Towe-Goodman Nissa R, Franz Lauren, Copeland William, Angold Adrian, Egger Helen
Center for Developmental Science, University of North Carolina-Chapel Hill.
Duke University Medical Center.
J Am Acad Child Adolesc Psychiatry. 2014 Apr;53(4):437-46. doi: 10.1016/j.jaac.2013.12.017. Epub 2014 Jan 13.
We examined the perceived impact of child anxiety disorders on family functioning, because such impact is a key predictor of mental health service receipt. In addition, we examined the relative impact of preschool anxiety compared to that of other early childhood disorders, and whether this impact persisted after accounting for the effects of comorbidity, or varied by child age and sex.
Drawing from a pediatric primary-care clinic and oversampling for children at risk for anxiety, 917 parents of preschoolers (aged 2-5 years) completed a diagnostic interview and reported on child psychiatric symptom impact on family finances, relationships, activities, and well-being.
After accounting for comorbid disorders, families of children with anxiety were 3.5 times more likely to report a negative impact of their child's behavior on the family relative to nondisordered children. Generalized and separation anxiety had an impact on family functioning similar to that of attention-deficit/hyperactivity disorder and disruptive disorders. There was a significant family impact for girls with social phobia, whereas there was no impact for boys.
Preschool anxiety has a significant, unique impact on family functioning, particularly parental adjustment, highlighting the family impairment linked with early anxiety, and the need for further research on barriers to care for these disorders.
我们研究了儿童焦虑症对家庭功能的感知影响,因为这种影响是接受心理健康服务的关键预测因素。此外,我们还研究了与其他幼儿期疾病相比,学龄前焦虑症的相对影响,以及在考虑共病影响后这种影响是否持续存在,或者是否因儿童年龄和性别而异。
从一家儿科初级保健诊所招募,并对有焦虑风险的儿童进行过度抽样,917名学龄前儿童(2至5岁)的家长完成了一次诊断访谈,并报告了儿童精神症状对家庭财务、关系、活动和幸福感的影响。
在考虑共病后,焦虑症儿童的家庭报告孩子行为对家庭产生负面影响的可能性是非焦虑症儿童家庭的3.5倍。广泛性焦虑症和分离焦虑症对家庭功能的影响与注意力缺陷多动障碍和破坏性行为障碍类似。社交恐惧症对女孩的家庭有显著影响,而对男孩则没有影响。
学龄前焦虑症对家庭功能有显著的独特影响,尤其是对父母适应能力的影响,凸显了与早期焦虑相关的家庭损害,以及对这些疾病护理障碍进行进一步研究的必要性。