情绪调节策略在注意缺陷多动障碍儿童症状与焦虑问题之间的中介作用

目的 探讨注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)儿童情绪调节策略在症状与其焦虑问题之间的中介作用。方法 采用便利整群抽样法从新疆维吾尔自治区喀什市10所小学10 211名在校生中筛选出符合条件的ADHD共435例为研究对象,采用SNAP-Ⅳ评估量表、儿童青少年情绪调节问卷、Conners父母症状问卷进行调查,采用Spearman秩相关分析、有调节的中介法分析数据。结果 ADHD儿童认知重评策略得分与症状得分、焦虑问题得分呈负相关(分别rs=-0.254、-0.270,P<0.001),症状得分与焦虑问题得分呈正相关(rs=0.329,P<0.001)。中介效应分析结果显示,认知重评策略在症状与焦虑问题中起部分中介效应,95%置信区间为0.008～0.027,中介效应占总效应的16.10%;同时性别在该中介模型中起调节作用(P<0.001)。结论 ADHD儿童认知重评策略在ADHD儿童症状与焦虑问题之间起中介作用,同时性别调节了ADHD患儿症状与认知重评策略、焦虑问题的关系。     

注意缺陷多动障碍儿童的体格生长和膳食特征：一项横断面研究

目的 调查注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)儿童的体格生长及膳食特征,并分析其与ADHD核心症状的关系。方法 纳入2020年6—12月在南京医科大学附属儿童医院初诊为ADHD的患儿268例(ADHD组),另选取同期健康体检的非ADHD儿童102例作为对照组。对两组儿童进行体格测评、膳食调查,并依据美国精神障碍诊断与统计手册第5版进行ADHD诊断及评分,采用因子分析、Spearman秩相关分析及中介效应分析评估ADHD核心症状、膳食模式及体格生长之间的关系。结果 ADHD组超重/肥胖检出比例显著高于对照组(35.8%vs 21.6%,P<0.05)。依据食物频率问卷共提取3种膳食模式:素食膳食模式、传统膳食模式及零食快餐模式。其中ADHD组儿童零食快餐模式因子得分高于对照组(P<0.05)。ADHD症状评分、零食快餐模式因子得分及体脂百分比两两之间呈显著正相关(P<0.05)。中介效应分析显示,零食快餐模式因子得分在ADHD症状评分与体脂百分比的关系中起到了部分中介作用,中介占比为26.66%。...     

注意缺陷多动障碍患儿Period3基因可变数目串联重复序列多态性分析

目的探讨Period3(Per3)基因18号外显子54 bp可变数目串联重复(VNTR)序列多态性与中国汉族儿童注意缺陷多动障碍(ADHD)伴睡眠障碍的相关性。方法选取2005年8月-2010年5月在本科就诊、符合美国《精神障碍诊断与统计手册(第4版)》诊断标准的166例ADHD患儿为ADHD组,另收集150例健康儿童为对照组。用睡眠障碍量表(SDSC)评分评定儿童睡眠障碍情况,采用PCR技术分析ADHD组患儿与健康对照组儿童Per3基因54 bp-VNTR多态性基因型和等位基因的频率分布。将ADHD患儿根据SDSC量表评分分为有睡眠障碍组和无睡眠障碍组,并比较2组间Per3基因54 bp-VNTR多态性。结果 Per3基因54 bp-VNTR多态性各基因型(Per34/4,Per34/5,Per35/5)及等位基因(Per34,Per35)频率在ADHD组和健康对照组间的分布差异均无统计学意义(Pa>0.05),在伴睡眠障碍组和不伴睡眠障碍组间的分布差异均有统计学意义(Pa<0.05),伴睡眠障碍组携带等位基因Per35明显多于不伴睡眠障碍组(χ2=15.028,P<0.001;OR=2.760,95%CI:1.635～4.658)。结论 Per3基因54 bp-VNTR多态性可能与ADHD的易感性无关,但可能与ADHD伴睡眠障碍有关。     

