7-10岁儿童焦虑障碍的调查和随访研究

目的:初步了解7～10岁儿童焦虑性障碍的患病率、病程的稳定性以及演变的情况。方法:使用儿童焦虑性情绪障碍筛查表(SCARED)对长沙市一所普通小学206名7～10岁的学生(男105名,女101;平均年龄8.72±0.92岁),进行焦虑障碍现状调查和为期两年的随访。由学生填写SCARED,由父母填写Achenbach儿童行为量表(CB鄄CL)。结果:在206名小学生中筛查出焦虑障碍阳性者55名(男生30名,女生25名),占总人数的26.70%,伴CBCL行为总分增高者18名(32.73%)。两年后随访时筛查出阳性者48名(男生21名,女生27名),占总人数的23.30%,伴CBCL行为总分增高者21名(42.86%)。第一次筛查阳性儿童两年后仍有34.55%存在焦虑,占总体的9.22%,伴行为总分增高者11名(57.89%)。结论:儿童焦虑障碍在儿童青少年中较普遍,在两年的随访中,9.22%稳定;伴发的行为问题随年龄增长而增多。     

改良脑电生物反馈治疗仪治疗儿童焦虑障碍的分析研究

目的探讨改良后的脑电生物反馈仪用于治疗儿童焦虑障碍患儿的依从性和满意度。方法将60名患儿随机分为对照组和研究组,分别用改良前后的脑电生物反馈治疗仪完成一个疗程治疗与干预,比较两组依从性和满意度的情况。结果研究组完成全程治疗28名,全程治疗率93.33%,对照组完成全程治疗24名,全程治疗率80%。研究组总满意率64.29%,对照组总满意率29.17%,研究组依从性93.33%,对照组依从性80%,两组依从性和满意度差异具有统计学意义(P0.05)。结论改良型脑电生物反馈仪一定程度上更贴合儿童青少年心理需求,有助于改善儿童患者的临床依从性,提高焦虑障碍患儿的满意度。     

综合医院非精神/心理科门诊焦虑障碍现况调查

目的:调查综合医院非精神/心理科门诊患者焦虑障碍的检出率及其危险因素。方法:采用分层抽样方法,应用复合性国际诊断交谈表(CIDI-3.0)对北京、西安、广州3城市3级别的9家综合医院非精神科门诊≥15岁的1083例患者进行筛查与诊断,调查综合医院非精神科门诊焦虑障碍的检出率,并分析焦虑障碍发生的危险因素。结果:共检出焦虑障碍患者82例,检出率为7.6%,其中合并特殊恐惧症(3.2%)和强迫症(2.8%)较多见。多因素非条件Logistic回归分析显示内科就诊(OR=1.93)、年龄15～39岁(OR=2.56)、受教育年限≤6年(OR=3.38)的患者更易患焦虑障碍。结论:综合医院非精神科门诊患者中合并焦虑障碍多见,年轻、受教育程度低可能为焦虑障碍的危险因素,内科患者较多合并有焦虑障碍。     

乌鲁木齐市焦虑障碍现况调查

目的:描述乌鲁木齐市社区居民焦虑障碍的患病率及其分布。方法:用现况调查多阶段分层抽样方法,2013年抽取乌鲁木齐市18岁及以上社区居民2178名,采用复合性国际诊断交谈表-3.0(CIDI-3.0)进行入户访谈,根据美国精神障碍诊断与统计手册第4版标准对焦虑障碍进行诊断。计算各类焦虑障碍12月患病率及终生患病率,采用χ²检验比较焦虑障碍患病率在不同性别、年龄、婚姻状态、受教育程度及收入水平分布的差异。结果:共1782人完成CIDI访谈,焦虑障碍加权终生患病率和12月患病率分别为6.50%和5.23%。患病率居前3位的类别分别为强迫障碍(4.77%)、特殊恐怖症(0.46%)和社交恐怖症(0.01%)。焦虑障碍终生患病率和12月患病率的性别、年龄、婚姻状态、受教育程度、收入水平分布的差异无统计学意义。结论:乌鲁木齐市社区居民焦虑障碍12月患病率较高。     

