「藥」不「藥」有關係？成年前期注意力不足過動「患」者的人際互動關係與藥物治療經驗

Abstract

注意力不足/過動症（Attention-deficit/Hyperactivity Disorder，簡稱ADHD）是兒童及青少年精神科中常見的診斷，過去多被認為症狀會隨著個體的成長消失，然近期DSM-5及諸多研究指出症狀會延伸至成人階段，並有教育年數較低、失業率較高、反社會行為、人際關係衝突等現象。 人際互動是終生持續的行為，為了解成年ADHD患者成長歷程中因症狀而遭遇之人際互動議題，並描述患者如何銜接醫療資源進行因應，本研究以質性研究取向，透過訪談進行資訊蒐集，並以樣版分析法進行分析。在網路平台及精神科從業人員的轉介下，研究者招募了11名受訪者，包含8名女性及3名男性，皆為大專以上的學歷，且受訪時皆在20歲到30歲。研究結果顯示多數受訪者在成長階段中，多因症狀產生不同行為問題，也間接影響人際互動關係，並與該階段的社會心理任務發展有關。然受訪者多至成年前期才意外覺察這些問題，求助精神醫療資源，並獲得ADHD的診斷。精神醫療系統主要由醫師作為資源連結的核心者，提供診斷性評估、藥物治療、心理師等資源，並透過受訪者在反覆回診的過程中與醫師找尋到解決困擾的平衡點。部分受訪者除了醫療資源外，仍會參與同儕網絡社群、成長工作坊、諮商等補充性資源，並以自身經驗參與社會議題的討論。研究結論指出ADHD症狀會間接影響成長經驗中的人際互動關係，但因學業表現佳而未被發現，直至社交情境累積的壓力形成自我求助的動機。受訪者求助後會透過藥物治療的過程，緩解症狀，並重構自己的資源網絡因應互動困擾。 研究者立基於研究結論分別針對成人ADHD患者、家屬與朋友、實務工作者及政策參與者提出建議。最終，受限於招募的受訪者學歷成就同質性、特質及居住的區域範圍，研究成果僅能呈現部分成人ADHD的生活面貌。

Attention-deficit/Hyperactivity Disorder is a common diagnosis in child and adolescent psychiatry. In the past, it was considered that ADHD would disappear when patients grew up. However, many researches, including DSM-5, find that ADHD patients still feel troubled with these symptoms even when they are adult. In the stage of early adult, patients have lower academic performance, unemployment, anti-social behaviors, and poor relationships. To understand how the symptoms influence the relationship between the adult ADHD patients during their life’s journey, and outline how they use medical resource to solve those problems, the researcher adopts qualitative research method. After recruiting from the Internet and psychiatrist’s transfering, the researcher interviews 11 adult ADHD patients aged during 20-30, got bachelor degree. The researcher uses Template Analysis to analyze these contents. The research shows that most interviewees have some inappropriate behaviors related to ADHD symptoms, which influence their human relationships and social psychological tasks. However, they aware these problems by accident, and seek psychiatry system for help during adult stage. Through psychiatrists, they get diagnosed, drug treatment, and counseling. Except for medical resources, some interviewees may also attend peer groups, workshops, and use their self-help experiences to attend some advocacies. It is concluded that ADHD symptoms affect patients’ relationships, but reduced the impacts by patients’ good academic performance. Suffering from lots of social stress, the patients seek for help, get drug treatment, and find their coping skills in their networks. Based on the conclusion, the researcher makes some suggestion for adult ADHD patients, their families and friends, workers, and policy makers. Limited by interviewees’ education level, personality trait, and living area, it only describes part of adult ADHD patients’ lives in this world.