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研究生:李貞儀
研究生(外文):Chen-Yi Li
論文名稱:注意力不足過動症童母親懷孕期間婚姻相關危險因子之探討
論文名稱(外文):The Marriage-related Risk Factors during Maternal Pregnancy in Children with Attention-deficit Hyperactivity Disorder
指導教授:張永源張永源引用關係龍佛衛龍佛衛引用關係
指導教授(外文):Yong-Yuan ChangFor-Wey Lung
學位類別:碩士
校院名稱:高雄醫學大學
系所名稱:行為科學研究所
學門:社會及行為科學學門
學類:心理學類
論文種類:學術論文
論文出版年:2001
畢業學年度:89
語文別:中文
論文頁數:57
中文關鍵詞:注意力不足過動症婚姻適應度婚姻滿意度母親懷孕期間個案對照研究
外文關鍵詞:Attention deficit hyperactivity disorder(ADHD)marital adaptationmarital satisfactionpregnancycase-control study
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注意力不足過動症(Attention-deficit hyperactivity disorder; ADHD)是一種早期發生,由注意力不足、過動和衝動等不同症狀形成的疾病。台灣在學齡兒童ADHD的預估盛行率為9.9﹪,與國外相比稍有偏高的趨勢,有探討其原因的必要。
遺傳研究的結果顯示,除了遺傳成分以外,尚有環境方面的因素在影響著疾病的形成。近年來有動物模式發現,懷孕時母親經歷較大的壓力,會影響其後代對壓力的神經生物反應;也有學者指出母親懷孕時的情緒狀態和經歷的壓力程度與胎兒罹患ADHD有關係。本研究擬從環境的角度來探討導致孩童罹患ADHD的可能原因。
本研究以回溯性個案對照研究法,探討ADHD孩童的母親在懷孕期間的婚姻適應和滿意度,以及經歷生活壓力事件的情形,與孩童罹患ADHD之間的關係。個案組是取自高雄地區長庚醫院高雄分院,60位經過兒童心智科診斷確定罹患ADHD的孩童之母親為對象,配對相同性別、年齡並經過教師用兒童活動量表(Conners, Werry-Quay Activity Scale for Teacher;CTRS)或父母用兒童活動量表(Werry-Weiss-Peters Activity Scale;WWPAS)篩選,未罹患ADHD的孩童之母親60位為對照組。以問卷評估其在懷孕此ADHD孩童期間的婚姻適應程度和婚姻滿意程度,以及懷孕期間曾經發生過的生活壓力事件。
研究結果發現,正向生活事件發生的頻率在個案組顯著少於對照組。個案組母親在懷孕期間的婚姻適應程度和滿意程度較對照組母親有顯著不良。經過條件對數迴歸分析後,婚姻適應程度和是否在懷孕期間結婚可以顯著預測ADHD的發生。

Attention deficit hyperactivity disorder (ADHD) is a chronic disorder that begins in early childhood and is manifested by a symptomatic pattern of difficulties with attention, motor activity, and impulsivity. It is estimated to affect 9.9﹪of school-age children in Taiwan.
Both genetic and environmental risk factors have been implicated in the etiology of ADHD. Animal research has established a relationship between prenatal stress and physiological changes in offspring, as well as increases in activity levels; some studies have found that the mood and the amount of stress encountered during pregnancy have a tendency to have occurred in ADHD children. This study investigated the role of environmental factors during pregnancy in the etiology of ADHD.
The purpose of this study was to investigate the relationship between the marriage-related risk factors and the incidence of stressful life events during pregnancy, and subsequent development of ADHD, using a retrospective case-control study.
Subjects for this sample were selected from Chang Gung Memorial Hospital at Kaohsiung. The case group included 60 patients that fulfilled the DSM-IV ADHD criteria. The controls (normal children screened by Conners, Werry-Quay Activity Scale for Teacher(CTRS) or Werry-Weiss-Peters Activity Scale(WWPAS)) were randomly selected and matched for their sexes and ages. Their biological mothers completed the questionnaires about marital adaptation, marital satisfaction, and the incidence of stressful life events during pregnancy.
The results showed that the incidence of positive life events was significantly lower in case group than that in control group. Marital adaptation and marital satisfaction during pregnancy were significantly lower in case group than that in control group. And a conditional logistic regression analysis showed that marital adaptation during pregnancy and pregnancy before marriage are important risk factors for ADHD.

