社交技能训练对自闭症谱系障碍患儿母亲疾病不确定感干预效果研究

祖燕飞; 杜亚松; 周颖群; 樊宁; 朱书仪; 曹阳; 江文庆; 徐光兴

doi:10.16835/j.cnki.1000-9817.2022.08.029

社交技能训练对自闭症谱系障碍患儿母亲疾病不确定感干预效果研究

doi: 10.16835/j.cnki.1000-9817.2022.08.029

1.
上海健康医学院心理健康教育与咨询中心，上海 201318
2.
上海交通大学医学院附属精神卫生中心
3.
上海新华医院发育行为与儿童保健科
4.
上海交通大学附属精神卫生中心
5.
苏州大学附属广济医院精神科
6.
上海市精神卫生中心儿少科
7.
华东师范大学心理与认知科学学院

基金项目:

国家重点研发计划重大慢性非传染性疾病防控研究子课题 2017YFC1309900

上海市徐汇区人工智能医疗院地合作项目 2020016

详细信息

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R748 B844.2
计量
- 文章访问数: 588
- HTML全文浏览量: 244
- PDF下载量: 40
- 被引次数: 0
出版历程
- 收稿日期: 2022-01-28
- 修回日期: 2022-03-18
- 网络出版日期: 2022-08-24
- 刊出日期: 2022-08-25

Social skill training for children with autistic spectrum disorder on the uncertainty of the disease from mothers

1.
Shanghai University of Medicine & Health Sciences/Department of Applied Psychology, Shanghai (201318), China

摘要

摘要: 目的应用教育和拓展社交技能项目(简称“PEERS^Ⓡ社交技术”)提高自闭症谱系障碍(ASD)患儿的社交能力，降低患儿母亲的疾病不确定感和不良情绪。方法于2017年9—10月，从上海市某特殊教育培训机构招募30对自闭症患儿母子，采用抽签法分为干预组和对照组(各15对母子)。基于PEERS^Ⓡ社交干预技术内容，采用认知行为团体形式，通过示范、角色扮演，小组演练方式，同时对自闭症患儿母子平行进行社交技术训练。干预前后分别使用疾病不确定感父母量表(PPUS)、患者健康问卷抑郁分表(PHQ-9)、贝克抑郁量表第二版中文版(BDI-Ⅱ-C)、贝克焦虑量表(BAI)、状态-特质焦虑问卷(STAI-Form Y)对母亲进行调查, 使用自闭症患儿行为量表(ABC)、自闭症患儿症状量表(CARS)、社会交往问卷(SCQ)对ASD患儿进行调查。结果干预组患儿行为量表和母亲的情绪量表得分前后测差值均小于0。干预后，干预组母亲与对照组母亲的疾病不确定感总分(74.93±13.58, 90.40±9.21)及不明确性(31.13±7.07，38.93±4.73)、缺乏信息(11.93±2.09，13.80±2.54)、不可预测(9.60±1.99，12.07±2.89)比较差异均有统计学意义(t值分别为-3.65，-3.55，-2.20，-2.72，P值均 < 0.05)。结论社交PEERS^Ⓡ团体干预能够提高ASD患儿的社交技巧，降低疾病不确定感各维度对母亲的影响。及时、有效的提供疾病相关信息，帮助母亲积极参与患儿的照顾与训练，可减少认知偏差、降低抑郁、焦虑等不良情绪。
- 孤独性障碍 /
- 人际关系 /
- 团体处理 /
- 干预性研究 /
- 儿童
Abstract: Objective To improve the social skills of children with ASD by using Program for the Education and Enrichment of Relational Skills(PEERS^Ⓡ), and to reduce the uncertainty towards ASD and negative emotions for mothers of ASD children. Methods From September to October 2017, 30 dyads of autistic mother and child were recruited and divided into intervention group and control group (15 mother-child dyads each). Based on the content of PEERS^Ⓡ social skill, cognitive behavior therapy was delivered in group format, through demonstration, role play and group exercise. At the same time, mother-child dyads were trained using parallel social technology. Mothers and children with ASD were investigated using Parents' Perception of Uncertainty Scale (PPUS), Patient Health Questionnaire-9 (PHQ-9), Chinese Version of the Beck Depression Inventory-II(BDI-Ⅱ-C), Beck Anxiety Inventory (BAI), State-Trait Anxiety Inventory(STAI-Form Y), and Autism Behavior Checklist (ABC), Cildhood Autism Rating Scale (CARS), and Social Communication Questionnaire (SCQ). Results Changes in ASD symptom score in children and emotional score of mothers in the intervention group were less than 0. The total score of mother disease uncertainty(74.93±13.58, 90.40±9.21), ambiguity(31.13±7.07, 38.93±4.73), lack of clarity information(11.93±2.09, 13.80±2.54), unpredictability(9.60±1.99, 12.07±2.89), significantly changed after intervention(t=-3.65, -3.55, -2.20, -2.72, P < 0.05). Conclusion Social PEERS^Ⓡ group intervention can enhance the social skills of children with ASD, reduce uncertainty of illness among mother of ASD children. Timely disease-related information, guidance for mothers to actively participate in child care and training, might help to reduce cognitive bias, depressive and anxiety symptoms among mothers.
- Autistic disorder /
- Interpersonal relations /
- Group processes /
- Intervention studies /
- Child
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

