南方医科大学学报 ›› 2026, Vol. 46 ›› Issue (4): 794-802.doi: 10.12122/j.issn.1673-4254.2026.04.08
• • 上一篇
杨新梅1(
), 王咏琪3, 莫晓华1, 朱智航1, 洪丹萍1, 胡樱子1, 彭凯琪2, 徐艺轩1, 刘锦岚4, 郭文娟2, 林绮文1, 麦俊杰1, 麦思茗1, 卢京洁1, 杨婵娟1, 周燕玲1, 程道猛1, 余萌2(
), 殷炜珍1(
)
收稿日期:2025-08-03
出版日期:2026-04-20
发布日期:2026-04-24
通讯作者:
余萌,殷炜珍
E-mail:yxm13167337991@163.com;yumengbnu@163.com;yinwz90@163.com
作者简介:杨新梅,硕士,E-mail: yxm13167337991@163.com
基金资助:
Xinmei YANG1(
), Yongqi WANG3, Xiaohua MO1, Zhihang ZHU1, Danping HONG1, Yingzi HU1, Kaiqi PENG2, Yixuan XU1, Jinlan LIU4, Wenjuan GUO2, Qiwen LIN1, Junjie MAI1, Siming MAI1, Jingjie LU1, Chanjuan YANG1, Yanling ZHOU1, Daomeng CHENG1, Meng YU2(
), Weizhen YIN1(
)
Received:2025-08-03
Online:2026-04-20
Published:2026-04-24
Contact:
Meng YU, Weizhen YIN
E-mail:yxm13167337991@163.com;yumengbnu@163.com;yinwz90@163.com
摘要:
目的 基于多维干预成效指标,初步探究可能影响注意缺陷/多动障碍(ADHD)儿童团体干预响应的个体与家庭特征。 方法 纳入2023年7月~2025年1月在广州医科大学附属脑科医院参与干预项目的62例6~9岁ADHD儿童,接受为期4~6周(共8次)的标准化团体干预,内容聚焦于注意力训练与情绪调节训练。通过一般情况量表、小学生情绪调节困难问卷(DERS)、易激惹量表(ARI)、马特森儿童社会技能评价量表(MESSY)与SNAP-Ⅳ评定量表-父母版收集前后测数据。鉴于两组干预在形式与结构上的一致,遂合并数据开展建模分析。以注意缺陷、情绪调节、社交技能等三方面变量的变化作为结局指标,通过LASSO回归对18项前测变量(涵盖8项心理特征和10项人口学与家庭背景变量)进行筛选,进而构建多元线性回归模型,识别稳定预测因子。 结果 在注意缺陷、易激惹、情绪调节困难和过于强势/过度自信为结局变量的模型中,结局指标自身的基线得分为显著正向预测因子(β=0.462~0.669,P_BH<0.05);敌对的前测得分对干预后情绪调节困难(β=-0.326,P_BH<0.01)、过于强势/过度自信(β=-0.543,P_BH<0.05)的改善表现出显著负向预测作用。 结论 本研究初步支持了基线症状、敌对特征对干预响应的预测作用。这些发现有助于在干预前对患儿的疗效进行初步预测,为实现ADHD的精准干预提供了可能的参考依据。
杨新梅, 王咏琪, 莫晓华, 朱智航, 洪丹萍, 胡樱子, 彭凯琪, 徐艺轩, 刘锦岚, 郭文娟, 林绮文, 麦俊杰, 麦思茗, 卢京洁, 杨婵娟, 周燕玲, 程道猛, 余萌, 殷炜珍. 患儿个体与家庭特征对注意缺陷/多动障碍团体干预效果的预测:基于多维模型构建与分析[J]. 南方医科大学学报, 2026, 46(4): 794-802.
