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1.陆军军医大学(第三军医大学)医学心理系军人发展心理教研室,重庆
2.陆军军医大学(第三军医大学)第二附属医院医学心理科,重庆
3.重庆城市管理职业学院智慧康养学院,重庆
4.重庆工程职业技术学院马克思主义学院,重庆
杨国愉,E-mail: ygy918@tmmu.edu.cn
收稿日期:2024-08-23,
修回日期:2024-12-17,
纸质出版日期:2025-03-15
移动端阅览
衡惠,郑莹灿,贺英,等.目标管理训练的方案构建及其对注意缺陷型注意缺陷多动障碍大学生的心理健康干预效果[J].陆军军医大学学报,2025,47(05):480-488.DOI:10.16016/j.2097-0927.202408091.
HENG H,ZHENG Y C,HE Y,et al.Construction of goal management training program and its efficacy for mental health intervention in college students with inattentive attention deficit hyperactivity disorder[J].J Army Med Univ,2025,47(05):480-488.DOI:10.16016/j.2097-0927.202408091.
衡惠,郑莹灿,贺英,等.目标管理训练的方案构建及其对注意缺陷型注意缺陷多动障碍大学生的心理健康干预效果[J].陆军军医大学学报,2025,47(05):480-488.DOI:10.16016/j.2097-0927.202408091. DOI:
HENG H,ZHENG Y C,HE Y,et al.Construction of goal management training program and its efficacy for mental health intervention in college students with inattentive attention deficit hyperactivity disorder[J].J Army Med Univ,2025,47(05):480-488.DOI:10.16016/j.2097-0927.202408091. DOI:
目的
2
探讨目标管理训练对注意缺陷型注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)大学生核心症状和心理健康水平的改善效果。
方法
2
采用德尔菲法,构建注意缺陷型ADHD大学生目标管理训练方案。在2024年3-6月,通过陆军军医大学第二附属医院及重庆市3所大学发布广告,招募注意缺陷型ADHD大学生共68人,采用计算机随机化法将研究对象分为试验组(34人)和对照组(34人)。试验组接受连续7周,每周1次,每次2 h的目标管理训练,对照组暂不接受训练。使用成人多动症症状自评问卷(Adult ADHD Self-Report Scale,ASRS)、情绪调节困难问卷(Dysregulation of Emotions Rating Scale,DERS)、七项广泛性焦虑障碍量表 (Generalized Anxiety Disorde-7,GAD-7)、抑郁症筛查量表(Patient Health Questionnaire-9,PHQ-9)、自我关怀问卷(Self-Compassion Scale,SCS)、生活满意度量表(Satisfaction with Life Scale,SWLS),在训练前1周内(前测)、训练后1周内(后测)对2组被试进行评估。
结果
2
① 2轮专家咨询的专家权威系数(Cr)为0.83,问卷回收率分别为100%和95%,肯德尔协调系数分别为0.081(
P<
0.01)、0.226(
P<
0.001),变异系数均
<
0.3,专家咨询结果可靠。目标管理训练包含1个一级指标、7个二级指标、20个三级指标。②7周目标管理训练后组别和时间交互作用显示,试验组在注意缺陷症状(Wald
χ
2
=28.35,
P<
0.001)、情绪调节困难(Wald
χ
2
=23.81,
P<
0.001)、焦虑(Wald
χ
2
=22.79,
P<
0.001)、抑郁(Wald
χ
2
=20.52,
P<
0.001)、自我关怀(Wald
χ
2
=9.36,
P
<
0.01)和生活满意度(Wald
χ
2
=3.97,
P
<
0.05)等指标的改善程度与对照组相比均具有统计学差异。
结论
2
目标管理训练能显著改善注意缺陷型ADHD大学生的核心症状,降低焦虑、抑郁水平,增强情绪调节、自我关怀能力,提高生活满意度。
Objective To explore the efficacy of goal management training (GMT) on core symptoms and mental status in college students with attention deficit hyperactivity disorder (ADHD) inattentive ty
pe. Methods Delphi method was used to construct a GMT program for college students with inattentive ADHD. Then
totally 68 college students with inattentive ADHD were recruited through advertisements published by hospitals and universities (Second Affiliated Hospital of Army Medical University
and 3 universities in Chongqing from March to June 2024. The subjects were randomly divided into an intervention group (
n
=34) and a control group (
n
=34). The intervention group received GMT for 2 h
once a week
for 7 weeks
