Gau Susan Shur-Fen, Chiu Yen-Nan, Soong Wei-Tsuen, Lee Ming-Been
Department of Psychiatry, National Taiwan University Hospital, and Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan.
J Formos Med Assoc. 2008 Sep;107(9):693-703. doi: 10.1016/S0929-6646(08)60114-X.
BACKGROUND/PURPOSE: The literature has documented maternal distress and behavioral problems among children with Down syndrome (DS), however, little is known about paternal adjustment and behavioural problems among the siblings of children with DS. Here, we examined parental psychopathology, parenting style and emotional/behavioral problems among children with DS, their siblings, and controls in Taiwan.
We recruited 45 families of children with DS (age, 2-4 years) and 50 families of normally developing children (age, 3-5 years). If there were more than two children in the case family, the sibling whose age was closest to the child with DS was recruited (age, 3-8 years). Both parents completed self-administered measures of their personality characteristics, psychopathology, family functioning, parenting styles, and child behavioral problems, using the Chinese versions of the Maudsley Personality Inventory, Brief Symptom Rating Scale, Family Adaptability and Cohesion Evaluation Scale, Parental Bonding Instrument, and Child Behavioral Checklist, respectively.
Children with DS demonstrated significantly more severe symptoms than normal children of a wide range of behavioral problems such as attention problems, delinquency, social problems, somatic complaints, thought problems, and withdrawal compared with the other two groups, and obtained similar parental treatment, except for paternal overprotection. Their parents suffered from more psychopathology and their mothers were less often employed than their counterparts. The siblings of children with DS obtained less overprotection from their mothers than children with DS and less maternal care and control than normal children. There was no difference in emotional/behavioral problems between the siblings and normal controls.
Our findings suggest that in addition to the physical, educational and psychological needs of children with DS, the psychological care of their mothers, fathers and siblings also needs to be evaluated. Moreover, parenting counseling should focus not only on children with DS, but their siblings as well.
背景/目的:文献记载了唐氏综合征(DS)患儿的母亲困扰及行为问题,然而,对于DS患儿兄弟姐妹的父亲适应情况及行为问题却知之甚少。在此,我们研究了台湾地区DS患儿、其兄弟姐妹及对照组儿童的父母精神病理学、养育方式和情绪/行为问题。
我们招募了45个DS患儿家庭(年龄2至4岁)和50个正常发育儿童家庭(年龄3至5岁)。如果病例家庭中有两个以上孩子,则招募年龄最接近DS患儿的兄弟姐妹(年龄3至8岁)。父母双方分别使用中文版的莫兹利人格问卷、简明症状评定量表、家庭适应性和凝聚性评估量表、父母教养方式问卷及儿童行为清单,完成关于自身人格特征、精神病理学、家庭功能、养育方式和儿童行为问题的自我评估。
与其他两组相比,DS患儿在注意力问题、违纪行为、社交问题、躯体主诉、思维问题和退缩等广泛行为问题上表现出比正常儿童更严重的症状,且除了父亲过度保护外,他们得到的父母对待方式相似。他们的父母患有更多精神病理学问题,且其母亲就业的比例低于对照组的母亲。DS患儿的兄弟姐妹从母亲那里得到的过度保护比DS患儿少,从母亲那里得到的关爱和管束比正常儿童少。兄弟姐妹与正常对照组在情绪/行为问题上没有差异。
我们的研究结果表明,除了DS患儿的身体、教育和心理需求外,还需要评估其母亲、父亲和兄弟姐妹的心理关怀。此外,养育咨询不仅应关注DS患儿,也应关注他们的兄弟姐妹。