注意力不足過動症兒童的情緒調控問題與家庭脈絡之關係探討

The Problem of Emotion Regulation and Its Association with Family Context in Children with Attention Deficit Hyperactivity Disorder

注意力不足過動症（ADHD）兒童的核心症狀雖然是注意力不足、過動／衝動，但情緒調控問題近來亦受到關切。本研究的目的為從家庭情緒脈絡觀點，探討「父母情緒表達」、「父母情緒教養」、及「家庭的情緒氣氛」對ADHD兒童情緒調控的預測，並比較ADHD兒童及控制組兒童在情緒調控能力及家庭情緒脈絡之差異。研究對象為60位ADHD學齡兒童及60位控制組兒童及其父母。研究方式包括由父母及兒童問卷評量，並透過模擬情境法測量兒童觀看父母衝突影片後的情緒反應及情緒調控能力。結果發現，ADHD兒童自覺害怕與難過強度較弱、平復害怕所需的時間較短、對害怕與生氣情緒的平復程度較容易；但父母評量結果則呈現ADHD兒童日常生活中害怕、難過、生氣之情緒較強烈，且情緒調控能力較弱。兩組兒童之家庭情緒脈絡顯示，ADHD兒童之父母負向情緒表達較多；較多摒除型及失控型情緒理念；較多父母衝突，父子依戀及母子依戀程度較弱。但其中對ADHD兒童情緒反應及情緒調控能力最具預測力的是父母的後設情緒理念，尤其當控制了兒童的症狀之後，父母情緒理念可以預測ADHD兒童的情緒反應及情緒調控能力。本研究顯示父母後設情緒理念對ADHD兒童情緒反應及情緒調控之重要性，此結果可提供臨床工作者訓練ADHD兒童調控情緒之參考。

Much of the current literature dealing with Attention Deficit Hyperactivity Disorder (ADHD) had focused on their two primary deficits; namely, inattention and hyperactivity/impulsivity. Their deficiencies in emotion regulation has also been concerned recently. Nevertheless, the difficulties of emotion regulation in children with ADHD cannot be fully accounted by their cognitive deficiency such as inattention, hyperactivity and impulsivity. Based on the “Tripartite Model of the Impact of the Family on Children's Emotion Regulation and Adjustment”, the purpose of this study was to examine the 3 family contexts-parent's emotion expression, parental meta emotion philosophy and emotional climate of the family among children with ADHD. Different impacts of the family contexts on children's emotion response and emotion regulation in children with and without ADHD were also compared. Participants included 60 children with ADHD and 60 no diagnosed controls between 6 and 12 years of age. Children's emotional response was coded through laboratory analogous method, and their parents were asked to fill out “Self Expressiveness in the Family Questionnaire, “Scale of Parental Meta-Emotion Philosophy,” “Conflict Tactic Scale,” and “The Emotion Questionnaire.” The results indicated that children with ADHD tended to underestimate their emotion response and overestimate their emotion regulation ability than their parents. As the reports of parents, children with ADHD displayed more emotion regulation difficulties than controls. Significant differences between groups were found in the family contexts. Among the 3 family contexts, parental meta- emotion philosophy was the significant predictor to the emotion response and emotion regulation of children with ADHD. Children's emotion response was predicted by parent's emotion dismissing philosophy and emotion dysfunction philosophy. Children's emotion regulation was predicted by parent's emotion coaching. Implications for the understanding and intervention of emotion regulation problems a mong children with ADHD were discussed.