and the control group did not receive training for the time being. The 2 groups were evaluated within 1 week before and in 7 weeks after intervention by using Adult ADHD Self-Report Scale (ASRS)
Dysregulation of Emotions Rating Scale (DERS)
Generalized Anxiety Disorde-7 (GAD-7)
Patient Health Questionnaire-9 (PHQ-9)
Self-Compassion Scale (SCS)
and Satisfaction with Life Scale (SWLS). Results ① The expert authority coefficient (Cr) of 2 rounds of expert consultation was 0.83
with a questionnaire recovery rate of 100% and 95%
respectively
the Kendall’s coordination coefficient was 0.081 (
P
<
0.01) and 0.226 (
P
<
0.01)
and the coefficient of variation was
<
0.3
indicating the results of the expert consultation were reliable. The constructed GMT program includes 1 first-level indicator
7 second-level indicators
and 20 third-level indicators. ② After 7 weeks of GMT intervention
the interaction between the 2 groups and time showed that the experimental group obtained significant improvements than the control group in terms of inattention symptoms (Wald
Chi
-square=28.35
P
<
0.001)
dysregulation of emotions (Wald
Chi
-square=23.81
P
<
0.001)
anxiety (Wald
Chi
-square=22.79
P
<
0.001)
depression (Wald
Chi
-square=20.52
P
<
0.001)
self-compassion (Wald
Chi
-square=9.
36
P
<
0.01)
and life satisfaction (Wald
Chi
-square=3.97
P
<
0.05). Conclusion GMT intervention can significantly improve the core symptoms of college students with inattentive ADHD
reduce anxiety and depression levels
enhance their emotion regulation and self-compassion abilities
and improve their life satisfaction.
POSNER J , POLANCZYK G V , SONUGA-BARKE E . Attention-deficit hyperactivity disorder [J]. Lancet , 2020 , 395 ( 10222 ): 450 - 462 . DOI: 10.1016/S0140-6736(19)33004-1 http://dx.doi.org/10.1016/S0140-6736(19)33004-1 .
FAYYAD J , DE GRAAF R , KESSLER R , et al . Cross-national prevalence and correlates of adult attention-deficit hyperactivity disorder [J]. Br J Psychiatry , 2007 , 190 : 402 - 409 . DOI: 10.1192/bjp.bp.106.034389 http://dx.doi.org/10.1192/bjp.bp.106.034389 .
NORVILITIS J M , INGERSOLL T , ZHANG J , et al . Self-reported symptoms of ADHD among college students in China and the United States [J]. J Atten Disord , 2008 , 11 ( 5 ): 558 - 567 . DOI: 10.1177/1087054707308496 http://dx.doi.org/10.1177/1087054707308496 .
陈琳 , 许诗玮 , 罗学荣 . 长沙市大学生注意缺陷多动障碍及影响因素 [J]. 中国学校卫生 , 2020 , 41 ( 12 ): 1856 - 1858, 1862 . DOI: 10.16835/j.cnki.1000-9817.2020.12.023 http://dx.doi.org/10.16835/j.cnki.1000-9817.2020.12.023 .
CHEN L , XU S W , LUO X R . Prevalence and risk factors of attention deficit hyperactivity disorder among college students in Changsha [J]. Chin J Sch Health , 2020 , 41 ( 12 ): 1856 - 1858, 1862 . DOI: 10.16835/j.cnki.1000-9817.2020.12.023 http://dx.doi.org/10.16835/j.cnki.1000-9817.2020.12.023 .