目 錄
頁數
中文摘要 …………………………………………………………… I
英文摘要 …………………………………………………………… II
目 錄 ……………………………………………………………… III
圖表目錄 …………………………………………………………… V
第一章 緒 論 …………………………………………………… 1
第一節 研究動機及重要性 ……………………………………… 1
第二節 研究目的 ………………………………………………… 2
第二章 文獻探討 ………………………………………………… 3
第一節 簡述注意力不足過動症 ………………………………… 3
第二節 ADHD的相關病因 ………………………………………… 7
第三章 研究概念架構 …………………………………………… 9
第四章 研究方法及進行步驟 …………………………………… 10
第一節 研究假設 ………………………………………………… 10
第二節 研究樣本 ………………………………………………… 10
第三節 研究工具與資料收集 …………………………………… 11
第四節 資料處理與分析 ………………………………………… 16
第五章 結 果 …………………………………………………… 17
第一節 個案組與對照組在人口學變項與相關屬性
之描述統計與比較 ……………………………………… 17
第二節 個案組與對照組在三種測量工具量表總分之比較 …… 18
第三節 個案組與對照組危險因子的條件對數迴歸分析 ……… 20
第六章 討 論 …………………………………………………… 22
第一節 婚姻適應程度和婚姻滿意程度 ………………………… 23
第二節 生活壓力事件 …………………………………………… 23
第三節 婚姻適應程度、婚姻滿意程度和婚姻相關生活壓力事件
與孩童罹患ADHD的關係 ………………………………… 23
第七章 結論與建議 ……………………………………………… 25
第一節 結 論 …………………………………………………… 25
第二節 建 議 …………………………………………………… 25
第三節 研究限制 ………………………………………………… 27
參考文獻 …………………………………………………………… 31
附 錄 ……………………………………………………………… 40
附錄一、個案組同意書 …………………………………………… 40
附錄二、對照組同意書 …………………………………………… 42
附錄三、量表原作者同意書 ……………………………………… 44
附錄四、教師用兒童活動量表(CTRS) ………………………… 47
附錄五、父母用兒童活動量表(WWPAS) ………………………… 49
附錄六、問卷填寫說明 …………………………………………… 51
附錄七、母親懷孕期間心理社會相關因素之自我檢核表 ……… 52
圖表目錄
頁數
圖 一 研究架構圖 ……………………………………………… 9
表4.1 CTRS的內部一致性係數 ………………………………… 36
表4.2 WWPAS的內部一致性係數 ………………………………… 36
表5.1 個案組與對照組人口學特徵變項之比較 ……………… 37
表5.2 兩組在三種測量工具總分之t檢定 ……………………… 37
表5.3 皮爾遜相關矩陣 ………………………………………… 38
表5.4 條件對數迴歸分析,預測因子間之共線性診斷 ……… 38
表5.5 可用以預測ADHD危險因子的對數迴歸分析
(未逐步淘汰的結果) …………………………………… 39
表5.6 可用以預測ADHD危險因子的對數迴歸分析
(經逐步淘汰分析結果) ………………………………… 39

王雅琴。(民79)。高雄市學齡兒童注意力不足過動症候群盛行率之研
究。行政院衛生署精神醫療保健研究計劃。
白璐、溫信財、陸汝斌、郭敏伶。(民76)。「成人生活壓力知覺量表」
之編修。中華心理衛生學刊,3(1),195-205。
宋維村。(民71)。注意力不足過動症候群:綜論。中華民國神經精神醫
學會會刊,第八卷,第一期,頁12-21。
林明珠。(民68)。兒童活動量之初步研究。國立台灣大學醫學院公共衛
生研究所碩士論文。
周文君。(民80)。注意力不足過動症候群之個案控制研究:活動量表、
行為檢定問卷、親子互動量表的臨床運用。高雄醫學院醫學研究所碩
士論文。
郭秀玲。(民70)。台灣北部地區三至十一歲兒童活動量的初步研究。國
立台灣大學醫學院公共衛生研究所碩士論文。
陳彰惠。(民86)。台灣婦女的家庭與工作生活:衝突與化解之道。1997
性別與兩性研討會論文集。
張玨、王舒芸。(民86)。台灣婦女心理衛生的迷思與事實。1997性別與
兩性研討會論文集。
謝坤鐘。(民81)。職業婦女婚姻角色衡突、婚姻適應與婚姻滿足之研
究。私立中國文化大學兒童福利研究所碩士論文。
American Psychiatric Association. (1968). Diagnostic and
Statistical manual of mental disorders (2nd ed.).