注意缺陷多动障碍儿童的睡眠结构研究

目的探讨注意缺陷多动障碍(ADHD)儿童的睡眠结构。方法2005-06—2006-04用多导睡眠监护仪(PSG)对首都儿科研究所神经内科就诊的41例ADHD患儿及30例正常儿童进行全夜睡眠结构检测。结果41例ADHD儿童中混合型(ADHD-C)24例、注意缺陷型(ADHD-I)11例、多动/冲动型(ADHD-H)6例。其中男35例,女6例(ADHD-I3、ADHD-C2、ADHD-H1例)。与对照组比较ADHD组REM潜伏期短、睡眠潜伏期延长、睡眠效率降低,差异有显著性(P<0·05);ADHD-C儿童睡眠Ⅱ期百分比较ADHD-I增加,差异有显著性(P<0·05);ADHD组睡眠周期性肢体运动(PLMS)发生率为41·5%,正常组PLMS发生率为13·33%,差异有显著性(P<0·05);ADHD组及正常对照组脑电图未见疒间性放电。结论(1)ADHD儿童存在REM睡眠结构的改变、入睡困难及睡眠效率降低;(2)PLMS也是导致ADHD儿童睡眠质量下降的原因之一;(3)ADHD儿童以男孩为主,女孩以注意力缺陷型为主。对学习困难的女孩应注意是否患有ADHD。     

学龄前儿童听处理评估量表在注意缺陷多动障碍儿童中的应用研究

目的 利用学龄前儿童听处理评估量表(以下称“听处理评估量表”)探讨学龄前注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)儿童的听处理(auditory processing,AP)特征。方法 41例ADHD及41例典型发育(typically developing,TD)儿童进行听处理评估量表、SNAP-Ⅳ评定量表及学龄前持续性注意力测试(Conners’Kiddie Continuous Performance Test,K-CPT)评估，分析比较两组儿童听处理评估量表得分差异及其与SNAP-Ⅳ评定量表和K-CPT结果的相关性。结果 ADHD组儿童听处理评估量表总分及除视觉注意维度外的其他维度得分高于TD组(P<0.05)。ADHD儿童中，SNAP-Ⅳ评定量表的注意缺陷维度得分与听处理评估量表总分(r_{s 30条}=0.531;r_{s 27条}=0.627)及其听觉解码(r_s=0.628)、听觉注意(r_s=0.492)、沟通交流(r     

有睡眠障碍和无睡眠障碍注意缺陷多动障碍患儿的认知行为特征

目的 比较有睡眠障碍和无睡眠障碍的注意缺陷多动障碍(ADHD)患儿的认知行为特征,评估睡眠障碍与ADHD患儿认知行为功能之间的关系.方法 选取2005年7月-2007年9月在广东省妇幼保健院儿童保健心理门诊确诊为ADHD的7～10岁患儿112例.男95例,女17例.根据儿童睡眠障碍诊断标准,分为无睡眠障碍ADHD组(n=55)和有睡眠障碍ADHD组(n=57).采用韦氏儿童智力量表、韦氏记忆量表、数字划消测验和Conners儿童行为问卷,分别对二组患儿的智力、记忆力、注意力和行为问题进行测试与对比分析.结果 1.有睡眠障碍ADHD组患儿全量表智商显著低于无睡眠障碍ADHD组,其中尤以操作智商降低为明显(P＜0.01),二组间言语智商比较差异无统计学意义(P＞0.05);2.有睡眠障碍ADHD组患儿的长时记忆、记忆商和数字划消得分均显著低于无睡眠障碍ADHD组(Pa＜0.01),数字划消失误率显著高于无睡眠障碍ADHD组(P＜0.01);3.有睡眠障碍ADHD组患儿的学习问题、冲动/多动、焦虑和多动指数因子得分均显著高于无睡眠障碍ADHD组(Pa＜0.01),品行问题和心身障碍因子得分二组间比较差异无显著性(Pa＞0.05).结论 有睡眠障碍ADHD患儿的认知行为受损更严重.     

