臺灣博碩士論文加值系統

中文摘要
研究指出藥物對注意力缺陷過動症（ADHD）雖有一定程度的幫助，但不足以幫助患童處理因症狀所導致的次級問題，包括：人際關係困難、低自尊、學業表現不佳、攻擊行為偏高等。因此針對過動疾患兒童的治療除了減少其過多的行為外（如衝動、過動、易分心），也應增加其不足的行為（如人際互動技巧、問題解決技巧、自我控制等）。本研究的主旨，在評估患童於服藥的情況下同時給予認知行為親子治療方案介入，治療方案之效益。共有14名兒童為受試者，平均年齡為9歲。研究工具包含四份量表：（一）家庭情境問卷（HSQ），（二）兒童注意力量表（CAP），（三）干擾行為評量表（DBDRS-PF），及（四）兒童行為檢核表（CBCL），分別於方案前、中、後填寫，進行統計分析。
本研究結果發現：（一）經過方案介入，受試於家庭情境問卷之困擾總分、平均嚴重度均顯著降低，並呈線性下降趨勢。（二）受試於兒童注意力量表之總分、注意力不集中、過動等分項分數均顯著降低，並呈線性下降趨勢。（三）受試於干擾行為評量表之注意力不良、過動--衝動等症狀行為均顯著降低，其對立反抗行為亦顯著降低，各分量表並呈線性下降趨勢。（四）受試於兒童行為檢核表中多數分項顯著降低，達臨床診斷分數之人數亦有降低。顯示本方案能有效改善ADHD的問題。
關鍵詞：學齡期、認知行為治療、注意力缺陷過動症

Abstract
Medication treatment has been considered the most common treatment for children with ADHD, it is helpful for attention span, impulsivity control, on-task behaviors and hyperactivities. Many secondary problems as a result of ADHD, such as interpersonal difficulties, low self-esteem, academic difficulties and high level of aggressive behaviors, the helpfulness of the medication is limited. The treatment of ADHD should focus both on decreasing the behaviors, which are excess (eg. hyperactivity, impulsivity and inattention), and increases the behaviors, which are lack (eg. interpersonal skills, problems solving skills, and self control skills). This research was aimed at evaluating the treatment effect of cognitive-behavioral therapy in a parent-child group for school age children with ADHD who were on medication at the same time. Fourteen school age children with ADHD were referred, and their parents were invited to participate in a 22-session treatment program. Four rating scales were used to evaluate the treatment effect before, during, and after the program. These rating scales included the Home Situation Questionnaire（HSQ）, the Children Attention Profile（CAP）, the Disruptive Behavior Disorder Rating Scale─Parent Form（DBDRS-PF）, and the Child Behavior Checking List（CBCL）.
The results indicated：（1）a significant decrease in the total score and the mean severity of the HSQ,（2）a significant decline in the total score, the inattention score, and the overactivity score on the CAP,（3）a significant improvement in the Inattention symptoms, Hyperactivity-Impulsivity symptoms, and symptoms of the Oppositional Defiant Disorder on the DBDRS-PF, and（4）a significant improvement in items of CBCL, and the numbers which over cut-point were decrease.
Keywords: school age, ADHD, CBT

目 錄
第一章 序論 ……………………………………………………………1
第一節 有關ADHD之歷史 …………………………………………2
第二節 ADHD之本質 ………………………………………………3
第三節 ADHD之診斷準則 …………………………………………4
第四節 ADHD之盛行率 ……………………………………………9
第五節 ADHD之病因學 ……………………………………………10
第六節 認知行為治療之原理 ……………………………………12
第七節 認知行為治療在ADＨＤ之運用 ………………………16
第八節 研究目的與研究假設 ……………………………………18
第二章 研究方法 ……………………………………………………20
第一節 研究對象 ……………………………………………20
第二節 研究工具 ……………………………………………27
第三節 施行方案 ……………………………………………31
第四節 研究步驟 ……………………………………………36
第五節 資料分析 ………………………………………………38
第三章 結果 …………………………………………………39
第一節 父母評量在方案中ADHD兒童於家庭情境問卷各項分量表分數之變化 ………………………………………………39
第二節 父母評量在方案中ADHD兒童於注意力量表各項分量表分數之變化 …………………………………………………46
第三節 父母評量在方案中ADHD兒童於干擾行為評量表各項分量表分數之變化 ……………………………………………52
第四節 父母評量在方案中ADHD兒童於兒童行為檢核表各項分量表分數之變化 …………………………………………58
第四章 討論 ………………………………………………………73
第一節 結論 ………………………………………………………73
第二節 討論 ……………………………………………………75
第三節 未來研究方向 …………………………………………78
參考文獻 ………………………………………………………………80
附錄 方案課程大綱……………………………………………………90

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