伴隨與未伴隨品行問題之ADHD兒童的反社會型態比較

注意力缺失／過動疾患（Attention Deficit Hyperactivity Disorder，簡稱ADHD）與伴隨品行問題（conduct problems，簡稱CP）之ADHD兒童的外顯行為相似，皆會出現攻擊、違抗等反社會行為，因此鑑別診斷經常面臨相當大的困難。是故，本研究之目的即為探究ADHD及ADHD/CP共發兒童於反社會型態中的區辨性特徵，以期提供臨床實務另一鑑別診斷之參考。回顧ADHD與ADHD/CP共發的反社會行為之相關文獻後，本研究採「攻擊」、「道德感」及「對動物殘忍」三特質作為ADHD與ADHD/CP共發兒童的區辨特徵。本研究於北部地區招募25位ADHD-only組國小兒童（平均年齡8.82歲），22位ADHD+CP組國小兒童（平均年齡8.88歲），採用投射測驗「Tell-Me-A-Story」評估受試者之攻擊與道德感特質，及「兒童與動物量表(Children and Animals Inventory)」瞭解受試者對動物殘忍行為之訊息。研究結果顯示，ADHD-only組與ADHD+CP組兩組兒童之攻擊特質、道德感、對動物殘忍行為皆達顯著差異，證實此三項特質可作為伴隨與未伴隨CP之ADHD兒童的重要區辨特徵；此結果亦隱含在攻擊兒童群體中，ADHD+CP兒童之心理病理發展可能為一獨立、特殊之建構。未來研究建議增加受試人數和組別，並進一步探究反社會型態之核心區辨特徵。

關鍵字

攻擊；注意力缺失／過動疾患；品行問題；道德感；對動物殘忍

並列摘要

The observed behaviors in Attention Deficit Hyperactivity Disorder (ADHD) and ADHD with conduct problems (CP) are rather similar. Both of them present antisocial behaviors such as aggression and disobedience. Therefore it's difficult to make discriminate diagnoses among children with aggressive behaviors. The purpose of this study was to examine the differences of antisocial patterns between ADHD children with/without CP. After reviewing related researches, three traits had been selected in this study: aggression, morality and cruelty to animals. The subjects were recruited from hospitals and special education system of elementary schools in metropolitan Taipei area. Twenty-five children (mean age=8.82) were included in ADHD-only group and twenty-two children (mean age=8.88) were included in ADHD+CP group. All the subjects were given a projective test ”Tell Me A Story” to assess aggression and morality, and the ”Children and Animals Inventory” was administered to assess the subjects' behaviors of cruelty to animals. The results of the present study revealed that ADHD-only group and ADHD+CP group showed significant differences in aggression (p＜.05), morality (p＜.001), and cruelty to animals (p＜.01). This study proved that ”aggression”, ”morality”, and ”cruelty to animals” are good discriminating indicators for ADHD children with/without CP. These findings also bear potentially important implications for the distinctive psychological etiology of the ADHD children with conduct problems. Limitations are discussed and recommendations are made for future research.

並列關鍵字

aggression ； Attention Deficit Hyperactivity Disorder ； conduct problems ； cruelty to animals ； morality

參考文獻

林美珠、劉秋木(2004)。兒童在Tel1-Me-A-Story上所呈現的人格側影之初探。中國測驗學會測驗學刊。51(2)，249-284。

Anchor, K. N.,Cross, H. J.(1974).Maladaptive aggression, moral perspective, and the socialization process.Journal of Personality and Social Psychology.30(1),163-168.