罹患注意力不足／過動症之青少年整體自尊之相關因子：增強敏感度和合併自閉症類群障礙症和抽搐症的角色

Correlates of Global Self-esteem in Adolescents with Attention-Defi cit Hyperactivity Disorder: Roles of Reinforcement Sensitivity and Comorbid Autism Spectrum and Tic Disorders

目的：本研究檢驗罹患注意力不足／過動症之青少年中，整體自尊高低程度與以行為抑 制／趨近系統評估的增強敏感度、合併自閉症類群障礙症和抽搐症、社會人口學因子、注 意力不足／過動症特質、內／外向行為問題之相關性。方法：邀請287 位年齡於11 至18 歲 間具有注意力不足／過動症診斷之青少年進入研究。以Rosenberg Self-Esteem Scale 評估整體 自尊高低程度，並分析檢驗其相關因子。結果：罹患注意力不足／過動症之青少年其行為抑 制傾向越高 (p < 0.001)、行為趨近傾向越低 (p < 0.05)、對於家庭關係越不滿意 (p < 0.001)、 憂鬱 (p < 0.001) 和焦慮 (p < 0.001) 症狀越嚴重、未接受藥物以治療注意力不足／過動症者 (p < 0.05)，整體自尊程度顯著較低。合併自閉症類群障礙症或抽搐症未與整體自尊呈現顯著相 關。結論：包括增強敏感度、家庭關係、憂鬱和焦慮症狀、有無接受藥物治療等多重因子， 和罹患注意力不足／過動症青少年之整體自尊高低程度具有相關性。

Objective: This study was to examine the correlations of global self-esteem with reinforcement sensitivity on the behavioral inhibition system and the behavioral approach system (BIS/BAS), comorbid autism spectrum disorder (ASD) and tic disorder, sociodemographic and attention defi cit hyperactivity disorder (ADHD) characteristics, as well as internalizing and externalizing problems among adolescents with ADHD. Methods: We recruited 287 adolescents aged 11-18 years with diagnosis of ADHD in this study. Their levels of global self-esteem were assessed using the Rosenberg Self-Esteem Scale. Results: Adolescents with ADHD who reported a higher level of BIS (p < 0.001) and a lower level of BAS (p < 0.05) reported to have signifi cantly low global self-esteem. By comparison, those who reported a lower degree of satisfaction in their family relationship (p < 0.001) and more severe depressive (p < 0.001) and anxiety (p < 0.001) symptoms as well as those who did not receive medication for ADHD (p < 0.05) reported to have signifi cantly low global self-esteem. But the presences of comorbid ASD and tic disorder were not signifi cantly associated with low global self-esteem. Conclusion: Multiple dimensions of factors, including reinforcement sensitivity, family relationship, depression and anxiety, and receiving medication for ADHD, were found to be signifi cantly associated with global self-esteem in adolescents with ADHD.