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目的从心理控制源的角度探讨父母教育对伴或不伴对立违抗障碍(ODD)的注意缺陷多动障碍(ADHD)患儿的影响。方法对湖南省长沙、益阳、娄底、郴州、永州、怀化6个城市5～17岁中小学生采用分层、随机、整群的抽样方法进行抽样调查,共抽样9495例儿童。采用二阶段流行病学调查方法。第一阶段筛查,即由调查儿童的父母、教师或抚养者填写儿童精神障碍调查筛查表(自编),凡父母或教师所填的症状筛查表有一条为“是”或ADHD、ODD诊断量表中任一个达到该疾病的诊断条目数者为筛查阳性;第二阶段为临床诊断,调查者对筛查阳性的中小学生用半定式诊断检查表和《美国精神疾病诊断与统计手册》4版进行临床诊断。确定单纯ADHD组247例,ADHD加ODD组138例,健康对照组217例。凡符合诊断标准的ADHD儿童和随机抽取的健康对照组儿童由父母填写一般情况调查表和子女教育心理控制源量表(PLOC)。结果1.健康对照组与单纯ADHD组比较,母亲教育方式和父母教养态度比较差异均具有统计学意义(Pa<0.01)。健康对照组与ADHD加ODD组比较,父母亲教育方式和父母教养态度,差异均具有统计学意义(Pa<0.01)。2.单纯ADHD组与健康对照组比较,教育成效与子女对父母生活的控制因子评分较高,而父母对命运或机遇信念因子评分较低,差异均具有统计学意义(Pa<0.05)。3.ADHD加ODD组与健康对照组比较,教育成效因子评分与父母对子女行为的控制因子评分较高,差异均具有统计学意义(Pa<0.01)。4.单纯ADHD组与ADHD加ODD组比较,父母对子女行为的控制因子评分较低,差异具有统计学意义(P<0.01)。结论父母负性心理控制源与伴或不伴ODD的ADHD患儿的不良行为发生、发展有一定联系,应改变父母对孩子教育认知的偏差。
Objective To explore the impact of parental education on children with Attention Deficit Hyperactivity Disorder (ADHD) with or without contradictory defensive disorder (ODD) from the perspective of psychological control. Methods A total of 9,495 children were enrolled in this study by stratified, randomized and cluster sampling method for primary and secondary school students aged from 5 to 17 in Changsha, Yiyang, Loudi, Chenzhou, Yongzhou and Huaihua in Hunan Province. A two-stage epidemiological survey method was used. The first phase of screening, that is, by the investigation of children’s parents, teachers or caregivers to fill in the child mental disorder survey (self), parents or teachers fill in the symptoms of the screening table for a “yes” or ADHD, ODD diagnostic scale in any one to reach the number of diagnostic items of the disease positive screening; the second phase of clinical diagnosis, the survey positive screening of children with semi-defined diagnostic checklist and the "diagnosis of mental illness in the United States And Statistics Manual 4 for clinical diagnosis. 247 cases of simple ADHD group, 138 cases of ADHD plus ODD group and 217 cases of healthy control group were determined. Children with ADHD who meet the diagnostic criteria and children who were randomly selected from the control group were asked to complete a general situation questionnaire and a parental PLEC scale from their parents. Results 1. Compared with the ADHD group, the difference between the mother’s education mode and parental rearing attitude was statistically significant (Pa <0.01). Compared with ADHD plus ODD group, the difference between parental education and parental rearing attitude in healthy control group was statistically significant (Pa <0.01). Compared with the healthy control group, the education effectiveness and the control factor score of children on parental life were higher than those of the healthy control group, but the parents had lower scores on the fate or chance and belief factor (P <0.05). ADHD plus ODD group compared with healthy control group, educational effectiveness factor score and parental behavior control factor score higher, the differences were statistically significant (Pa <0.01). Compared with ADHD plus ODD group, parents had a lower score of control factor on children’s behavior, the difference was statistically significant (P <0.01). Conclusion There is a certain relationship between negative control of parental control source and the occurrence and development of ADHD children with or without ODD, which should change the deviation of parents’ cognition of children’s education.