注意缺陷多动障碍及其共患学习困难儿童家庭环境特征

摘要

目的：探讨注意缺陷多动障碍(Attention￣deficit/hyperactivtiy disorder，ADHD)及其共患学习困难（Learning dis-ability,LD）儿童家庭环境特征。方法选用自制家庭一般情况量表、家庭环境量表中文版（Family Environment Scale-Chinese Version，FES￣CV）对单纯ADHD儿童101例、ADHD共患LD儿童56例及正常对照儿童92例进行评定。结果对照组、单纯ADHD组、ADHD共患LD组儿童年龄差异有统计学意义，对照组年龄较小（11.2±2.1vs.12.6±3.0vs.12.4±3.2,P=0.024）；三组儿童男性比例差异有统计学意义（56.14%vs.82.59%vs.86.08%,P<0.001）；三组儿童父亲职业类型（P=0.016）差异有统计学意义。在FES量表的亲密度因子（8.12±1.43vs.7.05±1.85vs.6.79±2.14）、情感表达因子（6.08±1.45vs.5.31±1.83vs.5.52±1.76）、知识性因子(5.47±2.08vs.4.12±2.01vs.4.05±1.97)、娱乐性因子（5.56±2.18vs.4.16±2.20vs.4.18±2.18）、道德宗教因子（5.76±1.39vs.5.51±1.45vs.5.39±1.68）、组织性因子（7.02±1.40vs.5.73±2.15vs.5.48±2.24）得分单纯ADHD组和ADHD共患LD组均低于对照组（P均<0.05），而在矛盾性因子上，与对照组比较，两组ADHD家庭矛盾性高；同时与单纯ADHD组比较，ADHD共患LD组儿童家庭家庭矛盾性明显增高（P<0.05）。结论单纯ADHD组和ADHD共患LD组儿童存在功能缺陷，包括亲密度差、家庭矛盾大、情感表达不佳、知识性、娱乐性、组织性差等，共患LD组增加ADHD儿童家庭矛盾性。%Objective To explore the family environmental characteristics of attention deficit hyper-activity disorder and learning disability. Methods 101 children with ADHD alone (ADHD group), 56 ADHD children with LD (ADHD plus LD group) and 92 normal children (control group) were evaluated with Homemade Family General Scale and Family Environment Scale-Chinese Version (FES￣CV). Results Significant difference was found among these three groups, with the lowest age in control group(11.2±2.1vs.12.6±3.0vs.12.4±3.2,P=0.024); There was a significant difference in the male children ratio among these groups(56.14%vs.82.59%vs.86.08%,P<0.001); and statistical differ-ence was found in vocational type of father(P=0.016). In the FES, the scores of intimacy factor, e-motional factor, knowledge factor, entertainment factor, moral religious factor, organizational factor in ADHD group and ADHD plus LD group were lower than control group (all P<0.05), while the score of contradiction factor was much higher in both ADHD and ADHD plus LD group. Further-more, the family contradiction in ADHD plus LD group was higher than ADHD group (P<0.05). Conclusion There were functional defects in both ADHD children and ADHD children combined with LD, including poor performances in intimacy, emotional expression, knowledge, entertainment and organization, and comorbidity with LD increases the family contradiction.