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自闭症谱系障碍和注意缺陷多动障碍儿童的不良童年经历和家庭适应力。

Adverse Childhood Experiences and Family Resilience Among Children with Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder.

机构信息

Department of Psychology, University of South Alabama, Mobile, AL.

出版信息

J Dev Behav Pediatr. 2019 Oct/Nov;40(8):573-580. doi: 10.1097/DBP.0000000000000703.

Abstract

OBJECTIVES

The purpose of the present study was to (1) examine the differences in adverse childhood experiences (ACEs) among children with autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and comorbid ASD/ADHD and healthy neurodevelopmental controls; (2) explore the levels of family resilience across diagnostic categories; (3) identify the differences in family resilience by the number of ACEs; and (4) explore the interaction between ACEs and the diagnostic category on family resilience.

METHOD

Participants were 2083 children between the ages of 6 and 17 years (M = 12.23, SD = 3.36) from the 2016 National Survey of Children's Health. The majority of the sample were male (68.7%) and white (78.6%).

RESULTS

Overall, youth diagnosed with solely ADHD had the highest number of ACEs (Madj = 1.94). In addition, individuals who endorsed exposure to 1 ACE reported higher levels of family resilience in comparison to those who reported 0 ACEs or 2 or more ACEs. Family resilience did not differ between youth who experienced 2 or more ACEs and youth who experienced 0 ACEs. Youth diagnosed with comorbid ASD/ADHD had the lowest levels of family resilience. Interestingly, family resilience did not differ between ADHD and neurotypical youth.

CONCLUSION

Youth diagnosed with ADHD seem to be at the highest risk for ACEs. Those with comorbid ASD/ADHD report the lowest levels of family resilience when controlling for exposure to ACEs. Families of youth with ASD had lower levels of family resilience than those of neurotypical youth when controlling for exposure to ACEs, whereas families of youth with solely ADHD displayed similar levels of family resilience in comparison to neurotypical youth and their families. Results have implications for prevention and intervention with ASD and/or ADHD youth and their families.

摘要

目的

本研究旨在:(1) 比较自闭症谱系障碍(ASD)、注意缺陷多动障碍(ADHD)和 ASD/ADHD 共病儿童与健康神经发育对照组儿童的不良童年经历(ACEs)差异;(2) 探索各诊断类别的家庭适应力水平;(3) 根据 ACEs 数量确定家庭适应力的差异;(4) 探讨 ACEs 与诊断类别对家庭适应力的交互作用。

方法

参与者为来自 2016 年全国儿童健康调查的 2083 名 6 至 17 岁儿童(M = 12.23,SD = 3.36)。大多数样本为男性(68.7%)和白人(78.6%)。

结果

总体而言,被诊断为单纯 ADHD 的青少年 ACEs 数量最多(Madj = 1.94)。此外,与没有 ACEs 或有 2 个或更多 ACEs的个体相比,报告暴露于 1 个 ACE 的个体的家庭适应力水平更高。经历 2 个或更多 ACEs 的青少年和经历 0 个 ACEs 的青少年之间的家庭适应力没有差异。被诊断为 ASD/ADHD 共病的青少年的家庭适应力最低。有趣的是,ADHD 青少年与神经典型青少年的家庭适应力没有差异。

结论

被诊断为 ADHD 的青少年似乎面临着 ACEs 的最高风险。在控制 ACEs 暴露的情况下,共病 ASD/ADHD 的青少年报告的家庭适应力最低。在控制 ACEs 暴露的情况下,患有 ASD 的青少年的家庭适应力低于神经典型青少年的家庭适应力,而患有单纯 ADHD 的青少年的家庭适应力与神经典型青少年及其家庭相似。研究结果对 ASD 和/或 ADHD 青少年及其家庭的预防和干预具有启示意义。

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