LIBUTZKI B , LUDWIG S , MAY M , et al . Direct medical costs of ADHD and its comorbid conditions on basis of a claims data analysis [J]. Eur Psychiatry , 2019 , 58 : 38 - 44 . DOI: 10.1016/j.eurpsy.2019.01.019 http://dx.doi.org/10.1016/j.eurpsy.2019.01.019 .
INSTANES J T , KLUNGSØYR K , HALMØY A , et al . Adult ADHD and comorbid somatic disease: a systematic literature review [J]. J Atten Disord , 2018 , 22 ( 3 ): 203 - 228 . DOI: 10.1177/1087054716669589 http://dx.doi.org/10.1177/1087054716669589 .
GOMEZ R , CORR P J . ADHD and personality: a meta-analytic review [J]. Clin Psychol Rev , 2014 , 34 ( 5 ): 376 - 388 . DOI: 10.1016/j.cpr.2014.05.002 http://dx.doi.org/10.1016/j.cpr.2014.05.002 .
NEFF K D . Self-compassion: theory, method, research, and intervention [J]. Annu Rev Psychol , 2023 , 74 : 193 - 218 . DOI: 10.1146/annurev-psych-032420-031047 http://dx.doi.org/10.1146/annurev-psych-032420-031047 .
GALVIN J , HOWES A , MCCARTHY B , et al . Self-compassion as a mediator of the association between autistic traits and depressive/anxious symptomatology [J]. Autism , 2021 , 25 ( 2 ): 502 - 515 . DOI: 10.1177/1362361320966853 http://dx.doi.org/10.1177/1362361320966853 .
BEATON D M , SIROIS F , MILNE E . The role of self-compassion in the mental health of adults with ADHD [J]. J Clin Psychol , 2022 , 78 ( 12 ): 2497 - 2512 . DOI: 10.1002/jclp.23354 http://dx.doi.org/10.1002/jclp.23354 .
GEURTS D E M , SCHELLEKENS M P J , JANSSEN L , et al . Mechanisms of change in mindfulness-based cognitive therapy in adults with ADHD [J]. J Atten Disord , 2021 , 25 ( 9 ): 1331 - 1342 . DOI: 10.1177/1087054719896865 http://dx.doi.org/10.1177/1087054719896865 .
CERRILLO-URBINA A J , GARCÍA-HERMOSO A , PARDO-GUIJARRO M J , et al . The effects of long-acting stimulant and nonstimulant medications in children and adolescents with attention-deficit/hyperactivity disorder: a meta-analysis of randomized controlled trials [J]. J Child Adolesc Psychopharmacol , 2018 , 28 ( 8 ): 494 - 507 . DOI: 10.1089/cap.2017.0151 http://dx.doi.org/10.1089/cap.2017.0151 .
LEVINE B , ROBERTSON I H , CLARE L , et al . Rehabilitation of executive functioning: an experimental-clinical validation of goal management training [J]. J Int Neuropsychol Soc , 2000 , 6 ( 3 ): 299 - 312 . DOI: 10.1017/s1355617700633052 http://dx.doi.org/10.1017/s1355617700633052 .
JENSEN D A , LUNDERVOLD A J , STUBBERUD J , et al . Goal management training improves executive control in adults with ADHD: an open trial employing attention network theory to examine effects on attention [J]. BMC Psychol , 2022 , 10 ( 1 ): 207 . DOI: 10.1186/s40359-022-00902-9 http://dx.doi.org/10.1186/s40359-022-00902-9 .
IN DE BRAEK D M J M , DIJKSTRA J B , PONDS R W , et al . Goal management training in adults with ADHD: an intervention study [J]. J Atten Disord , 2017 , 21 ( 13 ): 1130 - 1137 . DOI: 10.1177/1087054712468052 http://dx.doi.org/10.1177/1087054712468052 .
