完整認知行為治療對注意力缺失過動疾患兒童的療效：以症狀量表評估

Effectiveness of Comprehensive Cognitive-Behavioral Therapy for Attention Deficit/Hyperactivity Disorder Children:Using Syndrome Scales as Evaluation Tools

蔡曉薇(Hsiao-Wei Tsai)

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.2009.00048

摘要

注意力缺失過動疾患(ADHD)為臨床上常見之兒童疾患，本研究分析完整認知行為治療(CCBT)之療效，加入結合治療與門診治療作討論，探討各項治療的變化趨勢、不同治療的效果，以及臨床上的應用與效益。
研究對象為國小二年級至五年級兒童，依治療情況分為兒童與家長參與CCBT團體(心理治療組)，固定在門診追蹤、拿藥之個案(門診組)，以及同時參與CCBT團體與門診拿藥(結合組)，三組均追蹤半年，以干擾性行為量表-家長版(DBRS-PF)、兒童注意力問題量表(CAP)、家庭情境問卷(HSQ)評估治療成效。
研究結果發現，結合組有最多治療前後的差異，分別在DBRS-PF注意力、過動-衝動、對立反抗行為指標、CAP過動指標，以及HSQ平均嚴重度與總分指標中有顯著差異(p<.05)，並呈現出持續改善的傾向；心理治療組在DBRS-PF注意力指標與CAP過動指標中治療前後有顯著差異(p<.05)，並於對立反抗行為指標中有持續改善的傾向；門診組各項指標前後均無顯著差異，呈現穩定之狀況。顯現CCBT與藥物之結合能達到臨床上之最大效益，進一步支持CCBT團體之療效。

關鍵字

注意力缺失過動疾患 ； 學齡期兒童 ； 認知行為治療

並列摘要

Attention Deficit/Hyperactivity Disorder (ADHD) is a common clinical children’s disorder, this study analyzed the effectiveness of the Comprehensive Cognitive-Behavioral Therapy (CCBT) with the additional discussion of combined therapy and outpatient therapy to investigate the change in trend, the effectiveness of different therapies, and the application and benefit of clinical use.
Participants were children from grades two to five, depending on the therapy condition, children and parents were in the CCBT (psychotherapy group), routine outpatient clinic follow-up and medication use (outpatient group) or in both CCBT and outpatient clinic medication use (combined group), all three groups were followed up for half a year; The Disruptive Behavior Rating Scale -Parent Form (DBRS-PF), Child Attention Profile (CAP) and Home Situation Questionnaire (HSQ) were used to evaluate therapy effectiveness.
Study results found that the combination group had the greatest pre and post-test differences in the DBRS-PF inattention index, hyperactivity/impulsivity index, oppositional-defiant behavior index, CAP hyperactivity index, and HSQ average behavioral severity and total score of problem situations to the home setting had significant differences (p<.05), and showed a tendency for persistent improvement; Psychotherapy group had pre and post significant differences in the DBRS-PF inattention index , CAP hyperactivity index (p<.05), and oppositional-defiant behavior index had a tendency of persistent improvement; outpatient group did not show any pre and post-test significant differences in any of the indexes, showing a stabilized condition. The results illustrated that the combination of CCBT and medication can achieve maximum clinical benefits, further supporting the effectiveness of CCBT groups.

並列關鍵字

Attention Deficit/Hyperactivity Disorder ； school age children, ； cognitive-behavioral therapy ； group therapy

參考文獻

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