共患对立违抗性障碍的注意缺陷多动障碍儿童的认知特点研究

目的:探讨共患对立违抗性障碍(ODD)的注意缺陷多动障碍(ADHD)儿童的认知功能特点.方法:以单纯ADHD ODD、单纯ADHD和正常儿童各36例(性别、年龄与ADHD亚型组间匹配)为研究对象,采用龚耀先修订的韦氏儿童智力量表、韦氏记忆量表、数字划消、Stroop测验和瑞文标准推理测验对其智力、记忆力、注意力水平及执行功能进行评定.结果:两病例组的常识、类同、译码、言语智商、操作智商、全量表智商、A因子、C因子、经历定向、心智、再生、触觉、长时记忆、短时记忆、记忆商、瑞文标准推理测验标准分、Stroop测验A完成时间、C完成时间和总完成时间的测验成绩与正常对照组的差异具有显著性,两病例组间差异无显著性;正常组数字划消测验总分有显著高于两病例组(F＝2.521,P＝0.093)及平均失误率显著低于两病例组的趋势(χ2＝5.150,P＝0.076);ADHD组和正常对照组在算术、数字广度、积木、B因子、Stroop测验B完成时间和D完成时间上的差异具有显著性;ADHD ODD组的瑞文标准推理测验标准分有优于ADHD组的趋势(Z=-1.674,P=0.094).结论:伴或不伴ODD的ADHD儿童有着相似的认知模式,如扩大样本量,可能发现共患病组在某些认知功能上与纯ADHD组的差异.     

伴ADHD的对立违抗性障碍儿童行为特征分析

目的：了解伴注意缺陷／多动障碍(ADHD)的对立违抗性障碍(0DD)患儿的行为特征。方法：以ICD-10作为诊断标准对门诊就诊儿童进行诊断，得到ODD伴ADHD者40例(64.52％)．ODD不伴ADHD者22例(35．48％)。自编家庭情况调查表调查患儿的基本情况。用家长填Achenbach儿章行为量表评定儿童行为。结果：与ODD组相比。合并ADHD组的家长更多对患儿经常打骂和严厉管教：对儿童的不良行为更多地采取打骂的方式。合并组父亲急燥易怒者比ODD组多；合并组起病年龄及就诊年龄比ODD组早：合并组在CBCI。思维、注意问题，违纪、攻击行为，外化性问题，行为总分均高于ODD组。结论：ODD合并ADHD的患儿在思维、注意问题，违纪、攻击行为，外化性问题方面表现更突出，家长对儿童管教方式及不良行为处理方式影响ODD的发生。提示要注重ODD、ADHD的早期干预。     

对立违抗性障碍的行为特征及相关因素

目的：了解对立违抗性障碍(Oppositional Defiant Disorder,ODD)的行为特征及发病的相关因素。方法：对47例0DD患者的自尊调查量表(SEI)、Piers—Harris儿童自我意识量表(CSCS)、Conners父母问卷调查表(PSQ)及子女教育心理控制源量表(PL0C)结果进行相关分析。结果：儿童自我评价与父母对儿童的评价基本一致。Conners父母问卷、儿童自我意识量表分别与自尊调查量表和子女控制源量表存在不同程度相关性。结论：0DD儿童对立违抗情绪和行为的产生，孤僻、不合群、自尊心受挫明显及自我评价低的表现与父母不适当的教育方式有关。     

伴与不伴对立违抗性障碍的ADHD儿童行为特征分析

目的 :了解伴与不伴对立违抗性障碍 (ODD)的注意缺陷 /多动障碍 (ADHD)行为特征。方法 :对门诊就诊儿童以ICD - 10中ADHD和ODD诊断标准进行诊断 ,得到ADHD伴ODD者 78例 (占总数中 6 7.2 4 % ) ,ADHD不伴ODD者 38例 (占总数中 32 .76 % )。采用自行编制的家庭情况调查表 ,调查每一患儿情况。采用家长填Achenbach儿童行为量表 ,评定儿童行为。结果 :合并组家长对儿童不良行为处理方式 ,如经常打骂比ADHD组多 ;合并组社交、思维、注意、违纪问题 ,攻击行为 ,外化性问题 ,行为总分均高于ADHD组。结论 :ADHD合并ODD的发生率较高。ADHD合并ODD比单纯ADHD在社交、思维、注意、违纪、攻击行为方面有更广泛的损害 ,应引起重视。     