KANG H . Sample size determination and power analysis using the G*Power software [J]. J Educ Eval Health Prof , 2021 , 18 : 17 . DOI: 10.3352/jeehp.2021.18.17 http://dx.doi.org/10.3352/jeehp.2021.18.17 .
帅澜 , 张劲松 , 邱美慧 , 等 . 成人注意缺陷多动障碍诊断访谈中文修订版的效度和信度 [J]. 中国心理卫生杂志 , 2020 , 34 ( 4 ): 322 - 326 .
SHUAI L , ZHANG J S , QIU M H , et al . Validity and reliability of the Chinese version of the diagnostic interview for ADHD in adults [J]. Chin Ment Health J , 2020 , 34 ( 4 ): 322 - 326 .
ADAMIS D , FOX N , DE M DE CAMARGO A P P , et al . Prevalence of attention deficit hyperactivity disorder in an adult mental health service in the Republic of Ireland [J]. Int J Psychiatry Med , 2023 , 58 ( 2 ): 130 - 144 . DOI: 10.1177/00912174221106826 http://dx.doi.org/10.1177/00912174221106826 .
USTUN B , ADLER L A , RUDIN C , et al . The World Health Organization adult attention-deficit/hyperactivity disorder self-report screening scale for DSM-5 [J]. JAMA Psychiatry , 2017 , 74 ( 5 ): 520 - 527 . DOI: 10.1001/jamapsychiatry.2017.0298 http://dx.doi.org/10.1001/jamapsychiatry.2017.0298 .
KOOIJ J J S , BIJLENGA D , SALERNO L , et al . Updated European Consensus Statement on diagnosis and treatment of adult ADHD [J]. Eur Psychiatry , 2019 , 56 : 14 - 34 . DOI: 10.1016/j.eurpsy.2018.11.001 http://dx.doi.org/10.1016/j.eurpsy.2018.11.001 .
王力 , 柳恒超 , 杜卫 , 等 . 情绪调节困难量表在中国人群中的初步测试 [J]. 中国健康心理学杂志 , 2007 , 15 ( 4 ): 336 - 340 . DOI: 10.13342/j.cnki.cjhp.2007.04.020 http://dx.doi.org/10.13342/j.cnki.cjhp.2007.04.020 .
WANG L , LIU H C , DU W , et al . Test of difficulties in emotion regulation scale in Chinese people [J]. China J Health Psychol , 2007 , 15 ( 4 ): 336 - 340 . DOI: 10.13342/j.cnki.cjhp.2007.04.020 http://dx.doi.org/10.13342/j.cnki.cjhp.2007.04.020 .
何筱衍 , 李春波 , 钱洁 , 等 . 广泛性焦虑量表在综合性医院的信度和效度研究 [J]. 上海精神医学 , 2010 , 22 ( 4 ): 200 - 203 . DOI: 10.3969/j.issn.1002-0829.2010.04.002 http://dx.doi.org/10.3969/j.issn.1002-0829.2010.04.002 .
HE X Y , LI C B , QIAN J , et al . Reliability and validity of a generalized anxiety disorder scale in general hospital outpatients [J]. Shanghai Arch Psychiatry , 2010 , 22 ( 4 ): 200 - 203 . DOI: 10.3969/j.issn.1002-0829.2010.04.002 http://dx.doi.org/10.3969/j.issn.1002-0829.2010.04.002 .
徐维芳 , 彭漪 , 陈柄全 , 等 . GAD-7和PHQ-9自评心理测评量表评估心内科门诊患者焦虑、抑郁状态 [J]. 世界最新医学信息文摘 , 2018 , 18 ( 16 ): 12 - 14 . DOI: 10.19613/j.cnki.1671-3141.2018.16.006 http://dx.doi.org/10.19613/j.cnki.1671-3141.2018.16.006 .
