MOTHER-CHILD INTERACTION PATTERNS OF ADHD CHILDREN

주의력결핍 과잉활동아의 모-자 상호행동

  • Ha, Eun-Hye (Department of Psychology, Yonsei University) ;
  • Oh, Kyung-Ja (Department of Psychology, Yonsei University) ;
  • Hong, Kang-E (Div. of Child-Adol. Psychiatry, Seoul National University Children's Hospital)
  • 하은혜 (연세대학교 심리학과) ;
  • 오경자 (연세대학교 심리학과) ;
  • 홍강의 (서울대학교 의과대학 소아정신과)
  • Published : 1992.12.31

Abstract

The present study was designed to investigate variables associated with mother-child interaction patterns of Attention Deficit Hyperactivity Disorder(ADHD), and also to evaluate short-term effects of stimulant medication on the behaviors of ADHD children and their mothers during interaction. 15 ADHD boys(ages 5${\sim}$10 years) were treated with metylphenidate(0.5mg/kg per day) for 1 month, and their behaviors as well as their mothers for the 10 minute free play and 20 minute task performance period were videotaped through one-way mirror. The childrens attention was also evaluated using the Continuous Performance Task(CPT) and ratings of their hyperactive behaviors were obtained from their mother prior to the treatment. The videotaped interaction were rated according to the Response Class Matrix developed by Mash, Terdal & Anderson(1973). Results indicated that percentage of behavior of the mother and child during interaction was highly correlated with each other, which, in turn, was highly correlated with the symptom severity of the ADHD child. That is the more severe the cognitive and behavioral symptoms of ADHD, the more negative the interaction behavior pattern was. After 4 weeks of stimulant medication the mothers as well as the ADHD children showed a significant decrease in the percentage of negative-aggressive behavior during the task performance period. The results indicated that negative interaction behavior of the mothers was in large part a response to the negative behavior of their ADHD children.

본 연구에서는 주의력결핍 과잉활동 증상으로 진단한 5${\sim}$10세의 남자아동 15명과 그 어머니와의 상호행동을 녹화하여 Mash, Terdal과 Anderson(1973)의 반응유목 행렬표(Response Class Matrix)를 이용하여 평가한 후, 이들의 상호행동 양상과 아동, 어머니의 특성들과의 상관관계를 조사하였다. 이와함께 이들에게 중추신경각성제인 Methylphenidate를 1일 몸무게 기준 0.5mg을 한 달간 투약하여 치료 전파 치료 후 모-자 상호행동 양상을 비교하였다. 그 결과 아동과 어머니의 부정적 상호행동은 서로 상관이 높으며, 양자의 상호행동에 일관되게 상관이 높은 변인은 아동의 인지적, 행동적 증상의 심각성으로 아동의 증상이 심할수록 부정적인 모-자 상호행동이 두드러졌다. 그리고, 한달간의 약물치료 후 과제수행단계에서 아동과 어머니 모두 부정적-공격적 행동이 감소하였다. 이와 같은 결과는 어머니의 부정적 상호행동은 아동의 인지적, 행동적 증상에 따른 반응적인 것임을 시사하고 있다.

Keywords