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

钟琳; 张静; 左彭湘

doi:10.7499/j.issn.1008-8830.2210035

PDF(577 KB)

中国当代儿科杂志 ›› 2023, Vol. 25 ›› Issue (3) : 259-264. DOI: 10.7499/j.issn.1008-8830.2210035

论著·临床研究

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

钟琳, 张静, 左彭湘

作者信息 +

The mediating role of emotion regulation strategies between symptoms and anxiety problems in children with attention deficit hyperactivity disorder

ZHONG Lin, ZHANG Jing, ZUO Peng-Xiang

Author information +

文章历史 +

摘要

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r_s=-0.254、-0.270，P<0.001），症状得分与焦虑问题得分呈正相关（r_s=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。

Abstract

Objective To study the mediating role of emotion regulation strategies between symptoms and anxiety problems in children with attention deficit hyperactivity disorder (ADHD). Methods Convenience cluster sampling was performed to select 435 eligible children with ADHD from 10 211 students in 10 elementary schools in Kashgar of Xinjiang Uygur Autonomous Region. SNAP-IV Assessment Scale, Emotion Regulation Questionnaire for Children and Adolescents, and Conners Parent Symptoms Questionnaire were used to obtain relevant information. The Spearman correlation analysis and the moderated mediation method were used for data analysis. Results For the children with ADHD, the score of cognitive reappraisal was negatively correlated with the scores of symptoms and anxiety problems (r_s=-0.254 and -0.270 respectively, P<0.001), and the score of symptoms was positively correlated with the score of anxiety problems (r_s=0.329, P<0.001). The analysis of mediating effect showed that cognitive reappraisal played a partial mediating role between symptoms and anxiety problems, with a 95% confidence interval of 0.008-0.027, and the mediating effect accounted for 16.10% of the total effect. In addition, sex played a regulatory role in this mediation model (P<0.001). Conclusions Cognitive reappraisal plays a mediating role between symptoms and anxiety problems in children with ADHD, while sex regulates the relationship of symptoms with cognitive reappraisal and anxiety problems in these children.

导出引用

钟琳, 张静, 左彭湘. 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[J]. 中国当代儿科杂志. 2023, 25(3): 259-264 https://doi.org/10.7499/j.issn.1008-8830.2210035

ZHONG Lin, ZHANG Jing, ZUO Peng-Xiang. The mediating role of emotion regulation strategies between symptoms and anxiety problems in children with attention deficit hyperactivity disorder[J]. Chinese Journal of Contemporary Pediatrics. 2023, 25(3): 259-264 https://doi.org/10.7499/j.issn.1008-8830.2210035

