Briscoe-Smith Allison M, Hinshaw Stephen P
Pacific Graduate School of Psychology, Palo Alto, CA, USA.
Child Abuse Negl. 2006 Nov;30(11):1239-55. doi: 10.1016/j.chiabu.2006.04.008. Epub 2006 Nov 9.
The objectives of this study were to examine whether girls with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of having histories of abuse and to assess whether the presence of an abuse history may constitute a distinct subgroup of youth with ADHD.
We examined rates and correlates of child abuse in an ethnically and socioeconomically diverse sample of girls with attention-deficit/hyperactivity disorder (ADHD; n=140) and a matched comparison sample of girls without ADHD (n=88), all aged 6-12 years. A thorough chart review reliably established documented rates of physical and sexual abuse in both samples.
There were significantly higher rates of abuse for girls with ADHD (14.3%) than for the comparison sample (4.5%), with most of the abuse found in girls with the Combined as opposed to the Inattentive type. Higher rates of externalizing behaviors (including objective observations in a research summer camp) and peer rejection (indexed through peer sociometric nominations) characterized the subgroup of girls with ADHD with abuse histories compared to the subgroup without such histories, with moderate to large effect sizes. Subgroup differences regarding internalizing problems and cognitive deficits did not emerge. Findings regarding peer rejection were explained, in part, by higher rates of observed aggressive behavior in the abused subgroup.
The findings raise important questions about the possible etiologic and/or exacerbating role of abusive trauma in a subgroup of children with ADHD.
本研究的目的是检验患有注意力缺陷多动障碍（ADHD）的女孩是否有更高的受虐史风险，并评估受虐史的存在是否可能构成患有ADHD的青少年的一个独特亚组。
我们在一个种族和社会经济背景多样的样本中，研究了患有注意力缺陷多动障碍（ADHD；n = 140）的女孩以及匹配的无ADHD女孩对照样本（n = 88）中儿童虐待的发生率及相关因素，所有女孩年龄均在6至12岁。通过全面的病历审查可靠地确定了两个样本中记录的身体虐待和性虐待发生率。
患有ADHD的女孩的虐待发生率（14.3%）显著高于对照样本（4.5%），大部分虐待发生在患有混合型而非注意力不集中型的女孩中。与无受虐史的亚组相比，有受虐史的患有ADHD的女孩亚组具有更高的外化行为发生率（包括在研究夏令营中的客观观察）和同伴排斥率（通过同伴社会测量提名来衡量），效应量为中等至大。在内化问题和认知缺陷方面未出现亚组差异。关于同伴排斥的发现部分是由受虐亚组中观察到的攻击性行为发生率较高所解释的。
这些发现提出了关于虐待创伤在一部分患有ADHD的儿童中可能的病因和/或加剧作用的重要问题。
