4. 臨床,障害 1AM-057 日心第77回大会（2013） 㜞ᯏ⢻ᐢ᳢ᕈ⊒㆐㓚ኂ⠪ߩ P-F ࠬ࠲࠺ࠖߦ߅ߌࠆ U ᔕߩᬌ⸛ ٤⊕ᥓ⛗ 1╴ሶ 2⪤ේ㚅 3⼱ ⧷ବ 4ኹ↰᳗ 5ᆂየ㕏ᤩ 6ዊ㊁⥱ℭ 7ᵤᎹ⑲ᄦ 8 㧔1 ߺߥ߅ࠢ࠾࠶ࠢ2 ጟጊ㓚ኂ⠪⡯ᬺࡦ࠲3 ߚ߆ߚࠢ࠾࠶ࠢ4 ᣣ═ࠢ࠾࠶ࠢ 5 ࠕࠠࠢ࠾࠶ࠢ6 ₺ሶ∛㒮7 ߐ߆ࡎࠬࡇ࠲࡞8 ศ࿖㓙ᄢቇ㧕 ࠠࡢ࠼: 㜞ᯏ⢻ᐢ᳢ᕈ⊒㆐㓚ኂ㧘P-F ࠬ࠲࠺ࠖ㧘U ᔕ Unscorable response in Picture-Frustration Study to adults with High-Functioning Pervasive Developmental Disorders Tomoe SHIRAGA 1, Michiko TSUTSUI 2, Rika HAGIWARA 3, Hidetoshi TANI 4 Kazuhisa TERADA 5, Yasuaki SENOO 6, Shuei ONO 7 and Hideo TSUGAWA 8 (1 Minao Clinic,2 Okayama Vocational Center for Persons with Disabilities,3 Takata Clinic,4 Hikasa Clinic, 5 Aki Clinic,6 Nishi-Hachioji Hospital ,7 Asaka Hospital,8 Kibi International University) Key words: HFPDD, P-F Study, Unscorable response ᐢ᳢ᕈ⊒㆐㓚ኂ Pervasive Developmental Disorders: PDDߩ ਛᩭ⊛㗴ߦ㧘႐ߩⓨ᳇߇⺒ߥߥߤኻੱ㑐ଥߩ㓚ኂ߇ ࠆ␠ߥ߁ࠃߩߎޕળᕈߩ․ᓽ߇㧘P-F