Xinmei YANG, Yongqi WANG, Xiaohua MO, Zhihang ZHU, Danping HONG, Yingzi HU, Kaiqi PENG, Yixuan XU, Jinlan LIU, Wenjuan GUO, Qiwen LIN, Junjie MAI, Siming MAI, Jingjie LU, Chanjuan YANG, Yanling ZHOU, Daomeng CHENG, Meng YU, Weizhen YIN. Patient and family predictors of group intervention outcomes in children with attention-deficit/hyperactivity disorder: a multidimensional model analysis[J]. Journal of Southern Medical University, 2026, 46(4): 794-802.
| Index | Attention group (n=31) | Emotion group (n=31) | P |
|---|---|---|---|
| Age (year, Mean±SD) | 7.55±1.61 | 7.94±0.89 | 0.247 |
| Gender | 0.425 | ||
| Male | 29 (93.5) | 26 (83.9) | |
| Female | 2 (6.5) | 5 (16.1) | |
| Grade level | 0.602 | ||
| Grade 2 or below | 13 (41.9) | 11 (35.5) | |
| Grade 3 or above | 18 (58.1) | 20 (64.5) | |
| Residential area | >0.999 | ||
| Rural/town | 5 (16.1) | 4 (12.9) | |
| Urban | 26 (83.9) | 27 (87.1) | |
| Maternal education | >0.999 | ||
| Below college | 4 (12.9) | 3 (9.7) | |
| College or above | 27 (87.1) | 28 (90.3) | |
| Paternal education | 0.562 | ||
| Below college | 9 (29.0) | 7 (22.6) | |
| College or above | 22 (71.0) | 24 (77.4) | |
| Birth status | 0.288 | ||
| Cesarean delivery | 13 (41.9) | 9 (29.0) | |
| Vaginal delivery | 18 (58.1) | 22 (71.0) | |
| Allergy history | >0.999 | ||
| No | 26 (83.9) | 27 (87.1) | |
| Yes | 5 (16.1) | 4 (12.9) | |
| Medication history | 0.066 | ||
| No | 16 (51.6) | 23 (74.2) | |
| Yes | 15 (48.4) | 8 (25.8) | |
| Psychiatric family history | 0.104 | ||
| No | 30 (96.8) | 25 (80.6) | |
| Yes | 1 (3.2) | 6 (19.4) |
表1 两组患者人口学及家庭背景资料比较结果
Tab.1 Comparison of demographic and family background data between the two groups [n (%)]
| Index | Attention group (n=31) | Emotion group (n=31) | P |
|---|---|---|---|
| Age (year, Mean±SD) | 7.55±1.61 | 7.94±0.89 | 0.247 |
| Gender | 0.425 | ||
| Male | 29 (93.5) | 26 (83.9) | |
| Female | 2 (6.5) | 5 (16.1) | |
| Grade level | 0.602 | ||
| Grade 2 or below | 13 (41.9) | 11 (35.5) | |
| Grade 3 or above | 18 (58.1) | 20 (64.5) | |
| Residential area | >0.999 | ||
| Rural/town | 5 (16.1) | 4 (12.9) | |
| Urban | 26 (83.9) | 27 (87.1) | |
| Maternal education | >0.999 | ||
| Below college | 4 (12.9) | 3 (9.7) | |
| College or above | 27 (87.1) | 28 (90.3) | |
| Paternal education | 0.562 | ||
| Below college | 9 (29.0) | 7 (22.6) | |
| College or above | 22 (71.0) | 24 (77.4) | |
| Birth status | 0.288 | ||
| Cesarean delivery | 13 (41.9) | 9 (29.0) | |
| Vaginal delivery | 18 (58.1) | 22 (71.0) | |
| Allergy history | >0.999 | ||
| No | 26 (83.9) | 27 (87.1) | |
| Yes | 5 (16.1) | 4 (12.9) | |
| Medication history | 0.066 | ||
| No | 16 (51.6) | 23 (74.2) | |
| Yes | 15 (48.4) | 8 (25.8) | |