白血病患儿及其父母心理特点调查分析

目的探讨初诊及长期无病生存白血病患儿的情绪、自我意识特征及其父母的情绪特点。方法选用儿童焦虑性情绪障碍筛查表、儿童抑郁障碍自评量表和Piers-Harris儿童自我意识量表分别对40例初诊白血病、20例长期无病生存白血病和50例正常对照儿童进行评定,同时采用焦虑自评量表、抑郁自评量表对两组白血病儿童的父母进行心理测评。结果白血病患儿的焦虑和抑郁总分均显著高于正常对照组(P值分别为0.028和0.045);其中长期无病生存组患儿在躯体化/惊恐、广泛性焦虑和社交恐怖分量表评分明显高于正常对照组(P值分别为0.002、0.019、0.001和0.000)。初诊组患儿在社交恐怖分量表得分亦显著高于正常对照组(P=0.004),在学校恐怖分量表得分显著低于正常对照组(P=0.020)。总体白血病患儿的自我意识总分低于正常对照组(P=0.003),其中长期无病生存组在焦虑、合群、幸福与满足分量表得分显著低于正常对照组(P值分别为0.041、0.037和0.037),但自我意识总分与正常对照组相比差异无显著性(P=0.581);而初诊白血病组患儿在自我意识总分及行为、智力与学校情况、躯体外貌与属性、焦虑分量表得分显著低于正常对照组(P值分别为0.007、0.001、0.005、0.031和0.001)。白血病组父母焦虑和抑郁得分均显著高于我国常模组(P0.001),其中初诊白血病组父母的焦虑和抑郁症状检出率显著高于长期无病生存组(P值分别为0.015和0.032)。患儿父母的焦虑和抑郁得分有明显的相关性(r=0.95,P0.001),但与患儿的焦虑、抑郁及自我意识得分均无显著相关性(P0.05)。结论白血病患儿及其父母较正常对照组有更多的焦虑和抑郁情绪,白血病患儿的自我意识降低。因此,应重视对白血病患儿及其父母进行心理辅导及治疗。     

儿童注意缺陷多动障碍症状伴焦虑症状发生的调节中介因素研究

目的 探讨儿童注意缺陷多动障碍（ADHD）症状伴焦虑症状发生的调节中介因素。方法 共纳入12 271名小学生,年龄8.9±1.9岁,其中男生6 743名,女生5 508名,性别缺失20名。采用心理创伤问卷（父母版）和Conners父母用量表收集学生相关资料,问卷由学生父母填写。采用单因素分析、多因素分析和调节中介分析法处理数据。结果 单因素分析结果显示,总样本及男性和女性儿童的多动指数因子和儿童期创伤分别与焦虑因子呈正相关（P < 0.01）,ADHD和儿童期创伤正向预测焦虑障碍（P < 0.001）。多因素分析结果显示,总样本、男性和女性儿童的多动指数因子（ADHD症状）和儿童期创伤正向预测焦虑因子得分（P < 0.001）,ADHD和儿童期创伤正向预测焦虑障碍（P < 0.001）。调节中介分析结果显示,男性和女性的儿童期创伤是多动指数因子与焦虑因子间的中介因素（P < 0.05）,性别在多动指数因子与焦虑因子之间起调节作用（P < 0.001）。结论 ADHD症状/ADHD与焦虑症状/焦虑障碍关系密切。儿童期创伤在ADHD症状与焦虑症状间起中介作用,性别在ADHD症状与焦虑症状间起调节作用。     

学龄前儿童注意缺陷多动障碍决策树预测模型的前瞻性研究北大核心CSCD

目的探讨注意力时间联合行为量表在学龄前儿童注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)筛检中的应用价值。方法ADHD组来自2019年2月至2020年3月福建省妇幼保健院确诊的学龄前ADHD儿童200例,对照组来自同期同医院或幼儿园体检的儿童200例,记录注意力时间,并使用中文版SNAP-Ⅳ评定量表父母版(Chinese Version of Swanson Nolan and Pelham,VersionⅣScale-Parent Form)评估症状。以临床诊断为金标准,应用决策树分析法,评估注意力时间联合行为量表筛查ADHD的临床应用价值。结果ADHD组SNAP-Ⅳ条目1、4、7、8、10、11、14、15、16、18、20、21、22的得分高于对照组(P<0.05),注意力时间短于对照组(P<0.05)。将单因素分析2组间差异有统计学意义的变量作为自变量制定决策树模型,该模型预测ADHD的准确率为81%,预测非ADHD的准确率为69%,总体准确率为75%,受试者工作特征曲线下面积为0.816(95%CI:0.774~0.857,P<0.001)。结论基于注意力时间和行为量表建立的学龄前儿童ADHD筛查的决策树模型准确性较高,可用于临床快速进行儿童ADHD初筛,促进开展全人口ADHD筛查与管理。     