ࠬ࠲࠺ࠖߦࠇ߿ߔߊ㧘 ⹏ቯਇน⢻ᔕ㧔U ᔕ㧕ߩᄙߎߣ߇ᜰ៰ߐࠇߡࠆ㧔ḩ ↰ࠄ㧘2009㧧↰ㄝࠄ㧘1999㧕 ᧪ᧄޕP-F ࠬ࠲࠺ࠖߪ᠄ᕈࠍ᷹ ቯߔࠆዤᐲߢࠆ߇㧘PDD ߩ␠ળᕈࠍࠕࠬࡔࡦ࠻ߔࠆ࠷ ࡞ߣߒߡ↪ߢ߈ࠆน⢻ᕈ߽ࠆߒ߆ߒޕ㧘ߎࠇ߹ߢߩ⎇ⓥ ߩ߶ߣࠎߤ߇ఽ┬ࠍኻ⽎ߣߒߚ⎇ⓥߢࠅ㧘 ᚑੱߩ PDD ⠪ࠍ ኻ⽎ߣߒߚᬌ⸛ߪዋߥߢߎߘޕ㧘♖ㆃṛࠍࠊߥ PDD ⠪ High-Functioning PDD㧦HFPDDࠍኻ⽎ߦ㧘ቯဳ⊒㆐⟲ߣ ߩ U ᔕߩᲧセ㧘WAIS-III ߣߩ㑐ㅪ㧘⾰⊛ಽ㘃ߦߟߡᬌ⸛ ߒߚޕ ᣇ ᴺ ኻ⽎⠪ ⥃ᐥ⟲ 㧦PDD ߣ⸻ᢿߐࠇߚ IQ70 એߩᚑੱ 44 ฬ 㧔↵ᕈ 31 ฬ㧘ᅚᕈ 13 ฬ㧧ᐔဋᐕ㦂㧩32.14 ᱦ㧘SD㧩9.23㧘ᐔ ဋ IQ=101.61㧕ࠍኻ⽎ߣߒߚ⛔ޕ⟲ 㧦ᄢቇ↢ 72 ฬ㧔↵ᕈ 45 ฬ㧘ᅚᕈ 27 ฬ㧧ᐔဋᐕ㦂㧩20.08 ᱦ㧘SD㧩1.60㧕ࠍኻ⽎ߣ ߒߚߐߩߘޕ㧘Autism-Spectrum Quotient ᣣᧄ⺆ 㧔⧯ᨋࠄ㧘 2004㧕 ߅ࠃ߮ᔃߩℂ⺰⺖㗴ࠍ↪ PDD ߩน⢻ᕈߩࠆ⠪ࠍ㒰 ߚޕ ዤᐲ P-F ࠬ࠲࠺ࠖᣣᧄ⺆ ᚑੱ↪㧔ᨋࠄ㧘1956㧕ࠍ↪ߒ ߚߚ߹ޕ㧘WAIS-III ࠍ⥃ᐥ⟲ߦ↪ߒߚޕ ᚻ⛯߈ ⥃ᐥ⟲ 㧦5 ߆ᚲߩක≮ᯏ㑐ߦදജࠍଐ㗬ߒ㧘ฦක≮ ᯏ㑐ߦߡ♖⑼ක߅ࠃ߮ᔃℂ჻߇ታᣉߒߚ⛔ޕ⟲ 㧦ᄢቇߩ ᬺߦ߅ߡ㧘⺞ᩏ⠪ߩᢎ␜ߩ߽ߣ㓸࿅ߢታᣉߒߚޕ ⚿ ᨐ ⥃ᐥ⟲ߣ⛔⟲ߩ U ᔕߩᲧセ U ᔕߩᢙࠍᲧセߔࠆߚ㧘 Mann-Whitney ߩ U ᬌቯࠍ߅ߎߥߞߚ⚿ߩߘޕᨐ㧘⥃ᐥ⟲ߪ⛔ ⟲ࠃࠅ U ᔕߩᢙ߇ᗧߦᄙ߆ߞߚޕലᨐ㊂ߪ-0.33 |R|㧨 0.50ߣਛ⒟ᐲߢߞߚ㧔Table 1㧕 ޕ ޟℂ U ᔕߩᢙߣ WAIS-III ߣߩ㑐ㅪ ⥃ᐥ⟲ߦ߅ߌࠆޟFIQޠ ⸃ޠ ⺆ޟ㖸ᢛߩޠᓧὐࠍ߽ߣߦ㧘ߘࠇߙࠇᐔဋ㧗0.5SD