Washington, DC: Author.
American Psychiatric Association. (1980). Diagnostic and
Statistical manual of mental disorders (3rd ed.).
Washington, DC: Author.
American Psychiatric Association. (1987). Diagnostic and
Statistical manual of mental disorders (3rd ed., rev.).
Washington, DC: Author.
American Psychiatric Association. (1994). Diagnostic and
Statistical manual of mental disorders (4th ed.).
Washington, DC: Author.
Barkley, R. A.,& Cunningham, C. E. (1979). The effects of
methylphenidate on the mother-child interactions of
hyperactive children. Archives of General Psychiatry, 36,
201-208.
Barkley, R. A. (1981). Hyperactive children: A handbook for
diagnosis and treatment. New York: Guilford Press.
Barkley, R. A. (1990). Attention-defficit hyperactivity
disorder: a handbook for diagnosis and treatment. New York:
Guilford.
Barkley, R. A., DuPaul, G. J., & McNurray, M. B. (1990). A
comprehensive evaluation of attention deficit disorder with
and without hyperactivity. Journal of Consulting and
Clinical Psychology, 58, 775-789.
Barkley, R. A., Fisher, M., Edelbrock, C. S., & Smallish, L.
(1990). The adolescent outcome of hyperactive children
diagnosed by research criteria: I. An 8-year prospective
follow-up study. Journal of the American Academy of Child
and Adolescent Psychiatry, 29, 546-557.
Barkley, R. A., Anastopoulos, A. D., Guevremont, D. G., &
Fletcher, K. F. (1991). Adolescents with attention deficit
hyperactivity disorder: Patterns of behavioral adjustment,
academic functioning, and treatment utilization. Journal of
the American Academy of Child and Adolescent Psychiatry,
30, 752-761.
Barkley, R. A. (1997). Attention-deficit hyperactivity
disorder: A handbook for diagnosis and treatment (2nd ed.).
New York: Guilford Press.
Barkley, R. A., Koplowitz, S., Anderson, T.,& McMurray, M. B.
(1997). Sense of time in children with ADHD: Effects of
duration, distraction, and stimulant medication. Journal of
the International Neuropsychological Society, 3, 359-369.
Barkley, R. A. (1998). Attention-Deficit Hyperactivity
Disorder. Scientific American, 67-71.
Biederman, J., Faraone, S. V., Milberger, S., Curtis, S., Chen,
L., Marrs, A., Ouellette, C., Moore, P., & Spencer, T.
(1996). Predictors of persistence and remission of ADHD
into adolescence: Results from a four-year prospective
follow-up study. Journal of the American Academy of Child
and Adolescent Psychiatry, 35, 437-446.
Biederman, J., Faraone, S. V., Taylor, A., Sienna, M.,
Williamson, S., & Fine, C. (1997). Diagnostic continuity
between child and adolescent ADHD: Findings from a
longitudinal clinical sample. Paper presented at the annual
meeting of the American Academy of Child and Adolescent
Psychiatry, Toronto, Canada.
Chess, S. (1960). Diagnosis and treatment of the hyperactive
child. New York State Journal of Medicine, 60, 2379-2385.
Clements, S. D. (1966). Task Force One: Minimal brain
dysfunction in children (National Institute of Neurological
Diseases and Blindness, Monograph No.3). Rockville, MD:
U.S. Department of Health, Education, and Welfare.
Clements, A. D. (1991). The incidence of attention deficit
hyperactivity disorder (ADHD) in children whose mothers
experienced extreme psychological stress during pregnancy.
Dissertation.
Douglas, V. I. (1983). Attention and cognitive problems. In M.
Rutter (Ed.), Developmental neuropsychiatry (pp.280-329).
New York: Guilford Press.
Fride, E., & Weinstock, M. (1988). Prenatal stress increases
anxiety related behavior and alters cerebral lateralization
of dopamine activity. Life Sciences, 42, 1059-1065.
Fride, E., & Weinstock, M. (1989). Alterations in behavioral
and striatal dopamine asymmetries induced by prenatal
stress. Biochemistry, & Behavior, 32, 425-430.
