Messer S C, Beidel D C
Department of Psychiatry, Duke University Medical Center, Durham, NC 27710.
J Am Acad Child Adolesc Psychiatry. 1994 Sep;33(7):975-83. doi: 10.1097/00004583-199409000-00007.
This study explored psychosocial and "environmental" correlates of childhood anxiety disorders. The study examined relationships among parental psychiatric symptomatology, perceived family environment, temperament, and self-competence in children with a DSM-III-R anxiety disorder.
A community sample of third through sixth graders was screened initially for symptoms of test anxiety. Those with high and low scores were administered the Anxiety Disorders Interview Schedule for Children. Three groups (childhood anxiety disorder, test-anxious only, and normal controls) were identified and compared on the psychosocial variables.
Children with an anxiety disorder had greater impairment on the indices of perceived self-competence and temperamental flexibility than controls, with the test-anxious children showing intermediate, yet significant, levels of disturbance. There was a trend for children with an anxiety disorder to describe their families as less promoting of independence than the other groups. Finally, measures of parental psychiatric symptomatology revealed more obsessive-compulsive symptoms for the fathers of both the anxiety disorder and test-anxious children compared with controls.
Results are consistent with previous findings suggesting the familial transmission of anxiety disorders and recent speculations regarding a relationship between behavioral inhibition, environmental control, and anxiety. Further research may isolate psychosocial and family environmental factors as instrumental treatment targets in the management of childhood anxiety disorders.
本研究探讨儿童焦虑症的心理社会及“环境”相关因素。该研究考察了患有《精神疾病诊断与统计手册》第三版修订本(DSM-III-R)焦虑症的儿童中,父母精神症状、感知到的家庭环境、气质和自我能力之间的关系。
最初对三至六年级学生的社区样本进行考试焦虑症状筛查。对高分和低分者进行儿童焦虑症访谈量表测试。确定了三组(儿童焦虑症组、仅考试焦虑组和正常对照组),并对其心理社会变量进行比较。
与对照组相比,患有焦虑症的儿童在自我能力感和气质灵活性指标上的受损程度更大,考试焦虑儿童表现出中等但显著的干扰水平。患有焦虑症的儿童有将自己的家庭描述为比其他组更不鼓励独立的趋势。最后,父母精神症状测量显示,与对照组相比,焦虑症儿童和考试焦虑儿童的父亲有更多的强迫症状。
结果与先前表明焦虑症存在家族传递的研究结果以及最近关于行为抑制、环境控制与焦虑之间关系的推测一致。进一步的研究可能会将心理社会和家庭环境因素确定为儿童焦虑症管理中有重要作用的治疗靶点。