Fletcher K E, Fischer M, Barkley R A, Smallish L
Department of Psychiatry, University of Massachusetts Medical Center, Worcester 01655, USA.
J Abnorm Child Psychol. 1996 Jun;24(3):271-97. doi: 10.1007/BF01441632.
The sequential interactions of three groups of teenagers conversing with their mothers during both neutral and conflict discussion situations were evaluated. Groups consisted of (1) attention deficit hyperactivity disorder (ADHD) alone (n = 21), (2) ADHD with comorbid oppositional defiant disorder (ADHD/ODD; n = 40), and (3) a community control group of adolescents (n = 49). All groups had been followed concurrently for the past 8 to 10 years before being reevaluated in this study. Results indicated that (1) teens and parents in all groups interacted in a tightly linked manner, with the behavior of each member being significantly related only to the immediate antecedent behavior of the other; (2) mothers in all groups were more likely than teens to initiate positive behaviors; (3) teen interactions could be characterized as tit-for-tat while mothers could be typified as be-nice-and-forgive; (4) mother-teen dyads in the ADHD/ODD group displayed significantly higher rates of conflict behaviors than dyads in the other two groups, who did not differ significantly from each other on most measures; and (5) mothers in the ADHD/ODD group responded in a manner similar to their teens (greater negativity) and less like that of mothers in the other groups. The majority of conflict between ADHD children and their parents seemed due to comorbid ODD and such ODD is a family, not just a teen, characteristic.
对三组青少年在中性和冲突讨论情境下与母亲交谈时的连续互动进行了评估。分组如下:(1)单纯注意力缺陷多动障碍(ADHD)组(n = 21),(2)合并对立违抗障碍的ADHD组(ADHD/ODD;n = 40),以及(3)青少年社区对照组(n = 49)。在本研究重新评估之前,所有组在过去8至10年中一直同时接受跟踪。结果表明:(1)所有组中的青少年和父母以紧密相连的方式互动,每个成员的行为仅与另一个成员的直接先前行为显著相关;(2)所有组中的母亲比青少年更有可能发起积极行为;(3)青少年的互动可被描述为针锋相对,而母亲的互动可被典型化为友善和宽容;(4)ADHD/ODD组中的母子二元组显示出的冲突行为发生率显著高于其他两组中的二元组,后两组在大多数指标上没有显著差异;(5)ADHD/ODD组中的母亲的反应方式与其青少年相似(更大的消极性),而与其他组中的母亲的反应方式不同。ADHD儿童与其父母之间的大多数冲突似乎归因于合并的ODD,并且这种ODD是一种家庭特征,而不仅仅是青少年的特征。