2016春应用心理学毕业论文
学号:z09100018011姓名:姚洁论文指导老师:李菲菲
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华东师范大学网络学院
目录:
一.临床描述.............................................................................................1
1.在青春期的临床表现..................................................................................等等等1
2.青少年ADHD的其他特征...........................................................................等等等等等2
1.3多数情况下ADHD...........................................................................等等等等等等等2
1.4青春期ADHD..........................................................................等等等等等等等等.2
2.青春期的临床表现.....................................................................................等等等等等等2
2.1感知缺失等等等等等..........................................................等等等......2
2.2行为紊乱.........................................................等等等...............................2
2.3焦虑障碍..................................................等等.等等等等等等等等等.2
2.4情绪障碍........................................................................等等等等等等等等等2
3评估和诊断.......................................................................................................3
二.治疗..............................................................................................................5
1.治疗模式...........................................................................................................6
2.药物治疗等等等等等等等等等等等等等等等等等等7
3.社会干预治疗等等等等等等等等等等等等等等等等等7
4.心理治疗等等等等等等等等等等等等等等等等等等7
三预测未来研究..................................................................................................8
obin)的访谈手册【10】所列举的指标性问题也可以用来剔除可能干扰诊断结果的行为障碍.在做临床评估的时候也应该私下里,避开家长向青少年询问其所表现出来的一些看上去是冒险的粗鲁行为.这些行为包括偷偷抽烟,喝酒,毒品,经常性的逃课,无法克制的网瘾或是喜欢和社会不良分子混迹等等.如果青少年会骑车(自行车,电瓶车,甚至于是开车),临床医生还应询问在骑车时候的表现,如,是否经常违反交通规则,是否经常出现微小的挂擦事故,是否喜欢骑快车等等.罹患有ADHD的青少年经常会发生一些交通事故,给他人(或自己)造成伤害【11】【12】【13】临床决策支持,例如,应用循证医学证据,如美国儿科学会ADHD评估和治疗方针家庭和个人是实施治疗的干预措施,而这些个体都必须接受这些治疗方法.Pelham的研究报道显示,刺激药物的用法,是一种越来越不受欢迎的治疗方法,特别是针对青春期的孩子,样本中,87%的孩子都没有按规定服药,27.9%的孩子在11岁就停止药物治疗,67.9%的在15岁停止药物治疗.在这样的年龄阶段是不常见的,只有0.7%--4.7%的孩子在11—15岁的是在坚持药物治疗的.大多数个人是在10岁采取药物治疗,最后,一个3年独立的研究实验,在9--15年龄范围内的研究对象(1998-2000),药物治疗虽然得到改善,但是不会改善青少年对目前状况不满的情绪.因为,医生不可能长期监测病人,而青春期的孩子,对于父母的治疗要求有抵制和违抗,使得孩子不能及时得到治疗,对于青春期的ADHD的治疗,因为缺乏坚持规定疗法,医生和家长就很难控制孩子的行为【14】【15】【16】【17-19】【20】【21】【22】【23】【24】【25】【26】【27-29】【30】【31--33】【34】ADHD影响(noradrenergic多巴胺能和,即兴奋剂,抗抑郁药,抗高血压药物【35--37】如食欲抑制,睡眠紊乱【38】【39】【40】2.2药物治疗
大多数使用的兴奋剂:治疗的常用药包括甲强龙氢氯化物(),以及右旋安非他命硫酸盐.至于这些药物在减轻多动症症状方面的具体疗效还无法确定,但研究者相信它们可以调节多巴胺和去甲肾上腺素水平,使孩子注意力集中,减少冲动.当然这些药都存在或多或少的副作用,包括缺少食欲,暂时性的身高增长缓慢,痉挛以及睡眠问题等.但专家还是认为好处要远远超过该药带来的副作用.在结合药物和治疗的孩子中,68%被认为恢复正常,只单纯服用药物的孩子中这个数值达到56%,而只进行治疗和医师护理的孩子,恢复率分别为三分之一和四分之一.【41】【42】【43】【44】【45】技术解决组织和学术的干预措施帮助孩子集中注意力.着眼孩子喜欢的东西,和他一起游戏,调动孩子学习的兴趣,使他的注意时间加长.充实孩子的生活内容.尽量把孩子的生活安排得丰富多彩,让他有机会宣泄过剩的精力.美国儿科学会推荐药物筛选不能没有孩子的认知并同意除例医疗【46】此外,家长必须要知道该做些什么,如果这次试验的结果是积极的.而适得其反的反应并不罕见.避免含铅食物.铅中毒是引发多动症得原因之一,不给孩子吃铅食物,如皮蛋,爆米花等.不给孩子用铝制器皿.家庭和学校是儿童发展两个关键的场所,对多动症儿童治疗起着重要的作用,整个家庭的成员以及老师,同学以及其他周围的人都应给他们一份理解,一份同情及一份温暖,爱护,关心,帮助他们,就像关心体贴躯体有病的孩子一样,使他们有信心克服困难,坚持治疗,战胜心理障碍,恢复健康.【47】家长应该身教言教,提高自身素质,搞好家庭教育,好的家庭教育可以减轻多动症症状,家长教育不好可加重症状,教育管理多动症儿童是较困难和费力的,这就特别需要耐心和自我克制能力,否则会因为孩子的不听话而易冲动发怒,达不到管教好孩子的目的.父母离婚破碎家庭中发生率也较高.老师在教育方法上要避免过度疲劳,帮助学生提高学习效率,科学按排课程,建立合理的作息制度,以便提高注意力持续时间,对学习产生兴趣.医生通常会认为随着孩子长大,注意力分散的现象会随之消失,但事实上多动症的影响远远超出了孩童时代.最近研究发现,多动症孩子在进入青春期后有40-80%的人仍然存在各种不同症状,还有50%的人会持续发展到成人时期.很多心理学家都认为单纯的药物并不能完全根除孩子的问题,相应的治疗是必要的.通过治疗帮助孩子解决不善于结交朋友的问题,缺乏自信心的问题,还可以加强孩子的组织能力.所以最好让和他的父母或其他家庭成员一起配合治疗.【1】OlfsonM.Diagnosingmentaldisordersinoffice-basedpediatricpractice.JDevBehPediatr.1992,13:363–365
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