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有或无智力障碍儿童焦虑症的症状与发展

Symptoms and development of anxiety in children with or without intellectual disability.

作者信息

Green Shulamite A, Berkovits Lauren D, Baker Bruce L

机构信息

a Department of Psychology , University of California , Los Angeles.

出版信息

J Clin Child Adolesc Psychol. 2015;44(1):137-44. doi: 10.1080/15374416.2013.873979. Epub 2014 Feb 14.

Abstract

The purpose of this study was to examine group differences in presentation and trajectory of anxiety symptoms and disorders in children with moderate to borderline intellectual disability (ID) and children with typical cognitive development (TD). Examined anxiety disorders and symptoms in children with ID (n=74) or TD (n=116) annually from ages 5 through 9 using a parent structured interview and questionnaire. Logistic regression was used to examine odds of meeting anxiety criteria and hierarchical linear modeling was used to examine anxiety trajectory. Children with ID had significantly higher rates of clinical levels of anxiety on the Child Behavior Checklist at ages 8 and 9 and higher rates of separation anxiety disorder at age 5 compared to those with TD. Children with ID were also more likely to have externalizing problems co-occurring with anxiety. The rate of increase of anxiety symptoms over time was positive and similar in the two groups, and neither group showed sex differences in anxiety rates. Results suggest that children with ID have both higher rates of anxiety across time and are delayed in showing typical decreases in separation anxiety in early childhood. Implications for intervention are discussed in terms of the importance of screening for and treating anxiety in children with ID.

摘要

本研究的目的是考察中度至边缘性智力残疾(ID)儿童与典型认知发展(TD)儿童在焦虑症状及障碍的表现和发展轨迹上的组间差异。从5岁到9岁,每年使用家长结构化访谈和问卷对ID儿童(n = 74)或TD儿童(n = 116)的焦虑障碍和症状进行检查。使用逻辑回归来检验符合焦虑标准的几率,并使用分层线性模型来检验焦虑发展轨迹。与TD儿童相比,ID儿童在8岁和9岁时的《儿童行为清单》临床焦虑水平显著更高,在5岁时分离焦虑障碍的发生率更高。ID儿童也更有可能同时出现焦虑和外化问题。两组中焦虑症状随时间的增加率均为正值且相似,两组在焦虑发生率上均未表现出性别差异。结果表明,ID儿童在整个时间段内焦虑发生率更高,并且在幼儿期分离焦虑的典型下降方面有所延迟。根据对ID儿童焦虑进行筛查和治疗的重要性,讨论了干预的意义。

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