幼儿30月龄时父母教养方式与学龄前儿童注意缺陷多动障碍症状轨迹关联研究  

Study on the relationship between parenting styles of toddlers aged 30 months and attention deficit hyperactivity disorder symptom trajectories in preschool children

作　　者：李晗 童娟 汪兴 严双琴 黄锟[1] 伍晓艳[1] 陶舒曼[1,3] 朱贝贝 高慧 陶芳标[1] Li Han;Tong Juan;Wang Xing;Yan Shuangqin;Huang Kun;Wu Xiaoyan;Tao Shuman;Zhu Beibei;Gao Hui;Tao Fangbiao(Department of Maternal,Child and Adolescent Health,School of Public Health,Anhui Medical University/Key Laboratory of Population Health Across Life Cycle,Ministry of Education/Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course,Hefei 230032,China;Maternal and Child Health Care Center of Ma'anshan,Ma'anshan 243000,China;Department of Ophthalmology,the Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China;Department of Pediatrics,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学公共卫生学院儿少卫生与妇幼保健学系/出生人口健康教育部重点实验室/安徽省环境与人口健康重点实验室,合肥230032 [2]马鞍山市妇幼保健院,马鞍山243000 [3]安徽医科大学第二附属医院眼科,合肥230601 [4]安徽医科大学第一附属医院儿科,合肥230022

出　　处：《中华流行病学杂志》2025年第4期709-716,共8页Chinese Journal of Epidemiology

基　　金：国家自然科学基金联合基金(U22A20361)。

摘　　要：目的探讨幼儿30月龄时父母教养方式与学龄前儿童注意缺陷多动障碍(ADHD)症状轨迹的关联。方法研究对象为马鞍山优生优育队列2111名儿童及其父母。使用简易幼儿家庭教养方式量表评估幼儿30月龄时父母教养方式,界定温暖与互动、关注与接纳、户外与社交、忽视与限制4个维度的父母教养方式。采用Conners简明症状问卷中文版评估3、5、6岁儿童ADHD症状,利用组基轨迹模型拟合儿童ADHD症状轨迹。采用多项式logistic回归模型评估幼儿30月龄时父母不同教养方式与ADHD症状轨迹的关联。采用相加和相乘模型评估父/母亲消极教养方式在儿童ADHD症状轨迹中的交互作用。结果儿童ADHD症状轨迹划分为低(48.3%)、中(47.7%)、高(4.0%)得分轨迹组。在调整混杂因素后,多项式logistic回归分析结果显示,父/母亲消极教养方式与儿童ADHD症状轨迹有关(P<0.05),与低得分轨迹组相比,父/母亲低水平温暖与互动(父亲:OR=2.07,95%CI:1.68~2.54;母亲:OR=2.02,95%CI:1.64~2.48)、低水平关注与接纳(父亲:OR=1.94,95%CI:1.57~2.39;母亲:OR=1.47,95%CI:1.20~1.81)、低水平户外与社交(父亲:OR=1.74,95%CI:1.43~2.13;母亲:OR=1.60,95%CI:1.32~1.94)、高水平忽视与限制(父亲:OR=2.09,95%CI:1.67~2.62;母亲:OR=2.06,95%CI:1.65~2.56)与儿童ADHD症状中得分轨迹有统计学关联。母亲低水平温暖与互动、低水平户外与社交、高水平忽视与限制与儿童ADHD症状高得分轨迹有统计学关联,父亲消极教养方式与儿童ADHD症状高得分轨迹有统计学关联。父/母亲消极教养方式存在相乘交互作用(P<0.05)。相加交互作用结果显示,父/母亲消极教养方式存在协同作用,增加儿童ADHD症状高得分轨迹风险发生。结论父/母亲双方教养方式影响学龄前儿童ADHD症状轨迹,父/母亲消极教养方式会增加儿童ADHD症状中、高得分轨迹发生风险。父/母亲双方消极教养方式存在协同作用,二者同时Objective To explore the relationship between parenting styles of toddlers aged 30 months and attention deficit hyperactivity disorder(ADHD)symptom trajectories in preschool children.Methods The subjects were 2111 children and their parents in Ma'anshan Birth Cohort.Parenting styles were assessed at 30 months of age using the Brief Toddler Parenting Style Questionnaire,which defines parenting styles on four dimensions:warmth and interaction,attention and acceptance,outdoor and social activities,and neglect and restrictions.The Chinese version of the Conners Abbreviated Symptom Questionnaire was used to examine preschooler's ADHD symptoms aged 3,5,and 6 years.ADHD symptom trajectories were fitted using group-based trajectory modeling.The multinomial logistic regression model was used to evaluate the relationship between parenting styles at 30 months of age and ADHD symptom trajectories in children.The additive and multiplicative models were applied to analyze the interaction effect of negative parenting styles in children's ADHD symptom trajectories.Results ADHD symptom trajectories in children included the low-score(48.3%),moderate-score(47.7%),and high-score groups(4.0%).After adjusting for the confounding factors,the results of the multinomial logistic regression analysis showed that negative parenting styles of the father/mother were associated with ADHD symptom trajectories in children(P<0.05).The father/mother's low warmth and interaction(father:OR=2.07,95%CI:1.68-2.54;mother:OR=2.02,95%CI:1.64-2.48),low attention and acceptance(father:OR=1.94,95%CI:1.57-2.39;mother:OR=1.47,95%CI:1.20-1.81),low outdoor and social(father:OR=1.74,95%CI:1.43-2.13;mother:OR=1.60,95%CI:1.32-1.94),and high neglect and restriction(father:OR=2.09,95%CI:1.67-2.62;mother:OR=2.06,95%CI:1.65-2.56)were associated with ADHD symptom moderate-score trajectories compared to the low-score trajectory group,mother's low warmth and interaction,low outdoor and social,and high neglect and restrictions.Statistically significant association was seen

关 键 词：注意缺陷多动障碍 父母教养方式 学龄前儿童 队列研究 

分 类 号：R749.94[医药卫生—神经病学与精神病学]