એ ߩ⠪ࠍ⟲㧘ᐔဋ㧙0.5SD એਅߩ⠪ࠍਅ⟲ߦಽ㘃ߒ㧘t ᬌ ቯࠍ߅ߎߥߞߚ⚿ߩߘޕᨐ㧘 ޟFIQޠ⟲ߩᣇ߇ਅ⟲ࠃࠅ ߽ U ᔕߩᢙ߇ᗧߦዋߥ߆ߞߚ㧔p<.05㧕 ޟߚ߹ޕℂ⸃ޠ ⟲ߩᣇ߇ਅ⟲ࠃࠅ߽ U ᔕߩᢙ߇ᗧߦዋߥ߆ߞߚ 㧔p<.01㧕 ޕห᭽ߦ㧘 ⺆ޟ㖸ᢛޠ⟲ߩᣇ߇ਅ⟲ࠃࠅ U ᔕߩᢙ߇ᗧߦዋߥ߆ߞߚ p<.01㧕ޕ HFPDD ⠪ߩ U ᔕߩ․ᓽ ⥃ᐥ⟲ߦ߅ߌࠆ U ᔕߦߟߡ㧘 ಽ㘃ࠍ߅ߎߥߞߚޕಽ㘃ߔࠆߦߚߞߡ㧘࿁╵࡞࡞ߩේೣ ߦᓥ߁ߎߣ߇ߢ߈ߥ߆ߞߚ߽ߩߪ㧘 ޛ࿁╵࡞࡞ߩήⷞߣޜ ฬߒ㧘ߘߩઁߩ㨁ᔕߦߟߡ KJ ᴺࠍ↪ߡಽ㘃ߒߚߘޕ 㧘 㧔2㧕⋧ᚻߩ ߩ⚿ᨐ㧘 㧔1㧕႐㕙ࠍ⺋ߞߡᝒ߃ࠆޛ႐㕙ߩ⺋⸃ޜ ⸒⪲ࠍᢥሼㅢࠅᝒ߃ࠆޛሼ⟵ㅢࠅߩᗧޜ㧘 㧔3㧕⥄ಽൎᚻߥ್ ᢿߢ╵߃ࠆ⥄ޛᏆਛᔃ⊛ߥ⊒⸒ޜ 㧘 㧔4㧕⋧ߤߥޠߛࠎߥ߁ߘޟ ᚻߩ⸒⪲ߦኻߒߡߘߩ߹߹ੌ⸃ߔࠆޛฃേ⊛ߥᛚޜ 㧘 㧔5㧕ή ⸥߿ޛߩߤߥޠ̖ޟᔕߩᄬᢌ ߩޜ5 ߟߦಽ㘃ߐࠇߚޕ ⠨ ኤ ᧄ⎇ⓥߩ⚿ᨐ㧘⥃ᐥ⟲ߪ⛔⟲ࠃࠅ߽ U ᔕߩᢙ߇ᄙ߆ߞ ߚ↰ߪࠇߎޕㄝࠄ㧔1999㧕㧘ḩ↰ࠄ㧔2009㧕㧘㐳⼱Ꮉࠄ㧔2011㧕 ߩ⚿ᨐࠍᡰᜬߔࠆ߽ߩߢߞߚߒ߆ߒޕ㧘ᚑੱ PDD ⠪ࠍኻ⽎ ߣߒߚవⴕ⎇ⓥߣᲧセߔࠆߣ㧘ᳰፉࠄ㧔2010㧕ߪ 4.2 㧘㐳 ⼱Ꮉࠄ㧔2011㧕ߪ 4.5 ߢࠆߩߦኻߒ㧘ᧄ⎇ⓥߢߪ 1.98 ߢߞߚޕ ⺆ޟ㖸ᢛߪߢޠ㧘ߘࠇߙࠇ⟲ߩᣇ߇㧘 ޟFIQޠ ޟℂ⸃ޠ U ᔕߩᢙ߇ዋߥ߆ߞߚࠄ߆ߣߎߩߎޕ㧘ో⊛ߥ⍮⊛⢻ജ ߇㜞⠪㧘ߥ߆ߢ߽␠ળ⚻㛎߿Ᏹ⼂ജ߇ࠅ㧘⍮⼂ࠍ⸒⪲ߢ ⺑ߔࠆ⢻ജߩ㜞⠪ߪ㧘U ᔕߩዋߥߎߣ߇␜ߐࠇߚޕ U ᔕߩ₸߇ᄙ߆ߞߚ 4 ߟߩ႐㕙㧔႐㕙 8㧘12㧘15㧘 17㧕ߩ․ᓽߣߒߡ㧘႐㕙ߦឬ߆ࠇߡࠆએᄖߩ╙ਃ⠪߇ሽ ߔࠆ႐㕙ߦ߅ߡߪ㧘ฃり⊛ߦߥࠅ߇ߜߢߞߚߚ߹ޕ㧘⊹ Table 