中国健康心理学杂志

目的：探讨学习困难合并注意缺陷与多动障碍（ADHD）儿童接受心理行为干预联合重复经颅磁刺激（rTMS）对情绪障碍及孤独感的影响。方法：选择2023年1月至2025年1月某院收治的98例学习困难合并ADHD患者，使用随机数表法分为研究组（心理行为干预+rTMS,n=49）和对照组（rTMS,n=49），比较两组患者干预前后的症状[诺兰和佩勒姆第4版评定量表（SNAP-Ⅳ）]、认知功能[威斯康辛卡片分类测试（WCST）和数字符号转换测试]、情绪障碍[儿童抑郁障碍自评量表（DSRSC）和儿童焦虑性情绪障碍筛查量表（SCARED）]、孤独感[儿童孤独量表（CLS）和UCLA孤独量表简版（ULS-8）]和生活质量[儿童少年生活质量量表（QLSCA）]。结果：干预后，研究组SNAP-Ⅳ评分低于对照组（t=-4.192,-4.714,-4.644,-5.366;P<0.05）,WCST正确率和数字符号转换测试得分均高于对照组（t=9.254,9.117;P<0.05）,DSRSC和SCARED得分均低于对照组（t=-7.708,-8.443;P<0.05）,CLS和ULS-8水平低于对照组（t=-5.256,-7.622;P<0.05）,QLSCA得分高于对照组（t=7.048,9.899,7.636,8.030,7.401;P<0.05），差异有统计学意义。结论：心理行为干预联合rTMS可显著改善学习困难合并ADHD儿童的核心症状、认知功能、情绪障碍及孤独感，并提升其生活质量。

Objective:To explore the influence of combination of psycho-behavioral intervention and repetitive transcranial magnetic stimulation(rTMS)on emotional disorders and loneliness in children with learning difficulties complicated with attention deficit hyperactivity disorder(ADHD).Methods:A total of 98 patients with learning difficulties and ADHD admitted to the hospital from January 2023 to January 2025 were selected and categorized into study group(psycho-behavioral intervention plus rTMS,n=49)and control group(rTMS,n=49)based on random number table method.The symptoms [Swanson,Nolan and Pelham-IV scale(SNAP-IV)],cognitive function[Wisconsin Card Sorting Test(WCST)and digital symbol conversion test],emotional disorders[Depression Self-Rating Scale for Children(DSRSC)and Screen for Child Anxiety Related Emotional Disorders(SCARED)],loneliness[Children's Loneliness Scale(CLS)and UCLA Loneliness Scale(ULS-8)]and quality of life[Quality of Life Scale for Children and Adolescents(QLSCA)]were compared between both groups of children before and after intervention.Results:After intervention,the SNAP-IV scores in the study group were lower than those in the control group(t=-4.192,-4.714,-4.644,-5.366;P<0.05).The correct rate of WCST and score of digit symbol conversion test in the study group after intervention were higher compared to the control group(t=9.254,9.117;P<0.05).After intervention,the scores of DSRSC and SCARED were lower in the study group compared with those in the control group(t=-7.708,-8.443;P<0.05).The scores of CLS and ULS-8 in the study group after intervention were lower compared to the control group(t=-5.256,-7.622;P <0.05).After intervention,the study group had higher QLSCA scores than the control group(t=7.048,9.899,7.636,8.030,7.401;P<0.05).Conclusion:Psycho-behavioral intervention combined with rTMS can significantly improve the core symptoms,cognitive function,emotional disorders and loneliness,and enhance the quality of life in children with learning difficulties and ADHD.