주의력결핍 과잉행동장애 환자의 치료 순응도에 영향을 미치는 부모 요인에 관한 예비 연구
Treatment Compliance and Parents’ Characteristics in Children with Attention-Deficit Hyperactivity Disorder : Pilot Study
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초록
약물 순응도가 낮은 ADHD 환아의 부모들은 아동이 신체화와 비행의 경향을 보인다고 평가하는 경향이 있었고, 성격적으로 건강염려증과 신경 쇠약의 경향을 가지고 있었다. 양육에 대한 스트레스는 약물 치료를 지속한 부모들과 비교해큰 차이가 없었지만 양육 방식에 대해서 매우 낮은 부모 효능감을 느끼고 있었다. 이러한 요인들은 모두 부모의 불안과관련이 있으며, 이는 치료에 대한 확신의 저하와 약물의 부작용에 대한 민감성의 증가를 통해 ADHD 환아의 치료 순응도에 영향을 미치는 것으로 보인다. 본 연구는 ADHD 환아의 약물 치료 순응도에 영향을 미치는 부모의 요인을 평가한 예비연구로서 향후 이에 대해 더욱 체계적인 전향적 연구가 이루어 진다면 임상의가 약물에 대한 순응도를 예측하고이에 대처하기 위한 방안을 고안하는데 큰 도움이 될 것으로보인다.
Abstract
Objectives This study was conducted to compare characteristics of parents of attention-deficit hyperactivity disorder (ADHD) children in relationship to treatment compliance. Methods A total of 271 school-aged children diagnosed with ADHD were devided into two groups by treatment duration; early dropout group (n=117, treatments discontinued within three months) and continuous treatment groups (n=154, treatments continued for more than three months). Scores on the Korean Personality Inventory for Children (KPI-C), Minnesota Multiphasic Personality Inventory (MMPI), Korean Parenting Sense of Competence (K-PSOC), Korean Parenting Stress Index-Short Form (K-PSI-SF), and Parental Acceptance Rejection Questionnaire (PARQ) were compared between two groups. Results According to the results of the KPI-C, parents of the early dropout group showed a higher tendency to regard their children’s symptoms as ‘somatization’ and ‘delinquency’, compared with those of continuous treatment groups (49.9 vs. 46.3 and 60.9 vs. 58.2, p=0.048 and 0.046, respectively). Parents in the early dropout group showed higher scores on hypochondriasis and psychasthenia subscales in MMPI (54.7 vs. 52.1 and 51.5 vs. 48.5, p=0.024, and 0.017, respectively). The results of the K-PSOC showed that parents in the early dropout group perceived a lower sense of parenting competence (27.3 vs. 58.6, p=0.047). Conclusion Our findings suggested that characteristics of the parents and their perspectives regarding children’s symptoms could be possible factors associated with treatment compliance in ADHD. Further researches on this issue may provide opportunities to improve treatment compliance for children with ADHD.
참고문헌 (39)
- Dulcan M, "Practice parameters for the assessment and treatment of children, adolescents, and adults with attention-deficit", hyperactivity disorder. American Academy of Child and Adolescent Psychiatry, 1997, pp.36(10 Suppl), 85~121
- clinical psychiatry, "Kaplan & Sadock’s synopsis of psychiatry : Behavioral sciences", pp.Lippincott Williams & Wilkins, Sadock BJ
- Mannuzza S, "Adult outcome of hyperactive boys. Educational achievement, occupational rank, and psychiatric status", Arch Gen Psychiatry, 50, pp.565~576 (1993)
- Goldman LS, "Diagnosis and treatment of attention-deficit", hyperactivity disorder in children and adolescents.Council on Scientific Affairs, American Medical Association, 1998, pp.279, 1100~1107
- "Moderators and mediators of treatment response for children with attention-deficit", hyperactivity disorder: the Multimodal Treatment Study of children with Attention-deficit, Arch Gen Psychiatry, pp.1999, 56[DOI]
- Kempton S, "Executive function and attention deficit hyperactivity disorder: stimulant medication and better executive function performance in children", Psychol Med, 29, pp.527~538 (1999)
- Firestone P, "Factors associated with children’s adherence to stimulant medication", Am J Orthopsychiatry, 52, pp.447~457 (1982)
- Brown RT, "Adherence to methylphenidate therapy in a pediatric population: a preliminary investigation", Psychopharmacol Bull, 21, pp.28~36 (1985)
- Adler LD, "Review of medication adherence in children and adults with ADHD", Postgrad Med, 122, pp.184~191 (2010)
- DosReis S, "The meaning of attention-deficit", hyperactivity disorder medication and parents’ initiation and continuity of treatment for their child, 2009, pp.19, 377~383