学龄期注意缺陷多动障碍男生执行功能异质性与父母压力相关性的病例对照研究

目的：探讨注意缺陷多动障碍（ADHD）儿童的执行功能异质性与父母压力的关系。 方法：本研究为病例对照研究，病例组为学龄期ADHD男生（执行功能缺陷亚组和完好亚组），对照组为正常发育学龄期男生。分别以STROOP色-词测验、威斯康辛卡片分类测验 (WCST)、剑桥神经心理成套测验 (CANTAB)和韦氏儿童智力量表第4版（WISC-Ⅳ）的相应指标评价执行功能，Swanson Nolan and Pelham, Version Ⅳ(SNAP-Ⅳ)量表父母版注意缺陷、多动/冲动分量表评估儿童的ADHD临床症状，SNAP-Ⅳ对立违抗得分和Conners父母症状问卷（PSQ）评估儿童的共病情况，以父母压力指数量表（PSI）评估父母压力。 结果：ADHD组104例、对照组47例进入本文分析。两组年龄差异有统计学意义，两组SNAP-Ⅳ和PSQ各因子差异均有统计学意义。执行功能：执行功能缺陷亚组（51例）和完好亚组（53例）差异有统计学意义，执行功能完好亚组和对照组差异无统计学意义。ADHD组及其亚组较对照组比较，不论在儿童维度及总分、家长维度及总分、父母压力总分均显著升高，执行功能完好亚组较缺陷亚组除在注意缺陷多动因子中存在差异，在儿童维度及总分、家长维度及总分、父母压力总分差异均无统计学意义。 结论：ADHD儿童会带来父母压力增加，执行功能完好也不能改善父母压力的状况。     

Sleep quality in children and adolescents with attention-deficit and hyperactivity disorder

Sleep disturbances are associated with an increased risk of attention-deficit and hyperactivity disorder (ADHD), which can also lead to sleep problems. In this study we aimed to determine the variables that affect the relationship between ADHD and sleep quality. Moreover, we aimed to compare these variables in children and adolescents with ADHD and healthy controls. This cross-sectional study was conducted using a random sample of 122 ADHD patients and 100 healthy children in Turkey. A self-administered questionnaire was distributed to assess sleep quality using the Pittsburgh Sleep Quality Index (PSQI). The risk of impairment in sleep quality was associated with the presence of ADHD (OR: 13.3; 95% CI: 6.1–29.1), the presence of somatic disease (OR: 4.9; 95% CI: 1.9–12.2), and a family history of the psychiatric disorder (OR: 4.2; 95% CI: 1.3–13.1). The PSQI total score was higher in children with parental separation compared to those without parental separation (p=0.006). As the economic level of the participants decreased, the PSQI total score increased significantly (p=0.006). It was determined that combined-type ADHD was associated with impairment in sleep quality more than the other subtypes (p<0.001 and p=0.031, respectively). Our findings show that children with ADHD have significantly more sleep problems than healthy controls and that sociodemographic variables and familial characteristics affect sleep quality in healthy children and children with ADHD.     

CLOCK基因T3111C多态性与儿童注意缺陷多动障碍及相关睡眠障碍的关联研究

目的：探讨CLOCK基因3’非编码区SNP 位点T3111C与儿童注意缺陷多动障碍（attention deficit hyperactivity disorder, ADHD）及相关睡眠障碍的关联性。方法：取无亲缘关系的ADHD患儿166名以及正常儿童（对照组）150名,根据睡眠障碍量表（Sleep Disturbance Scale for Children, SDSC）评分筛查睡眠障碍,采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)技术,检测ADHD组和对照组CLOCK基因的T3111C基因型和等位基因的频率分布。结果：CLOCK基因的T3111C基因型及等位基因频率分布在ADHD组和对照组之间差异有统计学意义（P<0.05）,ADHD组中等位基因C频率显著高于对照组（χ2=7.254,P=0.007, OR=1.740,95%CI=1.160~2.612）。伴有睡眠障碍的ADHD患儿等位基因C频率显著高于不伴有睡眠障碍者（χ2=13.052,P<0.001,OR=2.766,95%CI=1.573~4.865）。结论：CLOCK基因T3111C位点与ADHD易感性存在关联,也是影响ADHD患儿相关睡眠障碍的重要因素。携带C等位基因的个体罹患ADHD以及ADHD相关睡眠障碍的相对风险增高。     