表 1 干预前后干预组与对照组母亲疾病不确定感得分比较(x±s)

Table 1. Comparison of the scores of the uncertainty of mother's disease between intervention group and control group before and after intervention(x±s)

测试时间	组别	人数	统计值	不明确性	缺乏澄清或复杂性	缺乏信息	不可预测	总分
前测	干预组	15		39.73±8.15	26.60±4.61	14.80±2.78	13.20±4.14	94.33±15.99
	对照组	15		37.60±4.48	23.40±4.98	12.80±2.88	11.13±2.29	84.93±11.29
			t值	0.89	1.83	1.93	1.69	1.86
			P值	0.38	0.08	0.06	0.10	0.07
后测	干预组	15		31.13±7.07	22.27±5.34	11.93±2.09	9.60±1.99	74.93±13.58
	对照组	15		38.93±4.73	25.60±4.94	13.80±2.54	12.07±2.89	90.40±9.21
			t值	-3.55	-1.78	-2.20	-2.72	-3.65
			P值	< 0.01	0.10	0.04	0.01	< 0.01

下载: 导出CSV

表 2 社交干预组母亲疾病不确定感得分跟踪比较(x±s)

Table 2. The result of following-up and comparison of the uncertain feeling of mother's disease in social intervention group(x±s)

时间	人数	不明确性	缺乏澄清或复杂性	缺乏信息	不可预测	总分
前测	15	39.73±8.15	26.60±4.61	14.80±2.78	13.20±4.14	94.33±15.99
第2次	15	34.87±6.46	24.53±4.29	13.33±2.77	11.60±3.07	84.33±11.62
后测	15	31.13±7.07	22.27±5.34	11.93±2.09	9.60±1.99	74.93±13.58
干预后6个月	15	27.53±10.01	20.20±5.71	10.87±3.16	10.00±4.38	68.60±15.56
F值		6.33	4.58	5.89	3.27	9.27
P值		< 0.01	< 0.01	< 0.01	< 0.05	< 0.01

下载: 导出CSV

参考文献(24)