焦虑障碍患者父母养育方式分析

父母的养育是通过家庭成员间的交往为儿童的心理-社会发展提供最初的群体生活,通过家庭游戏和家庭日常生活教授儿童社会行为规范,使儿童感受到父母情感上的支持,父母自身的行为和对待儿童的方式对儿童的心理成长起着不可替代的作用[1].父母不当的教养方式为焦虑障碍的产生提供了病前人格基础,是子女罹患焦虑障碍的危险因素之一[2].     

青少年焦虑研究的新进展

焦虑几乎是每个人在生活中都体验过的情感。在心理学上·焦虑不仅被认为是焦虑障碍（anxietyd。sorder）和惊恐障碍（panicdi。order）及创伤后应激障碍（pD。t－traunnatlcsires。山。orde）的主要成分．甚至其它情绪障碍尤其是抑郁、自我挫败、敌对等都包含焦虑成分。本文从健康心理学的角度来反映青少年焦虑研究的进展：青少年焦虑的特点、焦虑与家庭因素、焦虑句学校因素、焦虑与人格因素、焦虑的干预。1青少年焦用研究的现状有少年焦虑的研究引起越来越多的心理学家的重视。我们认为,青少年焦虑的发生无外乎是内外刺激事件与认知评价…     

分离性焦虑障碍史与成年期精神疾病的关系(综述)

本文对早期分离性焦虑障碍史与成年期精神疾病两者关系的国外研究文献进行了综述。分析表明:分离性焦虑障碍史与成年期多种精神疾病之间存在关联,纵向研究结果支持分离性焦虑障碍史作为成年期焦虑障碍谱系及抑郁的风险因素,但其是否作为成年期心境恶劣、双相情感障碍、人格障碍、进食障碍的风险因素还需纵向研究的确认。此外,在儿童期,分离性焦虑障碍与性别认同障碍存在共患关系,可能对个体性心理发展产生影响。现有研究中存在的不足是,在检验分离性焦虑障碍史与成年期精神疾病两者关系时,未见有对遗传和环境变量的控制,也少见有对共病进行控制,而这类控制对确认其是否作为风险及风险大小是十分必要的。     

西方儿童和青少年品行障碍的干预研究评析

目的 对西方儿童和青少年品行障碍干预理论及研究成果进行回顾与评价.方法 采用文献研究法.结果 品行障碍作为儿童和青少年常见的行为障碍之一,是当前西方研究的热点.西方较有影响的干预理论包括认知行为理论、社会学习理论和社会生态学理论,各个理论下的干预方案各有其独特之处.结论 西方的相关理论与实践研究,也将为我国相关研究提供有益的启示与借鉴.     

儿童焦虑研究评述

<正>焦虑作为人类心理失调的最主要和最经常出现的问题,一直是心理学比较活跃的研究领域。儿童作为不成熟的个体,在发展过程中面临着大量的矛盾与困难,因此,儿童焦虑具有普遍性。如果这些焦虑情绪不加干预,有可能影响儿童的日常生活,进一步转化成焦虑障碍,甚至持续至成年期,影     

儿童品行障碍危险因素的LOGISTIC回归分析

对１０２例７～１６岁品行障碍儿童采用ＬＯＧＩＳＴＩＣ回归分析其危险因素，发现父母对儿童粗暴打骂、严厉约束、家庭亲密程度差、父母管教儿童态度不一致、母孕期情绪不良、孕期各种疾病、出生时异常、妊娠早产等因素明显与儿童品行障碍发生有关。     

Exploring the Nature and Function of Anxiety in Youth with Autism Spectrum Disorders

[Clin Psychol Sci Prac 17: 281–292, 2010] This article considers the nosology and pathogenesis of anxiety disorders in youth with autism. The comparability of anxiety in the autism spectrum disorder (ASD) population in relation to the typically developing population has been suggested by some recent findings, but conceptual and empirical ambiguities remain. It is suggested that anxiety may play at least three roles: (a) a downstream consequence of ASD symptoms (e.g., via stress generation through social rejection); (b) a moderator of ASD symptom severity, such that certain core autism symptoms like social skill deficits and repetitive behaviors may be exacerbated by anxiety; and (c) as a proxy of core ASD symptoms. Suggestions for clarifying the nature and function of anxiety in autism are made.     