XU W F , PENG Y , CHEN B Q , et al . Assessment of anxiety and depression by self-rating scales of GAD-7 and PHQ-9 in cardiovascular outpatients [J]. World Latest Med Information , 2018 , 18 ( 16 ): 12 - 14 . DOI: 10.19613/j.cnki.1671-3141.2018.16.006 http://dx.doi.org/10.19613/j.cnki.1671-3141.2018.16.006 .
NEFF K D . The development and validation of a scale to measure self-compassion [J]. Self Identity , 2003 , 2 ( 3 ): 223 - 250 . DOI: 10.1080/15298860309027 http://dx.doi.org/10.1080/15298860309027 .
DIENER E , EMMONS R A , LARSEN R J , et al . The satisfaction with life scale [J]. J Pers Assess , 1985 , 49 ( 1 ): 71 - 75 . DOI: 10.1207/s15327752jpa4901_13 http://dx.doi.org/10.1207/s15327752jpa4901_13 .
JENSEN D A , HALMØY A , STUBBERUD J , et al . An exploratory investigation of goal management training in adults with ADHD: improvements in inhibition and everyday functioning [J]. Front Psychol , 2021 , 12 : 659480 . DOI: 10.3389/fpsyg.2021.659480 http://dx.doi.org/10.3389/fpsyg.2021.659480 .
王春枝 , 斯琴 . 德尔菲法中的数据统计处理方法及其应用研究 [J]. 内蒙古财经学院学报(综合版) , 2011 , 9 ( 4 ): 92 - 96 . DOI: 10.13895/j.cnki.jimufe.2011.04.019 http://dx.doi.org/10.13895/j.cnki.jimufe.2011.04.019 .
WANG C Z , SI Q . A study of data statistical processing method of Delphi method and its application [J]. J Inn Mong Finance Econ Coll , 2011 , 9 ( 4 ): 92 - 96 . DOI: 10.13895/j.cnki.jimufe.2011.04.019 http://dx.doi.org/10.13895/j.cnki.jimufe.2011.04.019 .
田军 , 张朋柱 , 王刊良 , 等 . 基于德尔菲法的专家意见集成模型研究 [J]. 系统工程理论与实践 , 2004 , 24 ( 1 ): 57 - 62, 69 . DOI: 10.3321/j.issn: 1000-6788.2004.01.010 http://dx.doi.org/10.3321/j.issn:1000-6788.2004.01.010 .
TIAN J , ZHANG P Z , WANG K L , et al . The integrating model of expert’s opinion based on Delphi method [J]. Syst Eng Theory Pract , 2004 , 24 ( 1 ): 57 - 62, 69 . DOI: 10.3321/j.issn: 1000-6788.2004.01.010 http://dx.doi.org/10.3321/j.issn:1000-6788.2004.01.010 .
VALLS-SERRANO C , CARACUEL A , VERDEJO-GARCIA A . Goal management training and mindfulness meditation improve executive functions and transfer to ecological tasks of daily life in polysubstance users enrolled in therapeutic community treatment [J]. Drug Alcohol Depend , 2016 , 165 : 9 - 14 . DOI: 10.1016/j.drugalcdep. 2016.04.040 http://dx.doi.org/10.1016/j.drugalcdep.2016.04.040 .
STUBBERUD J , LANGENBAHN D , LEVINE B , et al . Goal management training of executive functions in patients with spina bifida: a randomized controlled trial [J]. J Int Neuropsychol Soc , 2013 , 19 ( 6 ): 672 - 685 . DOI: 10.1017/S1355617713000209 http://dx.doi.org/10.1017/S1355617713000209 .
TEALE SAPACH M J N , CARLETON R N . Self-compassion training for individuals with social anxiety disorder: a preliminary randomized controlled trial [J]. Cogn Behav Ther , 2023 , 52 ( 1 ): 18 - 37 . DOI: 10.1080/16506073.2022.2130820 http://dx.doi.org/10.1080/16506073.2022.2130820 .