参考文献

1 Magnin E, Maurs C. Attention-deficit/hyperactivity disorder during adulthood[J]. Rev Neurol (Paris), 2017, 173(7-8): 506-515. PMID: 28844700. DOI: 10.1016/j.neurol.2017.07.008.
2 Wang T, Liu K, Li Z, et al. Prevalence of attention deficit/hyperactivity disorder among children and adolescents in China: a systematic review and meta-analysis[J]. BMC Psychiatry, 2017, 17(1): 32. PMID: 28103833. PMCID: PMC5244567. DOI: 10.1186/s12888-016-1187-9.
3 Weibel S, Menard O, Ionita A, et al. Practical considerations for the evaluation and management of attention deficit hyperactivity disorder (ADHD) in adults[J]. Encephale, 2020, 46(1): 30-40. PMID: 31610922. DOI: 10.1016/j.encep.2019.06.005.
4 Inci SB, Ipci M, Akyol Ard?? U, et al. Psychiatric comorbidity and demographic characteristics of 1,000 children and adolescents with ADHD in Turkey[J]. J Atten Disord, 2019, 23(11): 1356-1367. PMID: 27581245. DOI: 10.1177/1087054716666954.
5 D'Agati E, Curatolo P, Mazzone L. Comorbidity between ADHD and anxiety disorders across the lifespan[J]. Int J Psychiatry Clin Pract, 2019, 23(4): 238-244. PMID: 31232613. DOI: 10.1080/13651501.2019.1628277.
6 van Stralen J. Emotional dysregulation in children with attention-deficit/hyperactivity disorder[J]. Atten Defic Hyperact Disord, 2016, 8(4): 175-187. PMID: 27299358. PMCID: PMC5110580. DOI: 10.1007/s12402-016-0199-0.
7 Viering T, Hoekstra PJ, Philipsen A, et al. Emotion dysregulation and integration of emotion-related brain networks affect intraindividual change in ADHD severity throughout late adolescence[J]. Neuroimage, 2021, 245: 118729. PMID: 34813971. DOI: 10.1016/j.neuroimage.2021.118729.
8 刘双. 儿童注意缺陷多动障碍症状患儿发生焦虑症状的影响因素分析[J]. 中国妇幼保健, 2022, 37(13): 2460-2463. DOI: 10.19829/j.zgfybj.issn.1001-4411.2022.13.037.
9 Cleminshaw CL, DuPaul GJ, Kipperman KL, et al. Social deficits in high school students with attention-deficit/hyperactivity disorder and the role of emotion dysregulation[J]. Sch Psychol, 2020, 35(4): 233-242. PMID: 32673052. DOI: 10.1037/spq0000392.
10 Predescu E, Sipos R, Costescu CA, et al. Executive functions and emotion regulation in attention-deficit/hyperactivity disorder and borderline intellectual disability[J]. J Clin Med, 2020, 9(4): 986. PMID: 32244788. PMCID: PMC7231040. DOI: 10.3390/jcm9040986.
11 Mohammadi MR, Zarafshan H, Khaleghi A, et al. Prevalence of ADHD and its comorbidities in a population-based sample[J]. J Atten Disord, 2021, 25(8): 1058-1067. PMID: 31833803. DOI: 10.1177/1087054719886372.
12 Sanchis-Sanchis A, Grau MD, Moliner AR, et al. Effects of age and gender in emotion regulation of children and adolescents[J]. Front Psychol, 2020, 11: 946. PMID: 32528367. PMCID: PMC7265134. DOI: 10.3389/fpsyg.2020.00946.
13 Bussing R, Fernandez M, Harwood M, et al. Parent and teacher SNAP-IV ratings of attention deficit hyperactivity disorder symptoms: psychometric properties and normative ratings from a school district sample[J]. Assessment, 2008, 15(3): 317-328. PMID: 18310593. PMCID: PMC3623293. DOI: 10.1177/1073191107313888.
14 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5[M]. 5th ed. Arlington, VA, USA: American Psychiatric Association, 2013: 55-57.
15 陈亮, 刘文, 张雪. 儿童青少年情绪调节问卷在中高年级小学生中的初步修订[J]. 中国临床心理学杂志, 2016, 24(2): 259-263. DOI: 10.16128/j.cnki.1005-3611.2016.02.016.
16 汪向东. 心理卫生评定量表手册(增订版)[M]. 北京: 中国心理卫生杂志社, 1993.
17 温忠麟, 方杰, 谢晋艳, 等. 国内中介效应的方法学研究[J]. 心理科学进展, 2022, 30(8): 1692-1702. DOI: 10.3724/SP.J.1042.2022.01692.
18 Gross JJ. Emotion regulation: affective, cognitive, and social consequences[J]. Psychophysiology, 2002, 39(3): 281-291. PMID: 12212647. DOI: 10.1017/s0048577201393198.
19 Hagstr?m J, Maigaard K, Pagsberg AK, et al. Reappraisal is an effective emotion regulation strategy in children with Tourette syndrome and ADHD[J]. J Behav Ther Exp Psychiatry, 2020, 68: 101541. PMID: 31855740. DOI: 10.1016/j.jbtep.2019.101541.
20 Kordahji H, Ben-David S, Elkana O. Attachment anxiety moderates the association between ADHD and psychological distress[J]. Psychiatr Q, 2021, 92(4): 1711-1724. PMID: 34245401. DOI: 10.1007/s11126-021-09919-6.
21 Landis TD, Garcia AM, Hart KC, et al. Differentiating symptoms of ADHD in preschoolers: the role of emotion regulation and executive function[J]. J Atten Disord, 2021, 25(9): 1260-1271. PMID: 31904270. PMCID: PMC9104514. DOI: 10.1177/1087054719896858.
22 Cai RY, Richdale AL, Dissanayake C, et al. Emotion regulation in autism: reappraisal and suppression interactions[J]. Autism, 2019, 23(3): 737-749. PMID: 29792076. DOI: 10.1177/1362361318774558.
23 O'Neill S, Rudenstine S. Inattention, emotion dysregulation and impairment among urban, diverse adults seeking psychological treatment[J]. Psychiatry Res, 2019, 282: 112631. PMID: 31685283. DOI: 10.1016/j.psychres.2019.112631.
24 R?ll J, Koglin U, Petermann F. Emotion regulation and childhood aggression: longitudinal associations[J]. Child Psychiatry Hum Dev, 2012, 43(6): 909-923. PMID: 22528031. DOI: 10.1007/s10578-012-0303-4.
25 Preston T, Carr DC, Hajcak G, et al. Cognitive reappraisal, emotional suppression, and depressive and anxiety symptoms in later life: the moderating role of gender[J]. Aging Ment Health, 2022, 26(12): 2390-2398. PMID: 34842002. DOI: 10.1080/13607863.2021.1998350.
26 Martin J, Asjadi K, Hubbard L, et al. Examining sex differences in neurodevelopmental and psychiatric genetic risk in anxiety and depression[J]. PLoS One, 2021, 16(9): e0248254. PMID: 34473692. PMCID: PMC8412369. DOI: 10.1371/journal.pone.0248254.