注意缺陷多动障碍儿童共患对立违抗性障碍与父母养育方式的相关性

Association between oppositional defiant disorder and parenting style in children with attention deficit hyperactivity disorder

摘要:

目的 探讨注意缺陷多动障碍（attention deficit hyperactivity disorder，ADHD）儿童共患对立违抗性障碍（oppositional defiant disorder，ODD）与父母养育方式的相关关系。 方法 采用病例对照研究方法纳入482例ADHD儿童作为研究对象，其中未共患ODD（单纯ADHD组）322例，ADHD共患ODD（ADHD共患ODD组）160例，收集两组患儿一般人口学资料和父母养育方式量表评估得分情况。采用多因素logistic回归分析法探究父母养育方式与ADHD患儿共患ODD的关系。 结果 单纯ADHD组和ADHD共患ODD组父母养育方式得分（含拒绝因子、情感温暖因子、过度保护因子和偏爱因子）和一般人口学资料差异均无统计学意义（P>0.05）。在ADHD注意缺陷型患儿中，患儿年龄越大，父亲文化程度越低，共患ODD风险越大（P<0.05），而父母养育方式与共患ODD无显著关联（P>0.05）。 结论 ADHD患儿是否共患ODD与父母养育方式无明显相关性，临床工作中，应减少对ADHD共患ODD患儿父母都有养育方式不良的刻板印象，从多角度寻找共患ODD的原因，以提供合理的干预建议。

Abstract:

Objective To study the association between oppositional defiant disorder (ODD) and parenting style in children with attention deficit hyperactivity disorder (ADHD). Methods A case-control study was performed on 482 children with ADHD, among whom 322 did not have ODD (simple ADHD group) and 160 had ODD (ADHD+ODD group). General demographic data and the Parenting Style Scale assessment scores were collected from the two groups. A multivariate logistic regression analysis was used to identify the association between parenting style and ODD in children with ADHD. Results There was no significant difference in parenting style scores (including rejection factor, emotional warmth factor, overprotection factor, and preference factor) and general demographic data between the simple ADHD and ADHD+ODD groups (P>0.05). Among the children with the predominantly inattentive type of ADHD, the older the child or the lower the father's educational level, the higher the risk of ODD (P<0.05), while there was no significant association between parenting style and the development of ODD (P>0.05). Conclusions Parenting style is not significantly associated with the development of ODD in children with ADHD. In clinical practice, it is necessary to eliminate the stereotype that the parents of children with ADHD and comorbid ODD have a poor parenting style and look for the causes of development of ODD from multiple perspectives, so as to provide reasonable intervention recommendations.