[1]	MAENNER M J, SHAW K A, BAKIAN A V, et al. Prevalence and characteristics of autism spectrum disorder among children aged 8 years: autism and developmental disabilities monitoring network, 11 sites, United States, 2018[J]. MMWR Surveill Summar, 2021, 70(11): 1-16. doi: 10.15585/mmwr.ss7011a1
[2]	CAI R Y, RICHDALE A L, DISSANAYAKE C, et al. Brief report: Inter-relationship between emotion regulation, intolerance of uncertainty, anxiety, and depression in youth with autism spectrum disorder[J]. J Autism Develop Disord, 2018, 48(1): 316-325. doi: 10.1007/s10803-017-3318-7
[3]	ULJAREVIĈ M, CARRINGTON S, LEEKAM S. Brief report: effects of sensory sensitivity and intolerance of uncertainty on anxiety in mothers of children with autism spectrum disorder[J]. J Autism Develop Disord, 2016, 46(1): 315-319. doi: 10.1007/s10803-015-2557-8
[4]	SOUTH M, HANLEY M, NORMANSELL-MOSSA K, et al. "Intolerance of uncertainty" mediates the relationship between social profile and anxiety in both Williams syndrome and autism[J]. Autism Res, 2021, 14(9): 1986-1995. doi: 10.1002/aur.2554
[5]	RODGERS J, HODGSON A, SHIELDS K, et al. Towards a treatment for intolerance of uncertainty in young people with autism spectrum disorder: development of the coping with uncertainty in everyday situations (CUES^Ⓒ) programme[J]. J Autism Develop Disord, 2017, 47(12): 3959-3966. doi: 10.1007/s10803-016-2924-0
[6]	NEIL L, OLSSON N C, PELLICANO E. The relationship between intolerance of uncertainty, sensory sensitivities, and anxiety in autistic and typically developing children[J]. J Autism Dev Disord, 2016, 46(6): 1962-1973. doi: 10.1007/s10803-016-2721-9
[7]	CAI R Y, ULJAREVIC M, LEEKAM S R. Predicting mental health and psychological wellbeing in mothers of children with autism spectrum disorder: roles of intolerance of uncertainty and coping[J]. Autism Res, 2020, 13(10): 1797-1801. doi: 10.1002/aur.2341
[8]	MISHEL M H. Parents' perception of uncertainty concerning their hospitalized child[J]. Nurs Res, 1983, 32(6): 324.
[9]	LE COUTEUR A. Autism diagnostic interview: a semi-structured interview for parents and caregivers of autistic persons[J]. J Autism Dev Disord, 1989, 19: 363-387. doi: 10.1007/BF02212936
[10]	LORD C, RUTTER M, LE COUTEUR A. Autism diagnostic interview-revised: a revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders[J]. J Autism Dev Disord, 1994, 24(5): 659-685. doi: 10.1007/BF02172145
[11]	RUTTER M, BAILEY A, LORD C. The social communication questionnaire: manual[M]. Los Angeles: Western Psychological Services, 2003.
[12]	杨晓玲, 黄悦勤, 贾美香, 等. 孤独症行为量表试测报告[J]. 中国心理卫生杂志, 1993, 7(6): 279-280. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS199306017.htm YANG X L, HUANG Y Q, JIA M X, et al. Autistic Behavior Scale test report[J]. Chin Ment Health J, 1993, 7(6): 279-280. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS199306017.htm
[13]	SCHOPLER E, REICHLER R J, DEVELLIS R F, et al. Toward objective classification of childhood autism: childhood Autism Rating Scale(CARS)[J]. J Autism Develop Disord, 1980, 10(1): 91-103.
[14]	BECK A T, STEER R A, BALL R, et al. Comparison of Beck Depression Inventories-IA and-Ⅱ in psychiatric outpatients[J]. J Person Assess, 1996, 67(3): 588-597.
[15]	BECK A T, EPSTEIN N, BROWN G, et al. An inventory for measuring clinical anxiety: psychometric properties[J]. J Consult Clin Psychol, 1988, 56(6): 893.
[16]	SPIELBERGER C D, GORSUCH R L. State-trait anxiety inventory for adults manual and sample manual, instrument and scoring guide[M]. Palo Alto: Consulting Psychologists Press, 1983.
[17]	李文利, 钱铭怡. 状态特质焦虑量表中国大学生常模修订[J]. 北京大学学报(自然科学版), 1995, 31(1): 108-114. https://www.cnki.com.cn/Article/CJFDTOTAL-BJDZ501.013.htm LI W L, QIAN M Y. Revision of the state trait anxiety inventory with sample of Chinese college students[J]. Acta Scientiarum Naturalium Univ Pekin, 1995, 31(1): 108-114. https://www.cnki.com.cn/Article/CJFDTOTAL-BJDZ501.013.htm
[18]	KROENKE K, SPITZER R L, WILLIAMS J B W. The PHQ-9: validity of a brief depression severity measure[J]. J General Intern Med, 2001, 16(9): 606-613.
[19]	LAUGESON E A, FRANKEL F, MOGIL C, et al. Parent-assisted social skills training to improve friendships in teens with autism spectrum disorder[J]. J Autism Develop Disord, 2009, 39(4): 596-606.
[20]	LAUGESON E A, FRANKEL F, GANTMAN A, et al. Evidence-based social skills training for adolescents with autism spectrum disorders: The UCLA PEERS program[J]. J Autism Develop Disord, 2012, 42(6): 1025-1036.
[21]	MOULTON E, LAUGESON E. The Program for the Education and Enrichment of Relational Skills (PEERS)[M]. New York: Academic Press, 2020: 255-273.
[22]	ZHENG S, KIM H, SALZMAN E, et al. Improving social knowledge and skills among adolescents with autism: systematic review and Meta-analysis of UCLA PEERS for adolescents[J]. J Autism Dev Disord, 2021, 51(12): 4488-4503.
[23]	杜亚松, 李改智. 科学交友: 应对交往困难[M]. 北京: 人民卫生出版社, 2019. DU Y S, LI G Z. The science of making friends helping soctally challenged teens and young aduls[M]. Beijing: People's Medical Publishing House, 2019.
[24]	WAYMENT H A, AL-KIRE R, BROOKSHIRE K. Challenged and changed: quiet ego and posttraumatic growth in mothers raising children with autism spectrum disorder[J]. Autism, 2019, 23(3): 607-618.