Turk Psikiyatri Derg. 2023 Spring;34(1):24-30. doi: 10.5080/u26580.
Social phobia (SP) is one the commonest of comorbid anxiety disorders seen with ADHD. It is also known that Social phobia and ADHD patients have some differences in parental attitudes and attachment styles. We aimed to investigate the effects attachment status and parental attitudes in ADHD-social phobia comorbidity.
66 children and adolescents with ADHD were included for the study. the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version, DSM-5 November 2016-Turkish Adaptation (KSADS-PL-DSM5-T) was used for evaluating diagnosis. Socioeconomic status (SES) was scored with Hollingshead Redlich Scale. Sosyodemografic and clinical data were recorded. Adult Attachment Scale (AAS) and Parental Attitudes Research Instrument (PARI) were completed by the parents. The patients filled Kerns Security Scale (KSS). We compared the ADHD patients with and without SAD comorbidity in terms of scales used and sociodemographic-clinical variables.
There were no differences between ADHD + SP group and ADHD without SP group in terms of age, gender, SES, family structure and family history of diagnosed psychiatric disease (p>0.05). Rate of inattentive subtype of ADHD (p=0.05) and comorbid psychiatric disease frequency (p=0.00) was higher in ADHD+SP group compared to ADHD without social phobia group. However, the groups did not differ according to their attachment styles, their parent's attachment styles and parental attitudes (p>0.05).
Parental attitudes and attachment styles may not play a role in the development of SP comorbidity in children and adolescents with ADHD. Other biological and environmental factors should be kept in mind when evaluating and treating children with ADHD who have SP. Biological treatments and individualized interventions such as CBT may be chosen as a first line treatment rather than psychotherapies targeting attachment and parenting styles in those children.
社交恐惧症（SP）是 ADHD 患者常见的共病焦虑障碍之一。已知社交恐惧症和 ADHD 患者在父母态度和依恋风格上存在一些差异。我们旨在研究 ADHD-社交恐惧症共病患者依恋状况和父母态度的影响。
本研究纳入 66 名 ADHD 儿童和青少年患者。采用儿童青少年心境障碍和精神分裂症诊断性定式访谈表（Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version，DSM-5 November 2016-Turkish Adaptation，KSADS-PL-DSM5-T）评估诊断。采用 Hollingshead 雷德利希社会经济地位量表（Hollingshead Redlich Scale）评估社会经济地位（SES）。记录社会人口学和临床资料。由父母填写成人依恋量表（Adult Attachment Scale，AAS）和父母态度研究量表（Parental Attitudes Research Instrument，PARI）。患者填写 Kern 安全感量表（Kerns Security Scale，KSS）。比较 ADHD 患者伴或不伴 SAD 共病在使用量表和社会人口学-临床变量方面的差异。
ADHD+SP 组和 ADHD 无 SP 组在年龄、性别、SES、家庭结构和诊断性精神疾病家族史方面无差异（p＞0.05）。ADHD+SP 组注意缺陷多动障碍（ADHD）亚型发生率（p=0.05）和共病精神疾病频率（p=0.00）高于 ADHD 无社交恐惧症组。然而，两组在依恋模式、父母依恋模式和父母态度方面没有差异（p＞0.05）。
在 ADHD 儿童和青少年中，父母态度和依恋模式可能不是 SP 共病发展的原因。在评估和治疗伴有 SP 的 ADHD 儿童时，应考虑其他生物和环境因素。对于这些儿童，生物治疗和个性化干预，如 CBT，可能是首选治疗方法，而不是针对依恋和养育方式的心理治疗。
