自閉症類群障礙症幼兒行為問題與母親親職壓力及憂鬱的關係：因應策略的中介效果

Impact of child behavior problems on parenting stress and depressive symptoms among mothers of children with autism spectrum disorder: Mediation of coping strategies

陳冠伶(Kuan-Ling Chen)

指導教授 ： 吳進欽

高雄醫學大學/人文社會科學院/心理學系碩士班/碩士(2020年)

摘要

研究背景與目的：自閉症類群障礙症(autism spectrum disorder, ASD)幼兒行為問題與母親親職壓力及憂鬱具顯著相關。然而，過去很少研究探究ASD母親因應策略與親職壓力及憂鬱的關係，及探討因應策略在幼兒行為問題與母親心理健康的作用。因此，本研究檢驗ASD幼兒母親的因應策略在幼兒行為問題與親職壓力及憂鬱的中介效果。
方法：參與者為128位年齡為18-63個月大的ASD幼兒與其母親，母親自填親職壓力量表、貝克憂鬱量表及簡明因應量表，以評估自身的親職壓力、憂鬱及因應策略；填寫1.5-5歲兒童期行為檢核表評估ASD幼兒的內化、外化，及整體行為問題。
結果: 探索性因素分析萃取出三種因應策略：問題焦點因應、迴避因應，及分心因應。問題焦點因應與親職壓力及憂鬱負相關，迴避因應與親職壓力及憂鬱正相關。此外，問題焦點因應在ASD幼兒外化行為問題與母親親職壓力及憂鬱間具有中介效果。
結論: 本研究發現ASD幼兒母親採用問題焦點因應可以減緩幼兒行為問題對母親親職壓力及憂鬱的負面影響。本研究結果提供ASD幼兒早期療育及家庭服務的參考。

關鍵字

自閉症類群障礙症 ； 行為問題 ； 因應策略 ； 憂鬱 ； 親職壓力

並列摘要

Background and purpose: Previous studies found that child behavior problems were associated with parenting stress and depressive symptoms in mothers of children with autism spectrum disorder (ASD). However, few studies examined the relationships between coping strategies, parenting stress and mental health in mothers of young children with ASD and mediations of coping strategies between child behavior problems and parenting stress and mental health. This study investigated the mediations of coping strategies in the relationships between child behavior problems, parenting stress and depressive symptoms in mothers of children with ASD.
Methods: There are 128 mothers of children with ASD (18-63 months of age). The Parenting Stress Index, Beck Depression Inventory-Ⅱ, and Brief Coping Orientations to Problems Experienced Scale were used to measure parenting stress, depressive symptoms and coping strategies in mothers of children with ASD, respectively. In addition, Child Behavior Checklist 1.5-5 was used to assess internalizing, externalizing, and overall behavior problems of children with ASD.
Results: Exploratory factor analysis identified three coping categories: problem-focused coping, avoidance coping, and distraction coping. The results revealed that using problem-focused coping correlated with decreased parenting stress and depressive symptoms, whereas using avoidance coping associated with increased parenting stress and depressive symptoms. In addition, problem-focused coping mediated the association between externalizing behavior problems and parenting stress and depressive symptoms.
Conclusion: Using problem-focused coping could ease the impact of child behavior problems on parenting stress and depressive symptoms among mothers of children with ASD. Clinical implications for this study are discussed.

並列關鍵字

autism spectrum disorder ； behavior problems ； coping ； depressive symptoms ； parenting stress

參考文獻

Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173-1182.

Abidin, R. R. (1990). Parenting stress index, 3rd ed. Charlottesville, VA: Pediatric Psychology Press.

Achenbach, T. M., & Rescorla, L. A. (2000). Manual for the ASEBA pre-school forms and profiles: An integrated system of multi-informant assessment. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families.

American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders, 4th ed. revised. Washington, DC: American Psychiatric Association.

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders, 5th ed. Washington, DC: American Psychiatric Association.