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目的研究学龄期注意缺陷多动障碍(ADHD)患儿父母婚姻冲突、严厉管教与亲子依恋的关系。方法分别对ADHD患儿(ADHD组,103例)及一般情况匹配的正常儿童(对照组,103名)进行依恋安全性量表(KSS)、儿童感知婚姻冲突量表(CIPC)及自制的严厉管教方式问卷调查;分析ADHD患儿父母婚姻冲突、严厉管教与亲子依恋的关系。结果1)ADHD组母子及父子依恋安全性量表(KSS)分[(2.66±0.33),(2.68±0.46)]低于对照组[(2.97±0.32),(2.88±0.40)](P均<0.01);2)ADHD组CIPC冲突频率、冲突强度、冲突解决、自我归因、冲突内容因子分高于对照组,差异均具有统计学意义(P均<0.05);3)ADHD患儿母亲责骂评分与母子依恋安全性评分间呈负相关(r=-0.240;P<0.05),ADHD患儿父亲责骂和体罚评分与父子依恋安全性评分间呈负相关(r=-0.234、-0.276;P<0.05或<0.01);4)多元线性回归分析显示母亲责骂是ADHD患儿母子依恋安全性的重要影响因素(P<0.05),而CPIC冲突频率、冲突解决是ADHD患儿父子依恋安全性的重要影响因素(P<0.05或<0.01)。结论 ADHD患儿不良亲子依恋关系受到父母婚姻冲突及严厉管教方式的影响;建立和谐的父母婚姻关系,减少不良的父母管教方式有利于改善ADHD患儿亲子依恋关系。
Objective To study the relationship between parents’ marital conflicts, severe discipline and parent-child attachment in school-age children with ADHD. Methods A total of 103 children with ADHD (103 children with ADHD) and 103 children with normal controls (control group, 103 children) were enrolled in this study. The scores of attachment safety scale (KSS), children perceived marital conflict scale (CIPC) Questionnaire survey; analysis of ADHD children’s parents marital conflicts, severe discipline and parent-child relationship. Results 1) The KSS scores of maternal and father-child attachment in ADHD group were significantly lower than those in control group [(2.66 ± 0.33), (2.68 ± 0.46)] [(2.97 ± 0.32), (2.88 ± 0.40)] <0.01); 2) The frequency of CIPC conflict, conflict intensity, conflict resolution, self-attribution and content of conflict in ADHD group were significantly higher than those in control group (all P <0.05); 3) There was a negative correlation between scolding score and safety score of mother-child attachment (r = -0.240; P <0.05). There was a negative correlation between father scolding and corporal punishment score and parent-child attachment safety score (r = -0.234, -0.276; P <0.05 or <0.01); 4) Multivariate linear regression analysis showed that mother scolding was an important factor influencing the safety of mother-child attachment in children with ADHD (P <0.05), while CPIC conflict frequency and conflict resolution were the safety of parent-child attachment (P <0.05 or <0.01). Conclusion The unhealthy parental attachment relationship in ADHD children is affected by the marital conflicts and severe discipline of parents. Establishing a harmonious parental marriage and reducing the poor parental discipline help to improve parental attachment in children with ADHD.