本文選題：孤獨癥譜系障礙　切入點：家長　出處：《南華大學》2016年碩士論文　論文類型：學位論文

【摘要】：目的:了解孤獨癥譜系障礙(Autism Spectrum Disorders,ASDs)兒童家長不良心理應激水平的現(xiàn)狀,探討應用行為分析療法(Applied Behavior Analysis,ABA)訓練后,家長不良心理應激水平變化情況及其影響因素。方法:(1)使用焦慮自評量表(Zung Self-Rating Anxiety Scale,SAS)、抑郁自評量表(Zung Self-Rating Depression scale,SDS)、家庭功能量表(Family Assessment Device,FAD)及社會支持量表(Social Support Rating Scale,SSRS)對31名ASDs患兒家長及正常對照組進行調(diào)查,橫向比較家長不良心理應激水平、家庭功能與社會支持情況。(2)采用自身對照研究,其中29組ASDs患兒及家長進行應用行為分析療法(Applied Behavior Analysis,ABA)干預3個月,以研究者填寫孤獨癥治療評定量表(Autism treatment evaluation checklist,ATEC)作為臨床療效評定指標,以家長填寫SAS、SDS來評估家長不良心理應激水平,分別在訓練1個月末、3個月末用以上量表進行縱向評估,并進行相關性研究。結果:(1)ASDs組家長的焦慮發(fā)生率為35.5%,與正常對照組6.5%比較,差異具有統(tǒng)計學意義(c2=7.88,P0.05),ASDs組家長抑郁發(fā)生率為38.7%,與正常對照組9.7%比較,差異具有統(tǒng)計學意義(c2=7.12,P0.05)。(2)家庭功能方面,ASDs組在溝通、情感反應、情感介入、行為控制及總的功能上得分均高于正常對照組,得分越高表明相應方面功能越差,差異具有統(tǒng)計學意義(P0.05),而在問題解決、角色得分上差異無統(tǒng)計學意義(P0.05)。(3)社會支持方面,在總分、主觀支持及對支持的利用度上得分均低于正常組對照組,差異有統(tǒng)計學意義(P0.05),而在客觀支持得分上差異無統(tǒng)計學意義。(4)29名ASDs組患兒及其家長完成了為期3個月ABA訓練,經(jīng)干預后,患兒在語言/言語/交流、社交、感覺/知覺、健康/身體/行為四個方面得分均有下降,療效具有顯著性意義(P0.01)。家長心理焦慮、抑郁方面得分隨時間也逐漸下降,差異具有顯著性意義(P0.01)。(5)基線時家長SAS、SDS得分與SSRS總分呈負相關,ATEC總分呈正相關,癥狀各維度中與健康/身體/行為問題存在相關性(P0.05)。(6)家長SAS、SDS得分與治療三個月后療效存在相關性(r=-0.77,-0.79,均P0.01)。結論:(1)ASDs患兒家長不良心理應激水平較高。(2)ASDs患兒家長不良心理應激水平與患兒的核心癥狀(尤其是健康/身體/行為問題)呈正相關,與社會支持情況呈負相關。(3)ABA訓練不僅可以改善患兒核心癥狀,還可因此降低家長不良心理應激水平。(4)患兒家長的不良心理應激水平與ABA訓練療效存在相關性。
[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.
【學位授予單位】：南華大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R749.94

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