注意力缺陷過動症兒童之認知行為團體治療效果評估

The Efficacy of Cognitive-Behavioral Group Therapy for Children with Attention Deficit/Hyperactivity Disorder

曾名誼(Ming-Yi Tseng)

指導教授 ： 黃惠玲

高雄醫學大學/健康科學院/心理學研究所/碩士(2011年)

摘要

目的：注意力缺陷過動症（ADHD）是一常見於兒童的神經發展疾患，以注意力不良、過動 / 衝動為核心症狀，也易合併其他行為、情緒問題。國外研究傾向結合藥物和心理社會兩者的治療效果佳，但是台灣目前多以藥物治療為主，心理社會治療仍少。本研究欲探討結合藥物與認知行為治療，對患有ADHD學童之療效。研究假設接受結合治療的兒童會比僅接受藥物治療的兒童，在ADHD症狀和其他問題行為有較多的改善。方法：參與者由精神科門診轉介而來，分為兩組。對照組有17位持續接受門診治療，並穩定服藥之兒童；結合治療組有21位同時接受門診治療與認知行為治療之兒童。認知行為治療主要以親子團體方式進行，內容教導兒童問題解決技巧與不同情境下的應用，共有22個節次。結合治療組在團體前後進行評估，對照組亦在同樣的時間間距評估，由母親填寫兒童行為檢核表與干擾行為量表。研究資料分別以卡方檢定、t檢定和ANCOVA等進行統計分析。結果：分析結果發現結合治療組在兒童行為檢核表的焦慮/憂鬱、總分等症狀量尺、干擾性行為量表的過動/衝動量尺，比對照組有顯著改善。結論：研究結果與假設部分相符合，推論可能的原因並針對結果與先前研究進行比較。本研究結果支持認知行為治療應用於台灣已服藥的ADHD兒童之療效。

關鍵字

注意力缺陷過動症 ； 認知行為治療 ； 兒童行為檢核表 ； 干擾性行為評量表

並列摘要

Objectives: Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder. 7% to 12% of Taiwanese children have suffered from it. The core symptoms of ADHD are inattention, hyperactivity and/or impulsivity, following some peripheral problems. Some studies reveal that the combination of medication and psychosocial therapy are most effective. However, the primary treatment of ADHD is medication in Taiwan. This study was to examine the efficacy of combined treatment of stimulant medication and cognitive-behavioral therapy (CBT) for children with ADHD. Researcher assumed that there would be more improvement in subjects receiving combined treatment. Method: Subjects were referred from psychiatrists and were assigned to different groups. The comparison group included 17 children taking medication regularly. The combined group included 21children receiving medication and CBT. Children with ADHD and their parents participated in the CBT group, including 22 sessions of problem-solving skills. The researcher applied Child Behavior Checklist (CBCL) and Disruptive Behavior Rating Scale-Parent Form (DBRS-PF) to evaluate the children. The scales were completed by the mothers whose children with ADHD. The data were analyzed with chi-square test, t-test, and ANCOVA. Results: The combined treatment group had lower scores on Anxious/Depressed scale, total score scale on the CBCL, and hyperactivity/impulsivity scale on the DBRS with statistical significance. Conclusion: Results implied the combined treatment group improved more than the comparison group, supporting the efficacy of combined treatment for children with ADHD.

並列關鍵字

ADHD ； CBT ； CBCL ； DBRS

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