University of Virginia, Charlottesville, VA 22903-4400, USA.
J Am Acad Child Adolesc Psychiatry. 2011 Dec;50(12):1236-46. doi: 10.1016/j.jaac.2011.08.004. Epub 2011 Oct 5.
This study investigated the impact of parental attention-deficit/hyperactivity disorder (ADHD) symptoms on the peer relationships and parent-child interaction outcomes of children with ADHD among families completing a randomized controlled trial of parental friendship coaching (PFC) relative to control families.
Participants were 62 children with ADHD (42 boys and 20 girls, 6 through 10 years old) and their parents. Approximately half of the families received PFC (a 3-month parent training intervention targeting the peer relationships of children with ADHD), and the remainder represented a no-treatment control group.
Parental inattention predicted equivalent declines in children's peer acceptance in both treatment and control families. However, treatment amplified differences between parents with high versus low ADHD symptoms for some outcomes: Control families declined in functioning regardless of parents' symptom levels. However, high parental inattention predicted increased child peer rejection and high parental inattention and impulsivity predicted decreased parental facilitation among treated families (indicating reduced treatment response). Low parental symptoms among treated families were associated with improved functioning in these areas. For other outcomes, treatment attenuated differences between parents with high versus low ADHD symptoms: Among control parents, high parental impulsivity was associated with increasing criticism over time, whereas all treated parents showed reduced criticism regardless of symptom levels. Follow-up analyses indicated that the parents experiencing poor treatment response are likely those with clinical levels of ADHD symptoms.
Results underscore the need to consider parental ADHD in parent training treatments for children with ADHD.
本研究旨在调查父母注意缺陷多动障碍（ADHD）症状对接受父母友谊训练（PFC）的 ADHD 儿童家庭与对照组儿童的同伴关系和亲子互动结果的影响。
参与者为 62 名 ADHD 儿童（42 名男孩和 20 名女孩，年龄 6 至 10 岁）及其父母。大约一半的家庭接受了 PFC（一项针对 ADHD 儿童同伴关系的为期 3 个月的父母培训干预），其余的为未治疗对照组。
父母的注意力不集中预测了治疗组和对照组儿童的同伴接受度都有同等程度的下降。然而，治疗组加剧了父母 ADHD 症状高低之间的一些结果差异：控制组无论父母的症状水平如何，功能都在下降。然而，高父母的注意力不集中预示着孩子同伴拒绝的增加，高父母的注意力不集中和冲动预示着接受治疗的家庭中父母的促进作用下降（表明治疗反应下降）。治疗组中父母的低症状与这些领域的功能改善有关。对于其他结果，治疗组降低了父母 ADHD 症状高低之间的差异：在对照组父母中，高父母的冲动与随时间增加的批评有关，而所有接受治疗的父母无论症状水平如何，批评都减少了。后续分析表明，治疗反应不佳的父母可能是 ADHD 症状达到临床水平的父母。
研究结果强调了在 ADHD 儿童的父母训练治疗中需要考虑父母的 ADHD。