大学生社交焦虑团体治疗的比较研究

目的：对社交焦虑的大学生进行认知与行为疗法的团体治疗，比较两种方法的疗效。方法：选取社交焦虑的大学生22人随机分成两组，分别进行约16人小时团体的认知与行为疗法的治疗。用SAD、IAS、EPQ、ATQ，SCL－90五个量表，结合临床评估与自我报告等对干预疗效全面评估。结果：两组被试干预后在社交焦虑的主要感受、回避行为、自评症状，认知以及人格的N与E维度都有明显的改善。认知疗法对于改善被试的消极自动思维稍优于行为疗法，但未达到显著性水平，两组效果改善在所有指标上都没有显著差异，结论：认知疗法与行为疗法都能有效地改善大学生的社交焦虑水平，由于两组都采用团体治疗的方式、治疗师相同以及共存认知与行为因素，故两种方法疗效差异不显著。采用团体的方式干预社交焦虑有重要的意义。     

Clarifying the Temporal Relationship between Dependent Personality Disorder and Anxiety Disorders

The relationship between dependent personality disorder (DPD) and several of the anxiety disorders is explored. Recent meta-analytic findings (this issue) suggest that DPD is comorbid with social phobia, obsessivecompulsive disorder, and panic disorder but not with the other anxiety disorders. Examination of comorbidity rates clarifies the relationship between DPD and specific anxiety disorders, but this method does not address many of the important questions concerning this relationship. It remains unclear whether DPD is associated with an increased risk for developing an anxiety disorder or whether anxiety disorders increase the risk of developing DPD. Additionally, if DPD does serve as a risk factor for the development of anxiety disorders, it is unclear whether this risk is clinically meaningful. Finally, causal mechanisms leading from DPD to anxiety disorder have not been examined and warrant future investigation. Examination of comorbidity rates between DPD and the anxiety disorders does not address many clinically relevant issues surrounding the DPD-anxiety relationship, but it does highlight important directions for future research.     

Genetic and Environmental Influences on Child Reports of Manifest Anxiety and Symptoms of Separation Anxiety and Overanxious Disorders: A Community-Based Twin Study

Genetic and environmental influences in the determination of individual differences in self-reported symptoms of separation anxiety (SAD), overanxious disorder (OAD), and manifest anxiety (MANX) were evaluated in children and adolescents for three age groups (8–10, 11–13, and 14–16). Symptom counts for SAD and OAD were assessed for 1412 twin pairs using the children's version of the Child and Adolescent Psychiatric Assessment, and MANX scores were based on child report from the Revised Children's Manifest Anxiety Scales. Despite significant age and gender differences in thresholds of liability for child reports of symptoms of SAD and OAD, additive genetic and environmental effects could be set equal across age and gender for these variables. For MANX, however, the best-fitting model was a common effects sex-limitation model with estimates of heritabiliry varying dependent upon age and gender. Parameter estimates from the ACE models of OAD and SAD showed that additive genetic variation was a necessary component in the explanation of individual differences in child-reported symptoms of OAD (h ² = .37) across gender, but does not appear to be a major contributor to the explanation of individual differences in symptoms of SAD reported by children. Shared environmental effects (c ² = .40) were found to play a moderate role for SAD but could be dropped from the model for OAD and from all of the age groups for MANX, although the parameter approached significance among 11 yr to 13-year-old males.     

