自閉症類群障礙兒童青少年行為特質與家長親職壓力關聯性之後設分析

為人父母需面對許多的壓力，自閉症類群障礙症（Autism spectrum disorder, ASD）兒童的父母而言尤其如此。因為他們在養兒育女過程往往需要面臨更多的挑戰，不少研究也指出ASD兒童父母所感受到的壓力顯著高於其他發展障礙兒童的家長。近年來ASD兒童家長親職壓力的因素逐漸受重視，其中兒童的問題行為及症狀嚴重度帶來的影響已成為重要的探討議題；但是，目前相關研究所獲得的結果卻仍不一致。本研究採用後設分析瞭解ASD兒童青少年行為特質與親職壓力之關聯，同時也探究潛在調節變項（如：人口學、診斷與評量工具）對上述兩者關係的影響。本研究分別從「ProQuestDocuments」、「PubMed」、「PsyInfo」等八個國外的資料庫，蒐集1990年至2018年8月之相關的期刊論文，最終總共納入72篇文獻進行分析。研究結果顯示：（1）家長親職壓力分別與ASD兒童青少年問題行為具中度偏高的關聯性（r ̅= .385），與症狀嚴重度具中度關聯性（r ̅ = .326）。（2）次群體分析結果並無顯著的調節變項。（3）把同時評估問題行為及症狀嚴重度的研究排除後，比較這兩者各自與親職壓力之關聯性大小，發現並沒有差異。本研究指出在探討ASD兒童青少年家長親職壓力時，病童本身的問題行為及症狀嚴重度也必須同時加以考量。相關領域的研究及臨床工作人員能從本次研究結果取得更多重要的實用資訊，並能為往後研究提供新的方向。

關鍵字

自閉症類群障礙；親職壓力；問題行為；症狀嚴重度；後設分析

並列摘要

Every parent has to deal with different kinds of stress. This is especially true for those of children with Autism Spectrum Disorder (ASD), because they often have to face more challenges when raising their children. Evidence indicates that these parents experience a higher level of stress than those of children with other types of developmental disorders. Recently, issues regarding parenting stress and factors that might influence it have caught researchers’ attention, and among those, concerns with behavioral problems and symptoms severity in ASD children have been addressed. However, no consistent conclusion has been reached yet. This study, with the use of meta-analyses, aimed to investigate the correlations between parenting stress and behavioral characteristics in children with ASD. The present study also explored whether moderator variables （e.g., demographics, diagnostic instruments）affecting these correlations existed. This investigator searched 8 databases（e.g., ProQuestDocuments, PubMed, PsycINFO）, and this search was limited to articles that were published from 1990 to August 2018. After deleting the references that did not meet the screening criteria, 72 studies remained. The results supported the following conclusions: First of all, the correlations between parenting stress and ASD children’s behavioral problems (r ̅ = .385) and their symptoms severity (r ̅ = .326) were both in a medium range of effect sizes. Secondly, the subgroup analysis showed that no moderator variable was found. Lastly, after excluding the research that simultaneously focused on ASD children’s behavioral problems and their symptom severity, this research investigated the association between parenting stress and ASD behavioral problems, and that between parenting stress and the severity of symptoms in ASD children. The results showed that there was no difference between these two associations In conclusion, this study found that both ASD children’s behavioral problems and symptom severity need to be equally addressed when investigating parenting stress. This investigator hopes that the present research outcomes would provide detailed and useful recommendations for clinicians and researchers in a relevant field, and bring forth new ideas for future research.