ABA训练对孤独症谱系障碍儿童家长不良心理应激影响的研究

发布时间：2018-03-06 17:49

本文选题：孤独症谱系障碍　切入点：家长　出处：《南华大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:了解孤独症谱系障碍(Autism Spectrum Disorders,ASDs)儿童家长不良心理应激水平的现状,探讨应用行为分析疗法(Applied Behavior Analysis,ABA)训练后,家长不良心理应激水平变化情况及其影响因素。方法:(1)使用焦虑自评量表(Zung Self-Rating Anxiety Scale,SAS)、抑郁自评量表(Zung Self-Rating Depression scale,SDS)、家庭功能量表(Family Assessment Device,FAD)及社会支持量表(Social Support Rating Scale,SSRS)对31名ASDs患儿家长及正常对照组进行调查,横向比较家长不良心理应激水平、家庭功能与社会支持情况。(2)采用自身对照研究,其中29组ASDs患儿及家长进行应用行为分析疗法(Applied Behavior Analysis,ABA)干预3个月,以研究者填写孤独症治疗评定量表(Autism treatment evaluation checklist,ATEC)作为临床疗效评定指标,以家长填写SAS、SDS来评估家长不良心理应激水平,分别在训练1个月末、3个月末用以上量表进行纵向评估,并进行相关性研究。结果:(1)ASDs组家长的焦虑发生率为35.5%,与正常对照组6.5%比较,差异具有统计学意义(c2=7.88,P0.05),ASDs组家长抑郁发生率为38.7%,与正常对照组9.7%比较,差异具有统计学意义(c2=7.12,P0.05)。(2)家庭功能方面,ASDs组在沟通、情感反应、情感介入、行为控制及总的功能上得分均高于正常对照组,得分越高表明相应方面功能越差,差异具有统计学意义(P0.05),而在问题解决、角色得分上差异无统计学意义(P0.05)。(3)社会支持方面,在总分、主观支持及对支持的利用度上得分均低于正常组对照组,差异有统计学意义(P0.05),而在客观支持得分上差异无统计学意义。(4)29名ASDs组患儿及其家长完成了为期3个月ABA训练,经干预后,患儿在语言/言语/交流、社交、感觉/知觉、健康/身体/行为四个方面得分均有下降,疗效具有显著性意义(P0.01)。家长心理焦虑、抑郁方面得分随时间也逐渐下降,差异具有显著性意义(P0.01)。(5)基线时家长SAS、SDS得分与SSRS总分呈负相关,ATEC总分呈正相关,症状各维度中与健康/身体/行为问题存在相关性(P0.05)。(6)家长SAS、SDS得分与治疗三个月后疗效存在相关性(r=-0.77,-0.79,均P0.01)。结论:(1)ASDs患儿家长不良心理应激水平较高。(2)ASDs患儿家长不良心理应激水平与患儿的核心症状(尤其是健康/身体/行为问题)呈正相关,与社会支持情况呈负相关。(3)ABA训练不仅可以改善患儿核心症状,还可因此降低家长不良心理应激水平。(4)患儿家长的不良心理应激水平与ABA训练疗效存在相关性。
[Abstract]:Objective: to investigate the status of bad psychological stress in parents of autistic children with autism spectrum disorder (Autism Spectrum disordersm), and to explore the application of behavioral analysis therapy in the training of applied Behavior analysis (Aba). Methods the changes of parents' unhealthy psychological stress level and its influencing factors were analyzed by using Self-Rating Anxiety scale, Self-Rating Depression scale, Family Assessment device and Social Support Rating scale SSRSs in 31 ASDs subjects. Methods: 1) Self-Rating Anxiety scale (SASs), Zung Self-Rating Depression scale (SDSs), Family function scale (Family Assessment device FAD) and Social support scale (SSRS) were used in 31 ASDs patients. The parents of the children and the normal control group were investigated. Self-control study was used to compare parents' poor psychological stress level, family function and social support. 29 groups of children with ASDs and their parents were treated with applied Behavior analysis of ABA for 3 months. The treatment evaluation checklist was used as the clinical curative effect evaluation index, and the parents filled in SAS SDS to assess the parents' bad psychological stress level. After training for one month and three months respectively, the questionnaire was used to evaluate the clinical efficacy of the patients, and the longitudinal assessment was made by using the above scale at the end of one month and three months respectively. Results the incidence of parents' anxiety was 35.55.Compared with the normal control group (6.5%), the incidence of parental depression was 38.7% in the control group (P 0.05) and 38.7% in the control group (P 0.05), compared with that in the control group (9.7%). The scores of communication, emotional response, emotional intervention, behavior control and total function in ASDs group were higher than those in normal control group. The higher the score was, the worse the corresponding function was. The difference was statistically significant (P 0.05), but in problem solving, there was no significant difference in role score (P 0.05). In social support, the scores of total score, subjective support and utilization of support were lower than those of the control group. The difference was statistically significant (P 0.05), but there was no significant difference in objective support scores. 29 children in ASDs group and their parents completed ABA training for 3 months. After intervention, the children were in language / speech / communication, social intercourse, feeling / perception. The scores of health / body / behavior were all decreased, and the curative effect was significant (P 0.01). The scores of parents' psychological anxiety and depression decreased gradually with time. At baseline, there was a negative correlation between the total score of SSRS and the total score of SSRS, and there was a positive correlation between the score of SSRS and the total score of SSRS. There was a correlation between symptom dimensions and health / body / behavioral problems (P0.05. 6) there was a correlation between the scores of SAS SDS of parents and the curative effect three months after treatment (P 0.01). Conclusion the level of unhealthy psychological stress of parents in children with ASDs is higher than that in children with ASDs (P < 0. 01). Conclusion the level of unhealthy psychological stress of parents in children with ASDs is higher than that in children with ASDs (P < 0. 01). The level of stress was positively correlated with the core symptoms (especially health / physical / behavioral problems). There was a negative correlation between ABA training and social support. It could not only improve the core symptoms of children, but also reduce the level of bad psychological stress of parents. 4) there was a correlation between the level of bad psychological stress and the effect of ABA training.
【学位授予单位】：南华大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R749.94

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