yu;CEN Chao-qun;ZOU E(Child Development Behavior Center,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院儿童发育行为中心,广州510630

出　　处：《实用临床医学（江西）》2024年第3期97-102,共6页Practical Clinical Medicine

摘　　要：目的 了解孤独症谱系障碍(autism spectrum disorder, ASD)儿童父母的心理健康状况,从而为家庭干预提供个性化的指导和支持。方法 收集2022年5月至2023年2月在中山大学附属第三医院儿童发育行为中心住院干预的115例孤独症儿童(年龄18~59个月)的父母问卷,包括患者健康问卷-4(patient health questionnaire-4,PHQ-4)、父母亲职压力量表简表(parenting stress index-short form, PSI-SF)、应对方式量表(Brief-COPE)。根据PHQ-4总分将患儿父母分为3组:正常组(N组,n=49)、轻度异常组(M组,n=35)、明显异常组(S组,n=31),并进行组间的育儿压力和应对方式的差异性比较。结果 42.6%的父母存在轻度异常、27.0%的父母存在明显异常的心理健康状况,N组、M组、S组3组间的亲职压力总分(P<0.001)、失调性应对总分(P=0.004)以及否认(P=0.029)与自责(P=0.008)的消极应对策略分比较差异有统计学意义,但以问题为导向及以情绪为导向的积极应对策略分差异无统计学意义(P>0.05);S组上述变量均较N组和M组明显升高,提示S组的父母有更高的养育压力,更多地使用以否认与自责为主的消极应对策略。结论 ASD儿童父母的心理健康状况不容乐观,在基于家庭的学龄前ASD儿童干预中,需高度重视家长的心理健康问题,其中针对家长的应对方式的指导(如增加积极应对策略而减少使用消极应对策略)是一个值得尝试的干预靶点。Objective To investigate mental health of parents of preschool children with autism spectrum disorder(ASD)so as to provide personalized guidance and support for family interventions.Methods Parental questionnaires were collected from 115 children with ASD(aged 18-59 months)who were hospitalized for intervention at Child Development Behavior Center of the Third Affiliated Hospital of Sun Yat-sen University from May 2022 to February 2023,including Patient Health Questionnaire-4(PHQ-4),Parenting Stress Index-Short Form(PSI-SF),and Cop-ing Style Scale(Brief-COPE).According to the PHQ-4 total score,the parents were divided into 3 groups:normal group(Group N,n=49),mildly abnormal group(Group M,n=35),and seriously abnormal group(Group S,n=31),and the differences in parenting stress and coping styles were compared between the groups.Results 42.6%of parents had mild abnormalities and 27.0%had seriously abnormal mental health conditions,and the differences in the total parenting stress scores(P<0.001),the total dysfunctional coping scores(P=0.004),and the negative coping strategy scores of denial(P=0.029)and self-blame(P=0.008)were statistically significant be-tween Group N,Group M,and Group S,but the difference in problem-oriented and emotion-oriented positive coping strategy scores was not statistically significant(P>0.05).The results of further pairwise comparison showed that the above variables were significantly higher in Group S compared to the other two groups,indicating that parents in Group S had higher parenting pres-sure and used more negative coping strategies mainly based on denial and self-blame.Conclusion Mental health of parents of preschool children with ASD is not optimistic,and needs to be given high priority in home-based interventions for ASD preschoolers,with instruction in parental coping styles(e.g.,increasing the use of positive coping strategies and decreasing the use of negative coping strategies)being a worthwhile target.

关 键 词：孤独症谱系障碍 父母心理健康 父母亲职压力 应对方式 学龄前儿童 

分 类 号：R748[医药卫生—神经病学与精神病学]