Parental and self-report of sleep in children with attention-deficit/hyperactivity disorder

OBJECTIVE: To determine the prevalence of parent-reported and self-reported sleep disturbances in a sample of school-aged children with attention-deficit/ hyperactivity disorder (ADHD). DESIGN: Cross-sectional survey questionnaire. SETTING: A multidisciplinary ADHD evaluation clinic in a children's teaching hospital (ADHD sample) and 3 elementary schools in southern New England (control sample). PARTICIPANTS: Forty-six unmedicated, school-aged children (mean age, 89.4 +/- 18.7 months; 74% male) diagnosed as having ADHD by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria who had been screened for marked symptoms of sleep-disordered breathing, and 46 normal control children (mean age, 86.5 +/- 16.9 months; 70% male). INTERVENTION: None. MAIN OUTCOME MEASURE: Sleep habits and sleep disturbances reported by parents and children. RESULTS: Children with ADHD had significantly higher (more sleep-disturbed) scores on all sleep subscales of the Children's Sleep Habits Questionnaire (parent measure) than did controls; average sleep duration as reported by parents was also significantly shorter in the ADHD group. Children with ADHD also reported their own sleep to be more disturbed than controls did on the Sleep Self-report, particularly on items relating to bedtime struggles (P range, .05-.001). There was a much higher correlation between parent and child sleep report items for the children with ADHD (mean correlation, 0.55) than for the control children. CONCLUSIONS: Sleep disturbances, particularly at bedtime, are frequently reported by both parents and children with ADHD. Children undergoing evaluation for ADHD should be routinely screened for sleep disturbances, especially symptoms of sleep-disordered breathing. The causes of sleep-onset delay in children with ADHD should be considered in designing intervention strategies for children with difficulty falling and staying asleep.     

注意缺陷多动障碍共患发展性阅读障碍儿童的智力特征

目的 探讨注意缺陷多动障碍(ADHD)共患发展性阅读障碍(DD)儿童的智力特征.方法 纳入ADHD共患DD儿童55例、单纯ADHD儿童150例、单纯DD儿童22例作为研究对象,采用韦氏儿童智力测验第四版(WISC-Ⅳ)测试3组儿童的智力水平,比较3组儿童的智力特征.结果 ADHD共患DD组、单纯ADHD组、单纯DD组3...     

Nocturnal asthma symptoms and poor sleep quality among urban school children with asthma

ObjectiveThe aim of this study was to describe nocturnal asthma symptoms among urban children with asthma and assess the burden of sleep difficulties between children with varying levels of nocturnal symptoms.MethodsWe analyzed baseline data from 287 urban children with persistent asthma (aged 4–10 years) enrolled in the School-Based Asthma Therapy trial; Rochester, New York. Caregivers reported on nocturnal asthma symptoms (number of nights/2 weeks with wheezing or coughing), parent quality of life (Juniper’s Pediatric Asthma Caregivers Quality of Life Questionnaire), and sleep quality by using the validated Children’s Sleep Habits Questionnaire. We used bivariate and multivariate statistics to compare nocturnal asthma symptoms with sleep quality/quantity and quality of life.ResultsMost children (mean age, 7.5 years) were black (62%); 74% had Medicaid. Forty-one percent of children had intermittent nocturnal asthma symptoms, 23% mild persistent, and 36% moderate to severe. Children's average total sleep quality score was 51 (range, 33–99) which is above the clinically significant cutoff of 41, indicating pervasive sleep disturbances among this population. Sleep scores were worse for children with more nocturnal asthma symptoms compared with those with milder symptoms on total score, as well as several subscales, including night wakings, parasomnias, and sleep disordered breathing (all P < .03). Parents of children with more nocturnal asthma symptoms reported their child having fewer nights with enough sleep in the past week (P = .018) and worse parent quality of life (P < .001).ConclusionsNocturnal asthma symptoms are prevalent in this population and are associated with poor sleep quality and worse parent quality of life. These findings have potential implications for understanding the disease burden of pediatric asthma.     

