比较儿科强迫症、焦虑症和非焦虑儿童的家庭适应情况。

Comparing family accommodation in pediatric obsessive-compulsive disorder, anxiety disorders, and nonanxious children.

机构信息

Yale Child Study Center, New Haven, Connecticut.

出版信息

Depress Anxiety. 2014 Dec;31(12):1018-25. doi: 10.1002/da.22251. Epub 2014 Feb 22.

DOI:10.1002/da.22251

PMID:24677578

Abstract

BACKGROUND

Family accommodation describes ways in which parents modify their behavior to help a child avoid or alleviate distress caused by emotional disorders. Accommodation is associated with increased symptom severity, lower functioning, and poorer treatment outcomes. Accommodation is prevalent in childhood obsessive-compulsive disorder (OCD) and anxiety disorders (ADs) but no studies have compared accommodation in these groups or compared them to healthy controls to ascertain if accommodation is prevalent in the general population. This study addresses these gaps by comparing patterns of accommodation, factors that maintain accommodation, and its relation to symptom severity in OCD and AD, relative to healthy controls.

METHOD

We directly compared reports of accommodation to childhood OCD (N = 26) and AD (N = 31), and a comparison group of nonanxious (NA) children (N = 30). Mothers completed measures of accommodation (Family Accommodation Scale (FAS)/Family Accommodation Scale-Anxiety (FASA)), anxiety (Screen for Childhood Anxiety Related Emotional Disorders-Parent Report (SCARED-PR)), and OCD (Children's Yale-Brown Obsessive Compulsive Scale (CYBOCS)).

RESULTS

Family accommodation is prevalent among mothers of children with OCD and AD. Few differences were found between the two clinical groups who reported more accommodation (F[2,84] = 23.411, P < .001, partial η(2) = .358), greater distress (F[2,84] = 24.050, P < .001, partial η(2) = .364), and more consequences of not accommodating (F[2,84] = 18.967, P < .001, partial η(2) = .311), than the NA group. Accommodation was associated with severity of anxiety in AD (r = .426, P = .017) and OCD (r = .465, P = .017), but not in the NA group.

CONCLUSIONS

Findings highlight family accommodation as a phenomenon that applies broadly and in a similar manner to children with AD and OCD. Evaluating accommodation provides useful information for clinical care and is an important part of the assessment of children with AD and OCD.

摘要

背景

家庭适应是指父母改变行为方式以帮助孩子避免或减轻情绪障碍引起的痛苦的方式。适应与症状严重程度增加、功能下降和治疗效果较差有关。适应在儿童强迫症（OCD）和焦虑症（AD）中很常见，但尚无研究比较这些群体中的适应情况，也没有将其与健康对照组进行比较，以确定适应是否在普通人群中普遍存在。本研究通过比较 OCD 和 AD 与健康对照组的适应模式、维持适应的因素及其与症状严重程度的关系，来填补这一空白。

方法

我们直接比较了 26 名患有 OCD 的儿童、31 名患有 AD 的儿童和 30 名非焦虑儿童（NA 儿童）的母亲对家庭适应的报告。母亲完成了家庭适应量表（FAS）/家庭适应量表-焦虑（FASA）、焦虑症（儿童耶鲁布朗强迫症量表（CYBOCS））和 SCARED-PR）。

结果

OCD 和 AD 患儿的母亲普遍存在家庭适应现象。两个临床组报告的适应程度更高（F[2,84] = 23.411，P <.001，部分η² =.358），痛苦更大（F[2,84] = 24.050，P <.001，部分η² =.364），不适应的后果更多（F[2,84] = 18.967，P <.001，部分η² =.311），差异不大。适应与 AD（r =.426，P =.017）和 OCD（r =.465，P =.017）的焦虑严重程度相关，但在 NA 组中没有相关性。