Department of Child and Adolescent Psychiatry, Meram Faculty of Medicine, NE University, Meram, Konya, 42080, Turkey.
Eur Child Adolesc Psychiatry. 2013 Sep;22(9):523-32. doi: 10.1007/s00787-013-0392-z. Epub 2013 Mar 5.
Attention-deficit hyperactivity disorder (ADHD) is often comorbid with anxiety disorders and previous studies observed that anxiety could have an impact on the clinical course of ADHD and comorbid disruptive behavioral disorders (conduct disorders and oppositional-defiant disorders). Anxiety sensitivity (AS) is a different concept from anxiety per se and it is believed to represent the constitutionally based sensitivity of individuals to anxiety and anxiety symptoms. We aimed to assess the associations between anxiety, AS and symptoms of disruptive behavioral disorders (DBD) in a clinical sample of children and adolescents with ADHD. The sample consisted of 274 treatment naive children with ADHD aged 8-17 years. The severity of ADHD symptoms and comorbid DBD were assessed via parent rated Turgay DSM-IV-Based Child and Adolescent Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S), Conners' Parent Rating Scale (CPRS), and Conners' Teacher Rating Scale (CTRS). AS and severity of anxiety symptoms of children were evaluated by self-report inventories. The association between anxiety, AS, and DBD was evaluated using structural equation modeling. Analyses revealed that AS social subscale scores negatively predicted symptoms of conduct disorder (CD) reported in T-DSM-IV-S. On the other hand, CD symptoms positively predicted severity of anxiety. No direct relationships were detected between anxiety, AS and oppositional-defiant behavior scores in any scales. These results may suggest a protective effect of AS social area on the development of conduct disorder in the presence of a diagnosis of ADHD, while the presence of symptoms of CD may be a vulnerability factor for the development of anxiety symptoms in children and adolescents with ADHD.
注意缺陷多动障碍（ADHD）常与焦虑障碍共病，既往研究观察到焦虑可能对 ADHD 的临床病程和共病破坏性行为障碍（品行障碍和对立违抗性障碍）产生影响。焦虑敏感（AS）是一个与焦虑本身不同的概念，它被认为代表了个体对焦虑和焦虑症状的基于体质的敏感性。我们旨在评估在 ADHD 儿童和青少年的临床样本中，焦虑、AS 和破坏性行为障碍（DBD）症状之间的相关性。该样本包括 274 名未经治疗的 ADHD 儿童，年龄为 8-17 岁。通过父母评定的 Turgay DSM-IV 基于儿童和青少年行为障碍筛查和评定量表（T-DSM-IV-S）、康纳斯父母评定量表（CPRS）和康纳斯教师评定量表（CTRS）评估 ADHD 症状和共病 DBD 的严重程度。通过自我报告量表评估儿童的 AS 和焦虑症状严重程度。使用结构方程模型评估焦虑、AS 和 DBD 之间的关联。分析结果显示，AS 社会分量表分数与 T-DSM-IV-S 中报告的品行障碍（CD）症状呈负相关。另一方面，CD 症状与焦虑的严重程度呈正相关。在任何量表中，均未检测到焦虑、AS 和对立违抗性行为得分之间存在直接关系。这些结果可能表明，在 ADHD 诊断存在的情况下，AS 社会领域对品行障碍的发展具有保护作用，而 CD 症状的存在可能是 ADHD 儿童和青少年焦虑症状发展的脆弱性因素。