Mental Health Checkups for Children and Adolescents: A Means to Identify, Prevent, and Minimize Suffering Associated With Anxiety and Mood Disorders

Early identification of disease and intervention when necessary are a cornerstone of contemporary medical practice. This approach has been successful in reducing suffering associated with the progression of unchecked medical problems to full-blown disease. Many healthcare systems, in turn, support this approach via routine checkups. The same cannot be said for mental health care. This article evaluates a school-based mental health checkup approach in the context of anxiety and depression in children and adolescents. We outline how checkups can identify children with emotional disorders, along with risk factors that, if left unchecked, may contribute to eventual onset. We conclude by discussing the benefits and limitations of this approach.     

焦虑障碍经济负担研究的系统评价

目的：了解国外焦虑障碍经济负担研究的状况及研究方法，为我国开展焦虑障碍经济负担研究提供理论依据。方法：计算机检索相关文献。根据研究方法的不同分为焦虑障碍人均经济负担和国家经济负担研究，将各国的研究结果转换成2006年的货币价值后，根据购买力平价统一转换成美元。结果：纳入13篇文献，其中11篇为人均经济负担研究，2篇为国家经济负担研究。焦虑障碍人均直接经济负担最低为256美元／年，最高为8829美元／年，人均间接经济负担最少为328美元，最多达到8655美元／年。只有美国进行了焦虑障碍国家经济负担的研究，约为700亿美元／年。结论：焦虑障碍给家庭和社会带来沉重的经济负担。     

What Is the Optimal Treatment of Mood and Anxiety Disorders?

In clinical psychiatry, the underlying assumption of using an integrated approach (pharmacotherapy + psychotherapy) is that of an additive model of interaction between pharmacotherapy and psychotherapy, which could take place on the basis of specific changes to be induced by specific treatments. However, the simultaneous administration of pharmacotherapy and psychotherapy is based on a cross-sectional, flat view of the disorders which ignores their longitudinal development. An alternative way of integrating pharmacotherapy and psychotherapy involves their sequential administration. In clinical psychiatry, administration of treatment in sequential order has been mainly limited to instances of treatment resistance and involved different types of drugs, such as in drug-refractory depression. This type of sequential approaches, however, was not targeted to the stages of illness or particularly to residual symptoms. In this paper we describe the development of a sequential strategy based on the use of pharmacotherapy in the acute phase of depression and cognitive therapy in its residual phase. The sequential model introduces a conceptual shift in therapeutic practice. It may also involve the use of pharmacotherapy after psychological treatment, the sequential use of two psychotherapeutic techniques, and two pharmacological strategies. We will discuss the implications of the sequential model and some related issues which have clinical value.     

家庭治疗对青少年焦虑症患者的疗效研究

目的探讨家庭治疗对青少年焦虑症患者焦虑症状近期疗效及远期疗效。方法对干预组31例青少年焦虑症患者进行20周共10次系统家庭治疗合并药物治疗,对照组31例青少年焦虑症患者单用药物治疗20周。采用焦虑自评量表（SAS）,生活质量综合评定问卷（GQOLI-74）,父母教养方式评定量表（EMBU）分别于治疗前、治疗4周末、治疗20周末对患者进行评定,并分别进行两两比较。结果 1干预组和对照组治疗4周及治疗20周SAS分值较治疗前均有显著降低（治疗4周,t=3.411和t=2.434,P〈0.01;治疗20周,t=11.277和t=4.373,P〈0.01）,干预组治疗20周末显著低于治疗4周末（t=6.542,P〈0.01）;2干预组治疗4周末GQOLI-74无显著差异（t=1.0265,P〉0.05）,治疗20周末GQOLI-74较治疗前显著改善（t=8.666,P〈0.01）;3干预组治疗20周末EMBU中F1,F2,F4,M1,M3,M4较前显著改善（t=3.141,3.235,3.035,4.291,3.076,4.161;P〈0.05）。结论家庭治疗对青少年焦虑症患者有较好的疗效,尤其远期疗效较明显。