行為取向的父母訓練團體對學齡前注意力缺失過動疾患幼兒之療效

The Treatment Efficacy of Behavioral Parent Training Group for Preschoolers with Attention Deficit/Hyperactivity Disorder

高宗仁(Tsung-Jen Kao)

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

注意力缺失過動症(簡稱ADHD)為兒童期常見的神經發展疾患。本研究目的為探討行為取向的父母訓練團體(Behavioral Parent Training , 簡稱BPT)對學齡前注意力缺失過動症幼兒的療效。本研究將聚焦於核心症狀、整體情緒與行為問題及管教之困擾程度等三領域進行療效評估。
本研究之對象為由兒童精神科醫師轉介之31位診斷為ADHD的三到六歲學齡前幼兒，分派至BPT組(由母親參與團體課程, n=22) 及對照組(n=9)。本研究使用：(1) 干擾行為量表(Disruptive Behavior Rating Scale, DBRS)；(2) 兒童注意力量表(Child Attention Profile, CAP)；(3) 兒童行為檢核表 (Child Behavior Check List, CBCL)；(4) 家庭情境問卷 (Home Situation Questionaire, HSQ)作為評估工具。BPT組於介入前後由母親填寫量表，對照組則以相同間隔時距接受評估。
本研究使用重複抽樣統計法各別分析兩組評估指標於前、後測之差異。結果顯示BPT組在以下指標的後測分數皆顯著低於前測：DBRS的注意力缺失、過動--衝動、對立反抗指標；CAP的注意力缺失、過動指標、總分指標；CBCL的焦慮/憂鬱、退縮/憂鬱、違規行為、攻擊行為、社交問題、思考問題、注意力問題、內化問題、外化問題與總問題等症狀量尺及情感性問題、焦慮問題、身體化問題、注意力過動問題、對立性反抗問題及品行問題等DSM導向量尺；HSQ的平均困擾程度。對照組僅於情感性問題指標達顯著差異。透過本研究結果支持BPT對於學齡前ADHD之療效。

關鍵字

學齡前注意力缺失過動症 ； 行為取向父母訓練團體 ； 療效評估

並列摘要

Attention Deficit / Hyperactivity Disorder (ADHD) is a prevalent childhood neuro-developemntal disorder. The objective of this study was to investigate the efficacy of the Behavioral Parent Training (BPT) group on preschool-aged children with ADHD. The efficacy evaluation in study focused on three domains of core symptoms, overall emotional and behavioral problems, and the level of discipline problems.
The subjects were 31 three to six year-old children diagnosed with ADHD by child psychiatrists assigned to the BPT group (mothers attended the group treatment, n =22) or the control group (n=9). This study used the Disruptive Behavior Rating Scale (DBRS), the Child Attention Profile (CAP), the Child Behavior Check List (CBCL), and the Home Situation Questionnaire (HSQ) as evaluation tools. Mothers in the BPT group filled out the questionnaires before and after the treatments, and the control group was evaluated with the same time interval.
This study used resampling statistical method to individually analyze the pre and post differences in the evaluated indices. The results showed the BPT group had significantly lower pre-test scores compared to the post-test scores in the following indices: the inattention, hyperactivity/impulsivity and oppositional-defiant behavior indices of the DBRS; the inattention, hyperactivity/impulsivity and total indices of the CAP; the affective problem, anxiety problem, attention deficit/hyperactivity problem, and oppositional defiant problem of the Diagnostic and Statistical Manual (DSM) orient scale; the anxiety-depression, withdrawal-depression, social problem, thought problem, attention problem, aggressive behavior, internal problem, external problem, and total problem of symptom scales in the CBCL; and the average behavioral severity of the HSQ. There was only pre-post significance in the affective problem scale of the CBCL in the control group. Therefore, the result of this study supported that the BPT program is effective for preschoolers with ADHD.

並列關鍵字

Preschool ADHD ； Behavioral Parent Training ； Efficacy Evaluation

參考文獻

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