| Psychiatric family history | 0.104 | ||
| No | 30 (96.8) | 25 (80.6) | |
| Yes | 1 (3.2) | 6 (19.4) |
| Outcome | Pre-intervention | Post-intervention | t | P |
|---|---|---|---|---|
| Inattention | 1.86±0.60 | 1.59±0.60 | 4.741 | <0.001 |
| ARI | 4.91±3.61 | 3.60±3.63 | 2.391 | 0.017 |
| DERS | 69.00±11.29 | 64.10±14.82 | 2.096 | 0.036 |
| Inappropriately assertive/overconfident | 34.43±6.90 | 32.56±7.84 | 2.353 | 0.019 |
| Hostile | 19.85±6.38 | 19.53±6.68 | 0.534 | 0.594 |
| Adaptive/appropriate | 33.31±5.49 | 32.32±4.85 | 1.283 | 0.201 |
表2 合并干预组干预前后3方面指标得分变化情况
Tab.2 Pre-post intervention changes in scores across 3 outcome domains in the combined intervention group (n=62, Mean±SD)
| Outcome | Pre-intervention | Post-intervention | t | P |
|---|---|---|---|---|
| Inattention | 1.86±0.60 | 1.59±0.60 | 4.741 | <0.001 |
| ARI | 4.91±3.61 | 3.60±3.63 | 2.391 | 0.017 |
| DERS | 69.00±11.29 | 64.10±14.82 | 2.096 | 0.036 |
| Inappropriately assertive/overconfident | 34.43±6.90 | 32.56±7.84 | 2.353 | 0.019 |
| Hostile | 19.85±6.38 | 19.53±6.68 | 0.534 | 0.594 |
| Adaptive/appropriate | 33.31±5.49 | 32.32±4.85 | 1.283 | 0.201 |
图1 以注意缺陷改善为结局变量的20次多重插补LASSO回归模型中变量的入选情况
Fig.1 Variable selection frequency across 20 multiply imputed LASSO regression models with inattention improvement as the outcome.
图2 以易激惹改善为结局变量的20次多重插补LASSO回归模型中变量的入选情况
Fig.2 Variable selection frequency across 20 multiply imputed LASSO regression models with ARI improvement as the outcome.
图3 以情绪调节困难改善为结局变量的20次多重插补LASSO回归模型中变量的入选情况
Fig.3 Variable selection frequency across 20 multiply imputed LASSO regression models with DERS improvement as the outcome.
图4 以过于强势/过度自信改善为结局变量的20次多重插补LASSO回归模型中变量的入选情况
Fig.4 Variable selection frequency across 20 multiply imputed LASSO regression models with improvement of inappropriate assertiveness/overconfidence as the outcome.
| Outcomes | Predictors | b (95% CI) | β | P | P_BH | Adj_R2 |
|---|---|---|---|---|---|---|
| Inattention | (Constant) | -0.045 (-1.072, 0.981) | 0.930 | 0.930 | 0.180 | |
| Baseline inattention | 0.315 (0.126, 0.503) | 0.462 | 0.002 | 0.009 | ||
| Baseline hostile | -0.021 (-0.039, -0.003) | -0.327 | 0.023 | 0.070 | ||
| Baseline adaptive/appropriate | 0.004 (-0.019, 0.026) | 0.047 | 0.748 | 0.897 | ||
| Baseline ARI | 0.008 (-0.030, 0.046) | 0.072 | 0.659 | 0.897 | ||
| Baseline DERS | 0.003 (-0.009, 0.016) | 0.090 | 0.594 | 0.897 | ||
| ARI | (Constant) | 2.343 (-6.640, 11.327) | 0.601 | 0.601 | 0.476 | |
| Baseline ARI | 0.764 (0.485, 1.042) | 0.669 | <0.001 | <0.001 | ||
| Baseline DERS | -0.028 (-0.127, 0.071) | -0.078 | 0.562 | 0.601 | ||
| Baseline hostile | -0.147 (-0.293, 0.000) | -0.226 | 0.050 | 0.088 | ||
