Impact of Comorbidity on Parenting Stress and Parental Symptoms in Children with Attention Deficit-Hyperactivity Disorder

注意力缺陷過動症兒童之共病現象對父母的影響

臧汝芬(Ruu-Fen Tzang) ； 張玉坤(Yue-Cune Chang,) ； 劉珣瑛(Shen-Ing Liu) ； 吳光顯(Kwang-Hsieng Wu)

《台灣精神醫學》 21卷3期 (2007/09) Pp. 196-207

https://doi.org/10.29478/TJP.200709.0006

摘要

目的：本研究是探討過動兒的共病現象對過動兒、父母因素、親職壓力與症狀之影響，過動兒因素包括年齡、性別、次分類、共病現象、成績、人際關係、與家族遺傳疾病史；父母因素包括父、母年齡、社經地位、總壓力分數、父母特質壓力分數、父母情境壓力分數、父母生活壓力。方法：針對台北市某一醫學中心兒童心智科門診，診斷為過動兒之109個案，以Mini Kid會談手冊，作次分類與共病現象區分，由父母完成親職壓力量表、身心問題量表。結果：混合型過動兒合併共病現象時，過動兒有成績低落、人際關係差，共病現象使父母有親職壓力與身心症狀，焦慮症狀與外界環境限制的親職壓力，在過動兒合併共病組比無合併共病組為高。結論：共病現象對兒童本身、親職壓力與父母焦慮症狀有影響，呼籲介入過動兒的醫學模式（藥物治療加行為制約），來加強有共病現象過動兒父母的親職能力。

關鍵字

注意力缺陷過動症 ； 共病現象 ； 親職壓力 ； 身心症狀

並列摘要

Objectives: The aim of our study was to clarify the impact of comorbidity on understanding attention deficit-hyperactivity disorder (ADHD) risk factors (age, sex, subtypes, school performance, interpersonal relationships, and family hereditary) for children, parental risk factors (age of parents, socioeconomic status), and comorbidity impact on parental stress and symptoms among parents of children with ADHD. Methods: We consequently interviewed 109 children with ADHD and their parents using theMINI Kid to differentiate between children with ADHD, with and without comorbidity. Parental stress was measured using the parental stress index and the parental symptom scale (Symptom Check List, SCL-90). Results: Children with ADHD belonging to the combined subtype showed poor school performance and had poor interpersonal relationships. Comorbidity (concomitant disease) had an impact on ADHD risk factors, parental stress and symptoms. Parental anxiety symptoms of ADHD with comorbidity were more severe and parents felt more stressed about controllable environmental factors than parents of children with ADHD without comorbidity. Conclusion: Comorbidity had impacts on the children themselves, parental stress, and anxiety symptoms.We encourage the use of the ADHD medical modal (psychopharmacology and behaviormodification) to enhance parenting ability of ADHDchildren with comorbidity.

並列關鍵字

ADHD ； comorbidity ； parental stress and symptoms

參考文獻

Abidin RR,Wilfong E(1989).Parenting stress and its relationship to child health care.Child Health Care.18,114-116.

Anastopoulos AD,Guevremont DC,Shelton TL(1992).Parenting stress among families of children with attention deficit hyperactivity disorder.Journal of Abnorm Child Psychol.20,503-520.

Biederman J,Faraone SV,Keenan K(1992).Further evidence for family-genetic risk factors in attention deficit hyperactivity disorder. Patterns of comorbidity in probands and relatives psychiatrically and pediatrically referred samples.Arch Gen Psychiatry.49,728-738.

Brown RT,Borden KA,Clingerman SR(1988).Depression in attention deficit-disordered and normal children and their parents.Child Psychiatry Hum Dev.18,119-132.

Bussing R,Gary FA,Mason DM(2003).Child temperament, ADHD, and caregiver strain: exploring relationships in an epidemiological sample.J Am Acad Child Adolesc Psychiatry.42,184-192.