CAJ | 학술논문

目的探讨注意缺陷多动障碍(ADHD)儿童的情绪调控特点.方法对2012年8月至2014年4月到北京大学第六医院/精神卫生研究所门诊就诊,符合美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)诊断标准的282例ADHD儿童[(9.4±2.6)岁]和来自附近中小学的260名健康对照儿童[(9.5±1.7)岁],采用Conner儿童行为问卷、学龄儿童执行功能行为评定量表(BRIEF),Achenbach儿童行为量表(CBCL)和Rutter儿童行为问卷中的情绪因子或相关条目对ADHD情绪调控特点进行多维度的评定.结果控制了年龄、性别和智商因素的影响,Conner问卷中,ADHD组的情绪不稳定分(EL)高于健康对照组[(4.3±2.6)分比(1.4±1.5)分,P ＜0.001];BRIEF量表中,ADHD组的情绪调控分(ECTRL)高于健康对照组[(16.1±4.4)分比(12.0±2.5)分,P＜0.001];CBCL量表中,ADHD组的情绪失调分(DESR)高于健康对照组[(26.8±11.0)分比(6.6±6.8)分,P ＜0.001];Rutter问卷中,ADHD组的情绪症状分(ES)高于健康对照组[(2.7±2.0)分比(1.7±1.5)分,P＜0.001].根据ROC曲线,EL的曲线下面积(AUC)为0.84,95％可信区间(CI)0.80～0.87;ECTRL的AUC为0.81,95％ CI0.77 ～0.84;DESR的AUC为0.95,95％ CI 0.93 ～ 0.97;ES的AUC为0.66,95％ CI0.61 ～0.70.结论维度研究表明,ADHD儿童存在明显的情绪失调问题.
목적 탐토주의결함다동장애(ADHD)인동적정서조공특점.방법 대2012년8월지2014년4월도북경대학제륙의원/정신위생연구소문진취진,부합미국정신장애진단여통계수책제4판(DSM-Ⅳ)진단표준적282례ADHD인동[(9.4±2.6)세]화래자부근중소학적260명건강대조인동[(9.5±1.7)세],채용Conner인동행위문권、학령인동집행공능행위평정량표(BRIEF),Achenbach인동행위량표(CBCL)화Rutter인동행위문권중적정서인자혹상관조목대ADHD정서조공특점진행다유도적평정.결과 공제료년령、성별화지상인소적영향,Conner문권중,ADHD조적정서불은정분(EL)고우건강대조조[(4.3±2.6)분비(1.4±1.5)분,P ＜0.001];BRIEF량표중,ADHD조적정서조공분(ECTRL)고우건강대조조[(16.1±4.4)분비(12.0±2.5)분,P＜0.001];CBCL량표중,ADHD조적정서실조분(DESR)고우건강대조조[(26.8±11.0)분비(6.6±6.8)분,P ＜0.001];Rutter문권중,ADHD조적정서증상분(ES)고우건강대조조[(2.7±2.0)분비(1.7±1.5)분,P＜0.001].근거ROC곡선,EL적곡선하면적(AUC)위0.84,95％가신구간(CI)0.80～0.87;ECTRL적AUC위0.81,95％ CI0.77 ～0.84;DESR적AUC위0.95,95％ CI 0.93 ～ 0.97;ES적AUC위0.66,95％ CI0.61 ～0.70.결론 유도연구표명,ADHD인동존재명현적정서실조문제.
Objective To explore the characteristics of emotional regulation in children with attention-deficit/hyperactivity disorder (ADHD).Methods Two hundred and eighty-two children who were diagnosed as ADHD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-Ⅳ) were recruited from the child psychiatric clinic of Peking University Sixth Hospital/Institute of Mental Health from August 2012 to April 2014.And 260 normal children from the local primary schools were selected as the healthy control group.The emotional factors or items of Conners' Parent Rating Scale, Behavior Rating Inventory of Executive Function (BRIEF), Achenbach's Child Behavior Checklist (CBCL) and Rutter Children Behavior Questionnaire were used to assess the characteristics of emotional regulation multi-dimensionally.Results After controlling for the effects of age, sex and intelligence quotient (IQ), in Conner scale, the emotional lability (EL) scores of ADHD group were significantly higher than that of healthy control group [(4.3 ±2.6) vs (1.4 ± 1.5), P ＜0.001].In BRIEF scale, the emotional control (ECTRL) scores of ADHD group were significantly higher than that of control group [(16.1 ± 4.4) vs (12.0 ± 2.5), P ＜ 0.001].In CBCL scale, the deficient emotional self-regulation (DESR) scores of ADHD group were significantly higher than that of control group [(26.8 ± 11.0) vs (6.6 ± 6.8), P ＜ 0.001].In Rutter questionnaire, the emotional symptoms (ES) scores of ADHD group were significantly higher than that of control group [(2.7 ± 2.0) vs (1.7 ± 1.5), P ＜ 0.001].Based on the receiver operating characteristics (ROC) curve, the area under the curve (AUC) of EL was 0.84 with 95％ Confidence Intervals (CI) 0.81-0.87.The AUC of ECTRL was 0.81 with 95％ CI0.77-0.84.The AUC of DESR was 0.95 with 95％ CI 0.93-0.97.The AUC of ES was 0.66 with 95％ CI 0.61-0.70.Conclusions The study multi-dimensionally indicated that children with ADHD displayed significant deficient emotional regulation.