精神分裂症患者子女对立违抗性障碍的问题及研究

目的　了解我市精神分裂症患者子女罹患对立违抗性障碍 ( ODD)的现状和临床特征。方法　采用自编儿童行为学习调查表、Achenbach儿童行为调查表 ( CBCL)、韦氏儿童智力量表 ( C-WISC)。于 2 0 0 1年 1～ 1 2月对我市精神分裂症患者子女在小学上学 (其中实际有效人数 1 2 4人 )的 1 7例 ODD儿童 (研究组 )和 1 7名非 ODD儿童 (对照组 )进行对比分析。结果　 1 ODD的发生率在 1 2 4人中符合 ODD1 7例 ( 1 3 .71 % ) ,其中男 1 5 .49% ( 1 1 /71 ) ,女 1 1 .3 2 % ( 6/5 3 ) ,发生率超过 5 0 %的症状有经常发脾气、常与大人争吵、常发怒或怨恨他人、常发火或者被旁人烦扰、经常故意的烦扰他人。 2各量表评分 ,CBCL平均得分 ,研究组大于对照组 ( t=6.66,P<0 .0 1 ) ,C-WISC各项值中 So、D、BD、PA4项研究组低于对照组并有显著的差异性 ( P<0 .0 5 ) ,3 ODD合并学习障碍为 5 2 .9% ( 9/1 7) ,与对照组 1 7.6% ( 3 /1 7)比较差异性非常显著 ( χ2 =4.63 ,P<0 .0 5 )。结论　在精神分裂症患者子女中存有 ODD,这些患儿 ODD症状形式为敌对、消极与对抗主动性方面 ,ODD患儿伴有学习障碍 ,在注意力、记忆等基本认知功能方面比正常儿童受损     

中学生对立违抗性障碍的父母养育方式和家庭环境特征的初步研究

目的：了解单纯对立违抗性障碍（ODD）儿童的父母养育方式及家庭功能。方法：应用向制儿童行为调查表、家庭环境量表中文版（FES～CV）、父母养育方式量表（EMBU），对115例单纯ODD儿童（研究组）和115名非ODD正常儿童（对照组）进行评定和病例对照分析，结果：ODD组儿童家庭矛盾性得分较对照组高（P〈0．01），ODD组父母双亲的“情感温暖．理解”得分均明显比对照组得分低（父亲P〈0．01，母亲P〈0.05）．而其“惩罚，严厉”和“拒绝，否认”二因子得分则明显比对照组高（P〈0．01）；ODD组母亲的“过分干涉，过度保护”，因子得分也明显高于对照组（P〈0．01）。结论：ODD中学生的家庭存在高度的矛盾性．他们的父母养育方式不良，应引起重视。     

伴与不伴对立违抗性障碍的注意缺陷多动障碍儿童自我意识分析

目的:探讨注意缺陷多动障碍(ADHD)儿童伴对立违抗性障碍(ODD)的自我意识特点。方法:对湖南省六个地区进行抽样调查,共抽样9495名儿童。用二阶段流行病学调查方法后,凡符合诊断标准的儿童填写儿童自我意识量表(Children's self-concept Scale,CSCS),其中最后CSCS资料齐全者425人(对照组146人,单纯ADHD 170人,AD-HD伴ODD 109人)。结果:单纯ADHD组及ADHD合并ODD组在量表总分方面明显低于对照组(P<0.01),主要表现在行为因子、智力因子、焦虑因子、合群因子、幸福因子方面;在躯体因子这一项目上单纯ADHD组及ADHD合并ODD组得分也低于对照组(P<0.05)。ADHD合并ODD组在量表总分上要明显低于单纯ADHD组,表现在行为因子、智力因子、焦虑因子、合群因子、幸福因子方面;在躯体因子这一项目上ADHD合并ODD组得分要高于单纯ADHD组。结论:伴或不伴ODD的ADHD患儿的自我意识都明显比正常儿童差,而伴ODD的ADHD患儿自我意识又要明显比不伴ODD的ADHD患儿差。     

对立违抗性障碍中学生的情绪特征

对立违抗性障碍(Oppositional defi-ant disorder,ODD)是一类以持久的违抗、敌意、对立、挑衅和破坏行为为基本特征的行为障碍。本研究对ODD的情绪特征进行初步探讨。1对象与方法1.1对象2004年11~12月在长沙市某中学筛查初一至高二年级2418名学生,依据DSM-Ⅳ中的ODD诊断标准为筛查标准制成筛查调查表,由其父母和班主任老师分别填写筛查表,以了解学生在不同场合的行为表现。教师卷全部收回,家长卷收到有效问卷2247份,回收率92.9%。凡符合ODD8条症状学诊断标准中至少4条,且症状持续6个月及以上者,为筛查阳性(共计228人,筛查阳性率为9.4…     

对立违抗性障碍儿童的父母养育方式、子女教育心理控制源及家庭功能特点

目的:了解具有对立违抗性障碍(oppositional defiant disorder,ODD)儿童父母养育方式、子女教育心理控制源及家庭功能的特点。方法:对来自湖南省中小学生精神障碍流行病学调查研究中的全部对象进行DSM-IV诊断,其中符合ODD诊断标准的对象225人及对照组225人由父母填写子女教育心理控制源量表,儿童自己填写父母养育方式评价量表、家庭亲密度和适应性量表中文版。结果:ODD组在父、母亲惩罚、干涉、偏爱、拒绝及父亲过度保护等方面得分显著高于对照组(P<0.05);同时在教育成效、子女对父母生活的控制、父母对子女行为控制方面得分显著高于对照组(P<0.01)。而ODD组家庭实际亲密度、实际适应性和理想适应性得分显著低于对照组(P<0.05)。结论:ODD患者的父母存在不良的养育方式,心理控制源外控性较强,家庭亲密度低、适应性差。     

