幼儿30月龄时父母教养方式与学龄前儿童注意缺陷多动障碍症状轨迹关联研究

Study on the relationship between parenting styles of toddlers aged 30 months and attention deficit hyperactivity disorder symptom trajectories in preschool children

幼儿30月龄时父母教养方式与学龄前儿童注意缺陷多动障碍症状轨迹关联研究

Authors：Li Han, Tong Juan, Wang Xing, Yan Shuangqin, Huang Kun, Wu Xiaoyan, Tao Shuman, Zhu Beibei, Gao Hui, Tao Fangbiao

Source：Zhonghua Liu Xing Bing Xue za Zhi

DOI：10.3760/cma.j.cn112338-20240826-00522

Abstract

Objective: To explore the relationship between parenting styles of toddlers aged 30 months and attention deficit hyperactivity disorder (ADHD) symptom trajectories in preschool children.

Methods: The subjects were 2 111 children and their parents in Ma'anshan Birth Cohort. Parenting styles were assessed at 30 months of age using the Brief Toddler Parenting Style Questionnaire, which defines parenting styles on four dimensions: warmth and interaction, attention and acceptance, outdoor and social activities, and neglect and restrictions. The Chinese version of the Conners Abbreviated Symptom Questionnaire was used to examine preschooler's ADHD symptoms aged 3, 5, and 6 years. ADHD symptom trajectories were fitted using group-based trajectory modeling. The multinomial logistic regression model was used to evaluate the relationship between parenting styles at 30 months of age and ADHD symptom trajectories in children. The additive and multiplicative models were applied to analyze the interaction effect of negative parenting styles in children's ADHD symptom trajectories.

Results: ADHD symptom trajectories in children included the low-score (48.3%), moderate-score (47.7%), and high-score groups (4.0%). After adjusting for the confounding factors, the results of the multinomial logistic regression analysis showed that negative parenting styles of the father/mother were associated with ADHD symptom trajectories in children (P<0.05). The father/mother's low warmth and interaction (father: OR=2.07,95%CI:1.68-2.54; mother: OR=2.02,95%CI:1.64-2.48), low attention and acceptance (father: OR=1.94,95%CI:1.57-2.39; mother:OR=1.47,95%CI:1.20-1.81), low outdoor and social (father: OR=1.74,95%CI:1.43-2.13; mother: OR=1.60,95%CI:1.32-1.94), and high neglect and restriction (father: OR=2.09,95%CI:1.67-2.62; mother: OR=2.06,95%CI:1.65-2.56) were associated with ADHD symptom moderate-score trajectories compared to the low-score trajectory group, mother's low warmth and interaction, low outdoor and social, and high neglect and restrictions. Statistically significant association was seen in negative parenting styles of fathers with the high-score group. There was a multiplicative interaction for hostile parenting (P<0.05). The additive interaction results showed that there was a synergistic effect of hostile parenting, which increased the risk of the high-score trajectories of ADHD symptoms in children.

Conclusions: Both parents' parenting styles influenced ADHD symptom change the trajectories in preschoolers. Negative parenting styles of the father/mother increase the risk of the moderate-score and high-score trajectories of ADHD symptoms in children. Hostile parenting by both parents has a synergistic impact on the risk of ADHD symptom trajectories in children, and the simultaneous presence of both increases the risk of the high-score trajectory of ADHD symptoms.

Key words: Attention deficit hyperactivity disorder; Parenting styles; Preschool children; Cohort study

摘要

目的：探讨幼儿30月龄时父母教养方式与学龄前儿童注意缺陷多动障碍（ADHD）症状轨迹的关联。

方法：研究对象为马鞍山优生优育队列2 111名儿童及其父母。使用简易幼儿家庭教养方式量表评估幼儿 30月龄时父母教养方式，界定温暖与互动、关注与接纳、户外与社交、忽视与限制4个维度的父母教养方式。采用Conners简明症状问卷中文版评估3、5、6岁儿童ADHD症状，利用组基轨迹模型拟合儿童 ADHD症状轨迹。采用多项式 logistic回归模型评估幼儿 30月龄时父母不同教养方式与 ADHD 症状轨迹的关联。采用相加和相乘模型评估父/母亲消极教养方式在儿童 ADHD症状轨迹中的交互作用。

结果：儿童 ADHD 症状轨迹划分为低（48.3%）、中（47.7%）、高（4.0%）得分轨迹组。在调整混杂因素后，多项式 logistic回归分析结果显示，父/母亲消极教养方式与儿童 ADHD症状轨迹有关（P<0.05），与低得分轨迹组相比，父/母亲低水平温暖与互动（父亲：OR=2.07，95%CI：1.68~2.54；母亲：OR=2.02，95%CI：1.64~2.48）、低水平关注与接纳（父亲：OR=1.94，95%CI：1.57~2.39；母亲：OR=1.47，95%CI：1.20~1.81）、低水平户外与社交（父亲：OR=1.74，95%CI：1.43~2.13；母亲：OR= 1.60，95%CI：1.32~1.94）、高水平忽视与限制（父亲：OR=2.09，95%CI：1.67~2.62；母亲：OR=2.06，95%CI：1.65~2.56）与儿童 ADHD症状中得分轨迹有统计学关联。母亲低水平温暖与互动、低水平户外与社交、高水平忽视与限制与儿童ADHD症状高得分轨迹有统计学关联，父亲消极教养方式与儿童ADHD症状高得分轨迹有统计学关联。父/母亲消极教养方式存在相乘交互作用（P<0.05）。相加交互作用结果显示，父/母亲消极教养方式存在协同作用，增加儿童 ADHD 症状高得分轨迹风险发生。

结论：父/母亲双方教养方式影响学龄前儿童 ADHD 症状轨迹，父/母亲消极教养方式会增加儿童ADHD 症状中、高得分轨迹发生风险。父/母亲双方消极教养方式存在协同作用，二者同时存在时会增加儿童发生ADHD症状高得分轨迹风险。

关键词：注意缺陷多动障碍； 父母教养方式； 学龄前儿童； 队列研究