Sleep Characteristics in Mothers of Children With Developmental Disabilities

Impaired sleep can contribute to conditions such as cardiometabolic disorders, depression, and decreased immune function. Mothers of children with developmental disabilities (DDs) may be at greater risk for impaired sleep due to the sleep problems of their children. This cross-sectional study described the self-reported sleep characteristics of mothers of children (ages 6-12) with DDs by using a sleep diary and the Pittsburgh Sleep Quality Index (PSQI) as quantitative and qualitative measures of sleep in these mothers. The Consensus Sleep Diary was modified to ascertain how the child's sleep and needs for care during the night impacted the mother's sleep. The results showed that mothers had short sleep duration (nearly 40% slept <7 hours per night), woke up an average of 2.2 times per night (most commonly due to caregiving needs of children), and had poor sleep quality (mean PSQI global score of 7.9 [SD=4.8]). The sleep problems of children with DDs may influence mothers’ sleep.     

注意缺陷多动障碍综合征患儿睡眠结构的初探

目的 探讨注意缺陷多动障碍（ADHD）综合征患儿的睡眠结构，睡眠中[XCJIANX5.tif]性放电及睡眠周期性肢体运动（PLMS）的情况；比较ADHD各亚型间睡眠结构的差异。方法 利用多导睡眠监护仪对2005年6月至2006年11月在首都儿科研究所神经科门诊就诊的符合DSM-Ⅳ诊断标准的58例ADHD患儿及30名正常儿童进行整夜睡眠结构监测。结果 ADHD组58例，其中4例睡眠监测未完成，实际完成54例。ADHD组中混合型（ADHD-C）31例（57.4％，31/54），注意缺陷型（ADHD-I）15例（27.8％，15/54），多动/冲动型（ADHD-H）8例（14.8％，8/54）。①与对照组比较，ADHD组快速动眼期（REM）潜伏期短、睡眠潜伏期延长和睡眠效率降低，差异有统计学意义（P<0.05）；②ADHD-C患儿睡眠Ⅱ期百分比较ADHD-I增加，差异有统计学意义（P<0.05）；③ADHD组PLMS发生率为37.0%（20/54），对照组PLMS发生率为13.3%（4/30），差异有统计学意义（P<0.05）；④ADHD组和对照组EEG未见[XCJIANX5.tif]性放电。结论 ①ADHD患儿存在REM睡眠结构的改变、入睡困难及睡眠效率降低；②睡眠Ⅱ期百分比的增多可使ADHD-C较ADHD-I有更多和更重的症状；③ADHD患儿睡眠过程中PLMS发生率较对照组显著升高，PLMS也是导致ADHD患儿睡眠质量下降的原因之一。     

Sleep habits, parasomnias and associated behaviors in school children with attention deficit hyperactivity disorder (ADHD)

Considerable clinical data support an association between sleep problems and attention deficit hyperactivity disorder (ADHD). We aimed to investigate the sleep habits, associated parasomnias and behavioral symptoms in primary school children with ADHD. Forty primary school children with a clinical diagnosis of ADHD and 40 age-sex-matched healthy community controls were recruited. The Children's Sleep Habits Questionnaire providing information regarding sleep habits and nighttime and daytime symptoms was used. About 22% of children with ADHD (versus 2.9% of the controls) needed their parents to accompany them while going to sleep (p: 0.008). Transitional objects were needed by 8.1% of ADHD children in contrast to 2.9% of controls. Nightmares, overactivity during sleep, habitual snoring, and bed-wetting were significantly higher in the ADHD group. ADHD children needed significantly more time to go to sleep on school days (p < 0.02). Children undergoing evaluation for ADHD should be routinely screened for sleep disturbances.