1䇭⥃ᐥ⟲䈫⛔⟲䈱Uᔕ䈱ᢙ䈱Ყセ ⡺߿߳ࠅߊߛߞߚߩࠆ႐㕙ߦ߅ߡߪ㧘⥄ಽߩᕁ߁߹ ⥃ᐥ⟲(n=44) ⛔⟲(n=72) U୯ ലᨐ㊂ R M SD Me M SD Me ߹ߦ╵߃ࠆߣ߁․ᓽ߇␜ߐࠇߚߜࠊߥߔޕ㧘ኻੱ႐㕙ߢߩ U䈱ᢙ 1.98 2.36 1 0.68 1.3 0 1017.5 ** -0.33 ⶄ㔀ߐ߿⊹⡺ߣߞߚߐ߹ߑ߹ߥ࠾ࡘࠕࡦࠬ߇ടࠊࠆߣ㧘U ** p <.01 ᔕ߇ࠇ߿ߔߊߥࠆߎߣ߇ࠄ߆ߦߥߞߚޕ ᰴߦ㧘U ᔕߩࠇ߿ߔ႐㕙ࠍࠄ߆ߦߔࠆߚߦ㧘႐ એߩߎߣ߆ࠄ㧘P-F ࠬ࠲࠺ࠖߢ㧘HFPDD ⠪ߩ␠ળᕈߩ․ 㕙ߏߣߩ U ᔕߩ₸ߦߟߡ㧘Fisher ߩ⋥ធ⏕₸⸘▚ࠍ ᓽࠍࠆ⒟ᐲߪᛠីߢ߈ࠆߣ⠨߃ࠄࠇࠆߒ߆ߒޕ㧘ᗧᏅߪ ߅ߎߥߞߚ⚿ߩߘޕᨐ㧘႐㕙 8㧘12㧘15㧘17 ߦ߅ߡ㧘⥃ᐥ ࠆ߇ലᨐ㊂ߪਛ⒟ᐲߢࠅ㧘HFPDD ⠪ߩ U ᔕߩᢙߪ ⟲ߩᣇ߇⛔⟲ࠃࠅᗧߦ㜞ߊ㧘HFPDD ⠪ߪ㧘႐㕙 8㧘12㧘 ቯဳ⊒㆐⠪ߣᲧߴߡ․ᄙߣߪ⸒߃ߥߚ߹ޕ㧘24 ႐㕙ਛ 15㧘17 ߦ߅ߡ U ᔕࠍߒ߿ߔߎߣ߇␜ߐࠇߚ㧔Table 2㧕 ޕU ᔕ߇ᄙߊߔࠆߩߪ 4 ႐㕙ߦ㒢ࠄࠇߡࠆߎߣ߆ࠄ㧘 ␠ળᕈߩࠕࠬࡔࡦ࠻ߩߚߦ㧘P-F ࠬ࠲࠺ࠖࠍ↪ߔࠆߎ Table 2䇭⥃ᐥ⟲䈫⛔⟲䈮䈍䈔䉎႐㕙Uᔕ䈱㗫ᐲ ႐㕙8 ႐㕙12 ႐㕙15 ႐㕙17 ߣߪലߢࠆߣߪ⸒߃ߥޕ ⥃ᐥ⟲ ⛔⟲ Fisher ⋥ធᴺ *p <.05 **p <.01 䌮 6 0 䋦 14 0 ** P=.002 䌮 8 3 䋦 18 4 * P=.020 䌮 5 0 䋦 11 0 ** P=.007 䌮 6 0 䋦 14 0 ઃ⸥㩷 ᧄ⎇ⓥߪ㧘ศ࿖㓙ᄢቇ୶ℂክᩏᆔຬળߩᛚࠍᓧߡⴕࠊࠇߚ㧔ᛚ⇟ภ㧦12㧙02㧕 ** P=.002 ― 286 ―
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