| Baseline adaptive/appropriate | 0.149 (-0.042, 0.340) | 0.197 | 0.121 | 0.170 | ||
| Residential area | 2.748 (0.358, 5.139) | 0.237 | 0.025 | 0.073 | ||
| Maternal education | 3.033 (0.286, 5.780) | 0.236 | 0.031 | 0.073 | ||
| DERS | (Constant) | -34.856 (-60.504, -9.208) | 0.009 | 0.009 | 0.357 | |
| Baseline DERS | 0.828 (0.467, 1.188) | 0.544 | <0.001 | <0.001 | ||
| Baseline hostile | -0.875 (-1.498, -0.252) | -0.326 | 0.007 | 0.009 | ||
Inappropriately assertive/overconfident | (Constant) | -3.214 (-17.691, 11.263) | 0.657 | 0.657 | 0.162 | |
Baseline inappropriately assertive/overconfident | 0.573 (0.171, 0.975) | 0.666 | 0.007 | 0.033 | ||
| Baseline hostile | -0.504 (-0.906, -0.101) | -0.543 | 0.016 | 0.039 | ||
| Baseline adaptive/appropriate | 0.215 (-0.107, 0.537) | 0.199 | 0.183 | 0.304 | ||
| Baseline DERS | 0.037 (-0.100, 0.174) | 0.071 | 0.593 | 0.657 |
表3 多元线性回归分析结果
Tab.3 Results of multiple linear regression analyses
| Outcomes | Predictors | b (95% CI) | β | P | P_BH | Adj_R2 |
|---|---|---|---|---|---|---|
| Inattention | (Constant) | -0.045 (-1.072, 0.981) | 0.930 | 0.930 | 0.180 | |
| Baseline inattention | 0.315 (0.126, 0.503) | 0.462 | 0.002 | 0.009 | ||
| Baseline hostile | -0.021 (-0.039, -0.003) | -0.327 | 0.023 | 0.070 | ||
| Baseline adaptive/appropriate | 0.004 (-0.019, 0.026) | 0.047 | 0.748 | 0.897 | ||
| Baseline ARI | 0.008 (-0.030, 0.046) | 0.072 | 0.659 | 0.897 | ||
| Baseline DERS | 0.003 (-0.009, 0.016) | 0.090 | 0.594 | 0.897 | ||
| ARI | (Constant) | 2.343 (-6.640, 11.327) | 0.601 | 0.601 | 0.476 | |
| Baseline ARI | 0.764 (0.485, 1.042) | 0.669 | <0.001 | <0.001 | ||
| Baseline DERS | -0.028 (-0.127, 0.071) | -0.078 | 0.562 | 0.601 | ||
| Baseline hostile | -0.147 (-0.293, 0.000) | -0.226 | 0.050 | 0.088 | ||
| Baseline adaptive/appropriate | 0.149 (-0.042, 0.340) | 0.197 | 0.121 | 0.170 | ||
| Residential area | 2.748 (0.358, 5.139) | 0.237 | 0.025 | 0.073 | ||
| Maternal education | 3.033 (0.286, 5.780) | 0.236 | 0.031 | 0.073 | ||
| DERS | (Constant) | -34.856 (-60.504, -9.208) | 0.009 | 0.009 | 0.357 | |
| Baseline DERS | 0.828 (0.467, 1.188) | 0.544 | <0.001 | <0.001 | ||
| Baseline hostile | -0.875 (-1.498, -0.252) | -0.326 | 0.007 | 0.009 | ||
Inappropriately assertive/overconfident | (Constant) | -3.214 (-17.691, 11.263) | 0.657 | 0.657 | 0.162 | |
Baseline inappropriately assertive/overconfident | 0.573 (0.171, 0.975) | 0.666 | 0.007 | 0.033 | ||
| Baseline hostile | -0.504 (-0.906, -0.101) | -0.543 | 0.016 | 0.039 | ||
| Baseline adaptive/appropriate | 0.215 (-0.107, 0.537) | 0.199 | 0.183 | 0.304 | ||
| Baseline DERS | 0.037 (-0.100, 0.174) | 0.071 | 0.593 | 0.657 |
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