Matsui Meiko, Yoshida Seiji, Tanaka Hidetaka, Yamawake Ginroku, Kurooka Yusuke, Ota Yoshitaka, Kubo Atsuko, Mizutani Midori, Ashida Akira
Department of Pediatrics, Osaka Medical and Pharmaceutical University Hospital, Takatsuiki, Japan.
OD Hypotension Clinic Tanaka, Osaka, Japan.
Front Pediatr. 2025 Apr 25;13:1543200. doi: 10.3389/fped.2025.1543200. eCollection 2025.
Orthostatic intolerance is the name of the disease in Europe and the United States; however, in Japan, it is commonly known as orthostatic dysregulation (OD). OD is a physical disorder caused by failure of the body's compensatory regulatory mechanism to adapt to changes in circulatory dynamics during orthostasis; however, in many cases, the influence of psychosocial factors has been noted. The mother-child relationship is a major psychosocial factor in children, and it has been reported that parent-child patterns associated with OD are often excessive parental interference and child over-adaptation. This study focused on the psychological and physical factors of OD and assessed the parent-child relationship patterns among children with postural tachycardia syndrome (POTS), a subtype of OD, and examined how they relate to the child's personality traits and autonomic neuron function.
A total of 36 six children diagnosed with POTS (mean age 13.5 ± 0.9 years) were compared with the results of the following questionnaires on parent-child relationships, personality traits, and the autonomic neuron function test: Family diagnostic test (a diagnostic test of parent-child relationship) for mothers and children, AN-EGOGRAM (the egograms that can be adapted to childhood and adolescence, when the ego is in the process of developing and growing), and a frequency analysis of heartrate and blood pressure variability for the children.
Assessments of the mother-child relationship patterns among children with POTS found significant associations between maternal "strict discipline" and children's negative feelings, excessive parental intervention and children's susceptibility to stress, and the degree of children's "feeling of rejection" and lower supine vasomotor sympathetic nerve activity. The findings also suggested that children with POTS typically exhibited lower scores in critical parent and free child personality traits, but higher scores in adapted child (AC). Notably, mothers of children with high AC scores reported less dissatisfaction with their spouses regarding childcare.
In the parent-child relationship in POTS, an association was observed between maternal "strict discipline" and children's negative feelings, suggesting that a less strict disciplinary approach may contribute to a more positive parent-child relationship.
直立不耐受在欧美是该病的名称；然而，在日本，它通常被称为直立调节障碍（OD）。OD是一种身体紊乱，由身体的代偿调节机制在直立位时无法适应循环动力学变化所致；然而，在许多情况下，已注意到心理社会因素的影响。母子关系是儿童的一个主要心理社会因素，据报道，与OD相关的亲子模式通常是父母过度干涉和孩子过度适应。本研究聚焦于OD的心理和生理因素，评估了姿势性心动过速综合征（POTS，OD的一种亚型）患儿的亲子关系模式，并研究了它们与孩子的人格特质和自主神经功能之间的关系。
将总共36名被诊断为POTS的儿童（平均年龄13.5±0.9岁）与以下关于亲子关系、人格特质和自主神经功能测试的问卷结果进行比较：母亲和孩子的家庭诊断测试（一种亲子关系诊断测试）、AN-自我图（可适应童年和青春期自我发展和成长过程中的自我图），以及对儿童心率和血压变异性的频率分析。
对POTS患儿的母子关系模式评估发现，母亲的“严格管教”与孩子的负面情绪、父母过度干预与孩子的压力易感性，以及孩子的“被排斥感”程度与仰卧位血管运动交感神经活动降低之间存在显著关联。研究结果还表明，POTS患儿在关键父母和自由儿童人格特质方面的得分通常较低，但在适应儿童（AC）方面的得分较高。值得注意的是，AC得分高的孩子的母亲对配偶在育儿方面的不满较少。
在POTS的亲子关系中，观察到母亲的“严格管教”与孩子的负面情绪之间存在关联，这表明采用不那么严格的管教方式可能有助于建立更积极的亲子关系。