INWOOD E , FERRARI M . Mechanisms of change in the relationship between self-compassion, emotion regulation, and mental health: a systematic review [J]. Appl Psychol Health Well Being , 2018 , 10 ( 2 ): 215 - 235 . DOI: 10.1111/aphw.12127 http://dx.doi.org/10.1111/aphw.12127 .
LEVINE B , SCHWEIZER T A , O’CONNOR C , et al . Rehabilitation of executive functioning in patients with frontal lobe brain damage with goal management training [J]. Front Hum Neurosci , 2011 , 5 : 9 . DOI: 10.3389/fnhum. 2011.00009 http://dx.doi.org/10.3389/fnhum.2011.00009 .
EYSENCK M W , DERAKSHAN N , SANTOS R , et al . Anxiety and cognitive performance: attentional control theory [J]. Emotion , 2007 , 7 ( 2 ): 336 - 353 . DOI: 10.1037/1528-3542.7.2.336 http://dx.doi.org/10.1037/1528-3542.7.2.336 .
FINLAY-JONES A , KANE R , REES C . Self-compassion online: a pilot study of an internet-based self-compassion cultivation program for psychology trainees [J]. J Clin Psychol , 2017 , 73 ( 7 ): 797 - 816 . DOI: 10.1002/jclp.22375 http://dx.doi.org/10.1002/jclp.22375 .
EDDY L D , EADEH H M , BREAUX R , et al . Prevalence and predictors of suicidal ideation, plan, and attempts, in first-year college students with ADHD [J]. J Am Coll Health , 2020 , 68 ( 3 ): 313 - 319 . DOI: 10.1080/07448481. 2018.1549555 http://dx.doi.org/10.1080/07448481.2018.1549555 .
COMBS M A , CANU W H , BROMAN-FULKS J J , et al . Perceived stress and ADHD symptoms in adults [J]. J Atten Disord , 2015 , 19 ( 5 ): 425 - 434 . DOI: 10.1177/1087054712459558 http://dx.doi.org/10.1177/1087054712459558 .
MIKLÓSI M , MÁTÉ O , SOMOGYI K , et al . Adult attention deficit hyperactivity disorder symptoms, perceived stress, and well-being: the role of early maladaptive schemata [J]. J Nerv Ment Dis , 2016 , 204 ( 5 ): 364 - 369 . DOI: 10.1097/NMD.0000000000000472 http://dx.doi.org/10.1097/NMD.0000000000000472 .
NEFF K . Self-compassion: an alternative conceptualization of a healthy attitude toward oneself [J]. Self Identity , 2003 , 2 ( 2 ): 85 - 101 . DOI: 10.1080/15298860309032 http://dx.doi.org/10.1080/15298860309032 .
VIGNA A J , POEHLMANN‐TYNAN J , KOENIG B W . Does self-compassion facilitate resilience to stigma? A school-based study of sexual and gender minority youth [J]. Mindfulness , 2018 , 9 : 914 - 924 . DOI: 10.1007/S12671-017-0831-X http://dx.doi.org/10.1007/S12671-017-0831-X .
OGG J A , BATEMAN L , DEDRICK R F , et al . The relationship between life satisfaction and ADHD symptoms in middle school students: using a bifactor model [J]. J Atten Disord , 2016 , 20 ( 5 ): 390 - 399 . DOI: 10.1177/1087054714521292 http://dx.doi.org/10.1177/1087054714521292 .
KROSHUS E , HAWRILENKO M , BROWNING A . Stress, self-compassion, and well-being during the transition to college [J]. Soc Sci Med , 2021 , 269 : 113514 . DOI: 10.1016/j.socscimed.2020.113514 http://dx.doi.org/10.1016/j.socscimed.2020.113514 .
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