完整認知行為治療對注意力缺失過動疾患兒童的療效：以兒童行為檢核表評估

The Effectiveness of a Comprehensive Cognitive Behavioral Therapy for Children with Attention-Deficit Hyperactivity Disorder: Using the Child Behavior Checklist as an Evaluating Tool

石昱棋(Yu-Chi Shih)

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(2009年)

https://doi.org/10.6832/KMU.2009.00043

摘要

目的：為探討完整認知行為親子治療對注意力缺失過動疾患（ADHD）兒童的療效，以門診治療及結合兩種治療方式予以對照。方法：來自精神科轉介且符合收案條件之46位ADHD男童，依序列入等待名單，並分配至門診組（定期回診追蹤服藥，n=17）、完整認知行為治療組（簡稱CCBT組，參與完整認知行為治療團體但未回診服藥，n=7）與門診加CCBT組（簡稱門＋C組，定期回診服藥且參與CCBT團體，n=22），治療效果以兒童行為檢核表（CBCL）評估。結果：以無母數統計之魏克遜符號等級考驗進行前後測差異比較，發現門＋C組在內化、焦慮/憂鬱、外化、攻擊行為、思考問題、總分等症狀量尺與情感性問題、焦慮問題、注意力過動問題等DSM量尺的後測分數顯著低於前測（p＜.05），CCBT組則是在焦慮/憂鬱、違規行為、思考問題、注意力問題、總分等症狀量尺與情感性問題、注意力過動問題、品行問題等DSM量尺中的後測顯著低於前測（p＜.05），而門診組在CBCL各量尺中的前後測分數皆無顯著差異（p＞.05）。討論：將與其他研究文獻做比較，探究治療療效歷程。

關鍵字

注意力缺失過動疾患 ； 認知行為治療 ； 兒童行為檢核表 ； 治療效果

並列摘要

Objective: To investigate the effectiveness of comprehensive cognitive behavioral therapy for ADHD children, using two methods of therapy, outpatient therapy and combination therapy as comparison. Methods: Forty-six boys with ADHD referred from the psychiatric department and qualified for the study were recruited, they went into the waiting list in the order referred, and were assigned to the outpatient group (routinely go back to outpatient clinics to follow up on medication use, n=17), the comprehensive cognitive behavioral therapy group (CCBT, participate in the comprehensive cognitive behavioral therapy group but does not go back to outpatient clinics for medication, n=7) or the outpatient plus CCBT group (O+C group, routinely go back to outpatient clinics for medication and participate in the CCBT group, n=22), the Child Behavior Checklist (CBCL) was used to evaluate therapy effectiveness. Results: Wilcoxon signed ranks test, a non-parametric statistical analysis, was used to conduct pre and post within group comparison, results found for the O+C group, post-test scores of internalizing, anxious/depressed , externalizing , aggressive behavior , thought problems , total problems of symptom scales and affective problems, anxious problems, attention deficit hyperactivity problems of DSM scales were significantly lower than pre-test scores (p＜.05). For the CCBT group, post-test of anxious/depressed, rule-breaking behavior, thought problems, attention problems, total problems in the symptom scales and affective problems, attention deficit hyperactivity problems, conduct problems in the DSM scale had significantly improved (p＜.05).The outpatient group did not show significant differences between pre- and post-test scores in CBCL subscales (p＞.05). Discussion: Will be compared with other studies, and investigate the therapy effectiveness process.

並列關鍵字

ADHD ； CBT ； CBCL ； therapy effectiveness

參考文獻

Barkley, R. A. (1997). Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD. Psychological Bulletin, 121(1), 65-94.

黃惠玲、莊勝發、王雅琴、陳永成、曾嫦嫦、邱彥南、陳映雷、余麗樺與吳英璋 （1994）。發展台灣地區的多軸兒童行為衡鑑評量表。載於中國測驗學會。華文社會的心理測驗（259-309）。台北：心理。

Abikoff, H., Hechtman, L., Klein, R. G., Gallagher, R., Fleiss, K., Etcovitch, J., et al. (2004a). Social Functioning in Children With ADHD Treated With Long-Term Methylphenidate and Multimodal Psychosocial Treatment. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 820-829.

Abikoff, H., Hechtman, L., Klein, R. G., Weiss, G., Fleiss, K., Etcovitch, J., et al. (2004b). Symptomatic improvement in children with ADHD treated with long-term methylphenidate and multimodalpPsychosocial treatment. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 802-811.

Achenbach, T. M., & Dumenci, L. (2001). Advances in Empirically Based Assessment: Revised Cross-Informant Syndromes and New DSM-Oriented Scales for the CBCL, YSR, and TRF: Comment on Lengua, Sadowksi, Friedrich, and Fisher (2001). Journal of Consulting and Clinical Psychology, 69, 699-702.