孤独症2～6岁患儿亲子依恋状况及影响因素

摘要

Objective To understand the attachment quality of autism children between 2-6 years and explore the possible influential factors, such as family environment, parent character and feeling atmosphere. Methods Drawing -off 55 autism children (49 male and 6 female) who visited the Third Affiliated Hospital of Sun Yat - Sen University from Jan. To Jun. 2007. The Attachment Q - Sort was used to test the attachment quality. Professional testers guidance parents to give scores in 9 grades based on according degree of children actual behavior and card content, 90 cards were divided into 9 groups, from the most difference to the most accord,constitute the distribution of each group of 10. Each test child would receive a group of 90 original score. Then,testers calculated the relation coefficient between autism children and normal children of the same period. The children whose relation coefficient were greater than 33 percent of normal children would be diagnosed with security attachment. Conversely, children would be diagnosed with no security attachment. Self - designed questionnaire about family environment, parent character and feeling atmosphere was used to explore attachment influence factors. Results For 55 autism children aged 2 -6 years, 16 cases (29. % ) of them had security attachment and 39 cases (70. 9% ) of them had unsure attachment. Earlier autism children took part in school, more likely they were diagnosed with security attachment ( OR = 0. 87, 95 % CI = 0.76 - 0.99 ). The better they had fa-mily atmosphere feeling, more likely they were diagnosed with security attachment(P = 0. 03). Conclusion Most oil -6 years old autism children have unsure attachment and children's scholar age and feeling atmosphere are influences factors.%目的 了解2～6岁孤独症患儿的亲子依恋特征,从家庭特征、父母特征和情感氛围等方面探讨孤独症患儿亲子依恋关系的可能影响因素.方法 以2007年1-6月在中山大学第三附属医院儿童发育行为中心就诊的55例孤独症患儿(男49例,女6例)及其父亲或母亲为研究对象.使用中国版幼儿依恋行为分类卡片测试孤独症患儿的依恋类型.专业测试人员指导家长按照卡片内容与儿童实际行为的符合程度(最符合到最不符合)进行9级评分,将90张卡片分成9组,从最不符合到最符合,构成每组10张的分布.每个被试的儿童会得到一组90个原始分数,然后将原始分数与同期健康儿童依恋安全性指标进行相关分析,得出的相关系数即为该儿童的依恋安全性得分.相关系数高于同期健康儿童依恋相关系数的第33百分位数者为安全型依恋,反之为不安全型.采用自编的<幼儿家庭生活情况调查表>了解孤独症患儿的家庭特征、父母特征和情感氛围等因素,分析孤独症患儿安全型依恋的影响因素.结果 55例孤独症患儿中,安全型依恋者16例,占29.1%;不安全型依恋者39例,占70.9%.对孤独症患儿亲子依恋关系影响因素的研究发现,孤独症患儿入托月龄越早,产生安全型亲子依恋关系的可能性越大(OR=0.87,95%CI=0.76~0.99);家庭气氛越好,产生安全型亲子依恋关系的可能性越大(P=0.03).结论 孤独症患儿的亲子依恋类型以不安全型依恋为主,入托年龄和家庭气氛影响孤独症患儿安全型依恋的产生.