情绪调节与注意缺陷多动障碍患儿焦虑/抑郁症状：社交问题的中介效应和家庭功能的调节

李思迅; 王美雯; 杨燕平; 王卓; 刘沛; 罗婷婷; 陶煜杰; 黄颐

doi:10.12182/20240360601

情绪调节与注意缺陷多动障碍患儿焦虑/抑郁症状：社交问题的中介效应和家庭功能的调节

Effect of Emotion Regulation on Anxiety/Depression Symptoms in Children With Attention-Deficit/Hyperactivity Disorder: The Mediating Role of Social Problems and the Moderating Role of Family Functioning

摘要

摘要:
目的探讨社交问题在情绪失调对注意缺陷多动障碍（attention-deficit/hyperactivity disorder, ADHD）患儿焦虑/抑郁情绪的影响路径中的中介效应，以及家庭功能可能的调节效应。
方法纳入确诊的6～12岁ADHD患儿235名，分别使用情绪调节核验表、Achenbach儿童行为量表社交问题子量表和焦虑/抑郁子量表及家庭功能评定量表评估其情绪调节、社交问题、焦虑/抑郁情绪及家庭功能，使用有调节的中介模型分析社交问题、家庭功能在情绪调节与焦虑/抑郁情绪之间是否存在中介及调节作用。
结果社交问题在ADHD患儿情绪调节对其焦虑/抑郁情绪的影响中起部分中介作用，直接效应值为0.26〔95%置信区间（confidence interval, CI）：（0.17, 0.36）, P<0.001 〕，间接效应值为0.13〔95%CI：（0.07, 0.19）, P<0.001〕，中介效应值占总效应值的33%。家庭功能在社交问题与焦虑/抑郁情绪当中起正向调节作用。
结论本研究结果有助于了解ADHD患儿焦虑/抑郁的复杂影响因素，为进一步制定ADHD患儿针对性干预手段和改善预后提供依据。

Abstract:
Objective To investigate the mediating effect of social problems in the effect pathway of emotional dysregulation influencing anxiety/depression emotions in children with attention-deficit/hyperactivity disorder (ADHD) and to explore the potential moderating effect of family functionality.
Methods A total of 235 children diagnosed with ADHD were enrolled in the study. The paticipants' age ranged from 6 to 12. Emotion Regulation Checklist, Achenbach's Child Behavior Checklist (CBCL) Social Problems Subscale, CBCL Anxious/Depressed Subscale, and Family Assessment Device were used to evaluate the emotional regulation, social problems, anxiety/depression emotions, and family functionality of the participants. A moderated mediation model was employed to analyze whether social problems and family functionality mediate and moderate the relationship between emotional regulation and anxiety/depression emotions.
Results Social problems partially mediated the impact of emotional dysregulation on anxiety/depression emotions in ADHD children, with the direct effect being 0.26 (95% confidence interval CI: 0.17, 0.36, P<0.001), the indirect effect being 0.13 (95% CI: 0.07, 0.19, P<0.001), and the mediating effect accounting for 33% of the total effect. Family functionality exhibited a positive moderating effect on the relationship between social problems and anxiety/depression emotions.
Conclusion This study contributes to the understanding of complex factors influencing anxiety/depression in children with ADHD, providing reference for the further development of targeted interventions for children with ADHD and the improvement of prognosis.

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