Gittelman, R., Mannuzza, S., Shenker, R., & Bonagura, N.
(1985). Hyperactive boys almost grown up: I. Psychiatric
status. Archives of General Psychiatry, 42, 937-947.
Hart, E. L., Lahey, B. B., Loeber, R., Applegate, B., & Frick,
P. J. (1995). Developmental changes in attention-deficit
hyperactivity disorder in boys: A four-year longitudinal
study. Journal of Abnormal Child Psychology, 23, 729-750.
Insel, T. R., Kinsley, C. H., Mann, P. E., & Bridges, R. S.
(1990). Prenatal stress has long-term effects on brain
opiate receptors. Brain Research, 511, 93-97.
Lambert, N. M., Hartsough, C. S., Sassone, S., & Sandoval, J.
(1987). Persistence of hyperactive symptoms from childhood
to adolescence and associated outcomes. American Journal of
Orthopsychiatry, 57, 22-32.
Li, Y. Y., & Yang, K. S. (1984). (Eds.). Symposium on the
character of the Chinese: An interdisciplinary approach
(2nd ed.). Taipei, Taiwan: Institute of Ethnology Academia
Sinica.
Luk, S. (1985). Direct observations studies of hyperactive
behaviors. Journal of the American Academy of Child and
Adolescent Psychiatry, 24, 338-344.
Mannuzza, S., Klein, R. G., Bonagura, N., Malloy, P., Giampino,
H.,& Addalli, K. A. (1991). Hyperactive boys almost grown
up: Replication of psychiatric status. Archives of General
Psychiatry, 48, 77-83.
Mannuzza, S., Gittelman-Klein, R., Bessler, A., Malloy, P.,&
LaPadula, M. (1993). Adult outcome of hyperactive boys:
Educational achievement, occupational rank, and psychiatric
status. Archives of General Psychiatry, 50, 565-576.
Milberger, S., Biederman, J., Faraone, S. V., Guite, J.,
Tsuang, M. T. (1997). Prenancy, delivery and infancy
complications and attention deficit hyperactivity disorder:
Issues of gene-environment interaction. Biological
Psychiatry , 41, 65-75.
Mulkins, R. C. S.(1993). Differentiation between children with
attention deficit -hyperactivity disorder and children with
undifferentiated attention deficit disorder using the
Maternal Perinatal Scale(attention deficit hyperactivity
disorder). Dissertation.
Peters, D. A. V. (1982). Prenatal stress: Effects on brain
biogenic amine and plasma corticosterone levels.
Pharmacology, Biochemistry, and Behavior, 17, 721-725.
Peters, D. A. V. (1990). Maternal stress increases fetal brain
and neonatal cerebral cortex 5-hydroxytryptamine synthesis
in rats: A possible mechanism by which stress influences
brain development. Pharmacology, Biochemistry, and
Behavior, 35, 943-947.
Shelton, T. L., Barkley, R. A., Crosswait, C., Moorehouse, M.,
Fletcher, K., Barrett, S., Jenkins, L., & Metevia, L.
(1997). Early psychiatric and psychological morbidity in
preschool children with high levels of aggressive and
hyperactive-impulsive behavior. Manuscript submitted for
publication.
Spadafore, L. A. (1998). Relationship between perinatal
complications and attention deficit hyperactivity disorder
and other behavioral characteristics. Dissertation.
Still, G. F. (1902). Some abnormal psychical conditions in
children. Lancet, 1, 1008-1012, 1077-1082, 1163-1168.
Strauss, A. A., & Lehtinen, L. E. (1947). Psychopathology and
education of the brain-injured child. New York: Grune &
Stratton.
Takahashi, L. K., Turner, J. G., & Kalin, N. H. (1992).
Prenatal stress alters brain catecholaminergic activity and
potentiates stress-induced behavior in adult rats. Brain
Research, 574, 131-137.
Weiss, G., &Hechtman, L. (1986). Hyperactive children grown
up. New York: Guilford Press.
Weiss, G., & Hechtman, L. (1993). Hyperactive children grown
up (2nd ed.). New York: Guilford Press.
Wicks-Nelson, R.,& Israel, A. C. (1991). Behavior disorders of
childhood (2nd.). NJ: Prentice-Hall.
Yang, J. (1991). Career counseling of Chinese women: Are they
in limbo. The Career Development Quarterly, 39, 350-359.

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