宁夏农村地区神经症性障碍危险因素的病例对照研究

目的:分析宁夏地区成人神经症性障碍的危险因素,特别是探讨民族、宗教信仰等因素与神经症性障碍的关系,为少数民族地区修订神经症性障碍的防治措施提供参考.方法:采用概率比例规模抽样方法,在宁夏农村地区随机抽取18岁及以上居民3269人,采用复合型国际诊断交谈表-计算机辅助中文版入户进行精神障碍的访谈,以近一年满足任一国际疾病和相关健康问题分类第十版(ICD-10)神经症性障碍诊断标准的研究对象为病例组,选择有生以来未满足任一精神障碍诊断标准的人群为对照组,危险因素分析采用非条件logistic逐步回归模型.结果:病例组283例,对照组1064例,均为农民.单因素分析结果显示:神经症性障碍组与对照组相比回族、女性、文盲、年龄大于40岁、有伊斯兰教信仰以及移民人群的比例较高(均P ＜0.05).Logistic回归分析结果显示,女性(OR=1.78)、回族(OR=1.65)、年龄＞40岁(OR=1.65)、移民(OR=1.49)、信仰伊斯兰教(OR=1.37)者患神经症性障碍的比率较高.结论:女性、回族、移民、较高年龄和有回教信仰可能是宁夏农村地区人群神经症性障碍的危险因素.     

Testing Multiple Conceptualizations of Oppositional Defiant Disorder in Youth

Recent theories conceptualize oppositional defiant disorder (ODD) as a two-dimensional construct with angry/irritable (i.e., affective) and argumentative/defiant (i.e., behavioral) components. This view has been supported by studies of nonreferred youth but not yet examined in clinic-referred youth. In a reanalysis of data regarding children who received one of two psychosocial ODD treatments, we examined multiple conceptualizations of ODD, whether children showed improvements across these ODD dimensions, and whether main and joint effects of ODD dimension improvement predicted clinical outcome. One hundred thirty-four clinic-referred youth (ages 7–14 years, 38% female, 84% White) who met Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for ODD received 1 of 2 psychosocial treatments. At pretreatment, 1-week follow-up, and 6-month follow-up, mothers reported child aggression and conduct problems, clinicians reported global clinical impairment and clinical improvement, and ODD symptom counts were collected from a semistructured diagnostic interview with mothers. Baseline ODD symptom were used to test previously supported multidimensional models. One- and two-factor conceptualizations were supported; however, the two-factor solution was preferred. With this solution, each dimension significantly and similarly improved across treatment conditions. Improvements across affective and behavioral ODD factors also had significant effects on clinician- and mother-reported clinical outcomes. The current findings provide empirical support for the ongoing study of multidimensional ODD conceptualizations in clinic-referred youth.     

Oppositional Defiant Disorder and Conduct Disorder in Boys: Patterns of Behavioral Covariation

Studied patterns of covariation among symptoms of conduct problems in an outpatient clinic sample of 177 boys. These patterns were examined in relation to criteria for oppositional defiant disorder (ODD) and conduct disorder (CD), according to the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSMIll-R]; American Psychiatric Association, 1987). Factor analysis of parent and teacher responses to a structured psychiatric interview revealed two dimensions of conduct problems similar to the distinction between ODD and CD. However, some symptoms often associated with CD (bullying and violation of major rules) consistently loaded uniquely on the factor composed of ODD symptoms, and the DSMIII-R symptoms of fighting and lying had approximately equal loadings on both factors. Cluster analysis of scores derived from summing items with unique loadings on the ODD and CD factors yielded three profiles: deviance on only the ODD factor, deviance on both the ODD and CD factors, and deviance on neither factor. A distinct cluster of children with elevations only on the CD factor did not emerge.     

Age 4 Predictors of Oppositional Defiant Disorder in Early Grammar School

Our ability to predict which children will exhibit oppositional defiant disorder (ODD) at the time of entry into grammar school at age 6 lags behind our understanding of the risk factors for ODD. This study examined how well a set of multidomain risk factors for ODD assessed in 4-year-old children predicted age 6 ODD diagnostic status. Participants were a diverse sample of 796 4-year-old children (391 boys).The sample was 54% White, non-Hispanic; 16.8% African American, 20.4% Hispanic; 2.4% Asian; and 4.4% Other or mixed race. The classification accuracy of two models of multidomain risk factors, using either a measure of overall ODD symptoms or dimensions of ODD obtained at age 4, were compared to one another, to chance, and to a parsimonious model based solely on parent-reported ODD using Automated Classification Tree Analysis. Effect Strength for Sensitivity (ESS), a measure of classification accuracy, indicated a multidomain model including a general measure of ODD symptoms at age 4 yielded a large effect (56.29%), a 13.7% increase over the ESS for the parsimonious model (ESS = 42.9%). The ESS (51.23%) for a model including two ODD dimensions (behavior and negative affect) was smaller than that for the model including a measure of overall ODD symptoms. The Classification Tree Analysis approach showed a small but distinct advantage that would be useful in screening for which children would most likely meet criteria for age 6 ODD.