探討影響過動症患童問題行為之危險因素中的調節效應及仲介效應

Explore the Moderation and Mediation Effects among those Risk Factors of ADHD Children’s Problematic Behaviors

廖文寬(Wen-Kuang Liao)

指導教授 ： 張玉坤

淡江大學/理學院/數學學系碩士班/碩士(2010年)

https://doi.org/10.6846/TKU.2010.00309

摘要

過動症的全名為注意力不足過動症(ADHD)，是兒童最常見的精神行為異常，其主要的特徵有不專注(Inattention)、活動過度(Hyperactivity)
及易衝動(Impulsivity)。ADHD患童除了個人、家庭及學校等方面的潛在影響因素外，常伴隨有精神病學的共病(comorbidity)現象。另外，父母本身的個人特質亦會影響患童病情，進而影響父母本身的親職壓力。
本研究將以過動兒的五項行為問題為研究主軸，分別是社交問題(Social Problem)、焦慮憂鬱(Anxiety/Depression)、注意力問題(Attention)、攻擊行為(Destructive)及暴力傾向(Aggression)等，探討其影響因素、父母因素、親職壓力和症狀影響之調節因子(Moderator)與仲介因子(Mediator)。
五項行為問題的鑑定是採用兒童行為檢核表(CBCL)由患童的父母來評量受試者特定子女的行為問題。
現今調節效應(Moderation)與仲介效應(Mediatio)被廣泛的運用在各種領域研究上，最常見的有社會科學及管理學領域上的運用探討其因子間的關係。Baron和Kenny(1986)曾撰文詳述仲介效應的概念與檢驗程序，普遍被視為是單一層次仲介變項檢驗的正式程序。Baron和Kenny(1986)文中提及的作法是透過三個線性方程式，利用迴歸分析來檢視仲介效應。調節效應同樣也可利用迴歸分析來檢視是否存在單一層次兩個變項對依變項的交互作用。
在孩童精神狀況可能影響的危險因子上，我門總共收錄了13項有關患童父母的指標、6項孩童危險因子(Child risk factor)和5項父母危險因子(Parent Risk Factor)。本研究的結果皆收錄在附錄中，希望研究結果對未來在此方面的臨床醫師能有所助益，以及實務方面對醫師在診治過動症患童時能更精準的掌握可能的危險因子，進而提升療效。

關鍵字

注意力不足過動症 ； 調節效應 ； 仲介效應

並列摘要

Attention-Deficit Hyperactivity Disorder (ADHD) is one of children's most common neural behavioral disorders. The principal characteristics of ADHD are inattention, hyperactivity, and impulsivity. For ADHD child, there are various potential risk factors from individual, family and school but also is heavily combine with psychological comorbidity. In addition, the personal characteristics of parent will have significant impact on the conditions of ADHD child which will influence the parenting stress.
In this study, we focus on those prognostic factors on the five problematic behaviors of ADHD children they are social problem, anxiety/depression, attention problem, destructive, and aggression. In addition, we will try to explore the potential moderation and/or mediation effects among those prognostic factors. The instrument, named CBCL ( Child Behavior Checklist), was used by parents to rate their child's problem behaviors.
The moderation and mediation effects were commonly used in the social science and/or management areas to establish the associations between some influential factors and outcome variables. The concept of mediation effects and the corresponding checking procedures were established by Baron and Kenny(1986). The proposed procedure was now been considered as the standard procedure to check the mediation effects through three linear equations which can be done by using linear regression analyses. The moderation effects can also be done by checking the interaction effects of two factors on a dependent variable in a regression model.
In this ADHD study, we collected 13 parental indexes, 6 ADHD children related risk factors, and 5 parents related risk factors. The results were summarized in the appendixes. We expect the finding may have value for clinicians in setting treatment plans and hence to improve the treatment effects.

並列關鍵字

ADHD ； Moderation ； Mediation

參考文獻

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