- Ibrahim el SR, "Rates of adherence to pharmacological treatment among children and adolescents with attention deficit hyperactivity disorder", Hum Psychopharmacol, 17, pp.225~231 (2002)
- Wirt RD, "Multidimensional description of child personality: A manual for the personality inventory for children" (1984), Western psychological Services
- Kim ST, "Manual of KPI-C" (1997), Korea guidance
- Kim JH, "A validity study of parent behavioral rating scales as diagnostic tools of attention deficit", hyperactivity disorder, 2000, pp.11, 282~289
- 김중술, "다면적 인성검사 : MMPI의 임상적 해설" (1988), 서울대학교 출판부
- Shin SJ, "Effects of stress, social support and efficacy on mothers’ parenting behaviors", Korean J Child Stud, 19, pp.27~42 (1998)
- Gibaud-Wallston J, "Development and utility of the parenting sense of competence scale" (1978), John F. Kennedy center for research on education and human development
- Johnston C, "A measure of parenting satisfaction and efficacy", Journal of Clinical Child Psychology, 18, pp.167~175 (1986)
- Abidin RR, "Parenting stress index short form" (1995), Pediatric Psychology Press
- Solis ML, "The Spanish version parenting stress index: a psychometric study", J Clin Child Psychol, 20, pp.372~378 (1991)
- Rohner RP, "The warmth dimension: Foundations of parental acceptance-rejection theory" (1986), Sage Publications, Inc
- Hwang HJ, "Parental acceptance and rejection in children with emotional and behavioral problems", Korean J Educ Psychol, 11, pp.331~350 (1997)
- Arizmendi T, "The Matching Familiar Figures Test: a primary, secondary, and tertiary evaluation", J Clin Psychol, 37, pp.812~818 (1981)
- 은소희, "주의력결핍 과잉행동장애", Korean Journal of Pediatrics, 51(9), pp.935~943 (2008), 대한소아과학회
- Pearson DA, "Effects of methylphenidate treatment in children with mental retardation and ADHD: individual variation in medication response", J Am Acad Child Adolesc Psychiatry, 43, pp.686~698 (2004)
- Lachar D, "Objective personality assessment of children: an exploratory study of the Personality Inventory for Children (PIC) in a child psychiatric setting", J Pers Assess, 42, pp.529~537 (1978)
- Achenbach TM, "The classification of child psychopathology:a review and analysis of empirical efforts", Psychol Bull, 85, pp.1275~1301 (1978)
- Dreger RM, "Behavioral classification project", J Consult Psychol, 28, pp.1~13 (1964)
- Pihl RO, "Learning disabled children as adolescents", J Learn Disabil, 17, pp.96~100 (1984)
- 김용희, "KPI-C 프로파일로 본 ADHD 아동의 행동특성", 한국심리학회지: 건강, 10(1), pp.83~93 (2005), 한국건강심리학회
- Jacobvitz D, "The early caregiver-child relationship and at tention-deficit disorder with hyperactivity in kindergarten: a prospective study", Child Dev, 58, pp.1496~1504 (1987)
- Anastopoulos AD, "Attention deficit hyperactivity disorder, In Cognitive therapy across the lifespan: evidence and practice", pp.418~440 (2003), Cambridge University Press
- Firestone P, "Characteristics of families completing and prematurely discontinuing a behavioral parent-training program", J Pediatr Psychol, 7, pp.209~222 (1982)
- Lahey BB, "Personality characteristics of the mothers of children with disruptive behavior disorders", J Consult Clin Psychol, 57, pp.512~515 (1989)
- Cobham VE, "The role of parental anxiety in the treatment of childhood anxiety", J Consult Clin Psychol, 66, pp.893~905 (1998)
- Teti DM, "Behavioral competence among mothers of infants in the first year: the mediational role of maternal self-efficacy", Child Dev, 62, pp.918~929 (1991)
- Mash EJ, "Parental perceptions of child behavior problems,parenting self-esteem, and mothers’ reported stress in younger and older hyperactive and normal children", J Consult Clin Psychol, 51, pp.86~99 (1983)
- Gondoli DM, "Maternal emotional distress and diminished responsiveness: the mediating role of parenting efficacy and parental perspective taking", Dev Psychol, 33, pp.861~868 (1997)
- Klein RG, "Clinical efficacy of methylphenidate in children and adolescents", Encephale, 19, pp.89~93 (1993)