孤独症谱系障碍儿童情绪行为问题与其母亲焦虑状况关联分析

目的 比较孤独症谱系障碍(ASD)儿童与典型发育(TD)儿童母亲的焦虑状况,探索ASD儿童情绪行为问题与其母亲焦虑水平间的关系。方法 通过临床诊断招募55名6~12岁智商≥70的ASD儿童及74名TD儿童,采用状态-特质焦虑问卷(STAI)评估入组儿童母亲的焦虑情况,采用长处与困难问卷(SDQ)评估两组儿童情绪行为问题及表现。结果 ASD儿童组母亲状态焦虑得分与特质焦虑得分高于TD组母亲(t=5.272、4.484、P<0.05),ASD儿童SDQ困难总分及多动/注意力缺陷、情绪症状、同伴交往问题及品行问题因子得分高于TD组儿童(t=10.791、7.482、4.295、12.925、3.544),亲社会行为因子分(t=5.084)低于TD组儿童,差异均有统计学意义(P<0.01)。校正混杂因素后,ASD组母亲状态、特质焦虑得分与儿童困难总分 S-AI: β=0.83 (95%CI: 0.19~1.46); T-AI: β=0.60 (95%CI: 0.05~1.14)]、情绪症状 S-AI: β=2.28 (95%CI:0.72~3.84); T-AI: β=2.04 (95%CI: 0.74~3.33)]存在正相关关系(P<0.05)。TD组母亲状态焦虑得分与儿童困难总分 β=0.50 (95%CI: 0.03~0.96)]、品行问题 β=1.74 (95%CI: 0.19~3.30)]存在正相关关系;特质焦虑得分与品行问题 β=1.54 (95%CI: 0.09~3.00)]存在正相关关系(P<0.05)。结论 ASD儿童母亲比TD儿童母亲更容易出现焦虑。其中ASD儿童母亲的焦虑水平与儿童情绪问题有关,TD儿童母亲的焦虑水平与儿童品行问题有关。

Associations of maternal anxiety with emotional and behavioral problems in children with autism spectrum disorder

Objective To compare maternal anxiety between children with autism spectrum disorder (ASD) and children with typical development (TD), and to explore the associations of maternal anxiety with emotional and behavioral problems in children with ASD. Methods A total of 55 ASD children and 74 TD children aged 6 to 12 years were recruited in this study. Station-Trait Anxiety Inventory (STAI) was used to evaluate maternal anxiety, and Strengths and Difficulties Questionnaire (SDQ) was used to assess children's emotional and behavioral problems. Results Mothers of ASD children had a higher level of maternal anxiety including state anxiety score and trait anxiety score (t=5.272, 4.484, P<0.05). In terms of SDQ, ASD children had higher scores of emotional and behavioral problems, hyperactivity/attention deficit, emotional symptoms, peer relationship problems and conduct problems(t=10.791, 7.482, 4.295, 12.925, 3.544, P＜0.05), and lower score of prosocial behaviors than TD children (t=5.084, P<0.01). In children with ASD, both maternal state anxiety and trait anxiety score were positively associated with total difficulties score S-AI: β=0.83 (95%CI: 0.19 - 1.46), T-AI: β=0.60 (95%CI: 0.05 - 1.14), P<0.01] and emotional symptoms score S-AI: β=2.28 (95%CI: 0.72 - 3.84), T-AI: β=2.04 (95%CI:0.74 - 3.33), P<0.01]. In TD children, maternal state anxiety score was positively associated with total SDQ score β=0.50 (95%CI: 0.03 - 0.96), P<0.05] and conduct problem score β=1.74 (95%CI:0.19 - 3.30), P<0.05], maternal trait anxiety score was positively related to conduct problem score β=1.54 (95%CI: 0.09~3.00), P<0.05]. Conclusions Mothers of ASD children have higher levels of anxiety than those of TD children. Maternal anxiety is associated with emotional problems in ASD children, while it is associated with conduct behaviors in TD children.