儿童期躯体情感虐待经历对大学生心理健康的影响

目的：探讨儿童期躯体情感虐待经历对大学生心理健康的影响。方法：对西安1 200名大学生就儿童期躯体情感虐待经历进行儿童虐待史问卷（Bernstein）（修订后）及症状自评量表 (Symptom Check List-90,SCL-90)进行不记名调查。结果：668名学生（55.7%）16岁前曾经历过羞辱、体罚、挨打或限制活动等躯体情感虐待,其中21.0%有过挨打 (包括用器械打)的经历。儿童期有严重躯体情感虐待经历的学生,其躯体症状、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执等症状因子分≥ 1的检出率明显高于无躯体情感虐待经历的学生。结论：中国儿童期羞辱、体罚等躯体情感虐待问题仍较常见,而且儿童期严重躯体情感虐待经历直接会影响到大学生心理健康,应该重视儿童虐待的干预及研究。［中国当代儿科杂志,2009,11（8）：675-678］     

大中专学生儿童期教师体罚经历回顾性调查研究

目的了解大中专学生儿童期被教师体罚经历,探讨教师体罚学生的影响因素及儿童期教师体罚经历与青少年心理问题的关联。方法对河北1所大学和1所中专的528名在校学生就有关儿童期虐待经历进行回顾性不记名自填式问卷调查。结果57．6％（304／528）的学生报告16岁前受到至少1次下列5项中的1项来自学校教师的体罚：非身体接触体罚53．4％（282／528）、徒手打16．1％（85／528）、用物品打10．2％（54／528）、限制活动0．2％（1／528）,没有学生报告教师曾使其窒息／烧烫／刺伤。与没有教师体罚经历的学生相比,儿童期有2项或2项以上教师体罚经历的学生其SCL-90量表中躯体症状、强迫症状、人际关系敏感、抑郁、焦虑、敌对、偏执、精神病性症状等因子均分和总均分均明显偏高;在过去1年里出现严重忧郁情绪、饮酒醉过、参与或卷入打架斗殴的比例以及目前吸烟等的发生率偏高。结论儿童被教师体罚现象较普遍。儿童期教师体罚经历与青少年心理问题显著相关。急需提高公众对儿童权利的意识,学校要为儿童营造一个友好的学习环境。     

广西壮族自治区青少年心理健康状况调查

目的了解广西壮族自治区青少年心理问题发生率、心理问题的类型和表现形式及其影响因素。方法使用90项症状自评量表(SCL-90)、一般情况调查表及父母教养方式评价量表(EMBU)对广西壮族自治区南宁、桂林、百色、玉林和北海5个城市9367名青少年(男4361名,女5006名;年龄12～18岁)采用问卷调查方式进行心理健康状况调查。以SCL-90各因子得分达到或超过中度痛苦水平(≥3分)为界,划分有无心理健康问题。EMBU每个条目以1～4分量化其轻重程度,结合SCL-90及一般情况调查结果,了解父母教养方式对青少年心理健康水平的影响。所有数据均经SPSS13.0及PEMS2.0软件处理。结果症状自评量表筛选出有心理问题1362人,心理问题检出率为14.5%,广西青少年各因子得分均低于2004年4省常模,其中得分较高的项目为强迫、人际关系敏感、敌对和偏执;女性心理问题发生率高于男性;非独生子女心理问题发生率高于独生子女;单亲家庭子女心理问题发生率高于非单亲家庭子女;少数民族青少年与汉族青少年心理问题的发生率比较无统计学差异;父母不同教养方式对青少年心理健康有不同程度的影响:情感温暖与青少年心理健康状况呈负相关;而惩罚、严厉、过分干涉、偏爱被试、拒绝、否认、过度保护等项因子与青少年心理健康状况呈正相关。结论青少年心理健康问题应得到广泛重视。     

不断提高儿童晕厥的诊治水平

晕厥是儿童常见病。国外报道15％的青少年至少有1次晕厥经历^[1],晕厥患儿占所有急诊患儿的1％～3％^[2]。目前,我国儿童晕厥的发病率尚无报道,但在临床工作中青少年患者并不少见。晕厥反复发作对患儿的身体、生活和学习均会造成严重不良影响,患儿及其家长心理负担沉重^[3]。近年来,     

上海地区7 326名在校学生高血压分布趋势及相关因素分析

目的了解上海城区中小学生血压现况、高血压检出率,为预防儿童高血压提供依据。方法测量上海城区11所中小学7326名6-18岁在校学生身高、体重、血压。结果在校学生高血压总检出率为6．9％（502／7326例）,高血压检出率在体质指数（BMI）正常学生中仅为4．8％（303／6053例）,在超重和肥胖学生分别为8．8％（84／946例）、17．9％（113／630例）;超重和肥胖学生高血压检出率显著高于BMI正常者（χ^2=98．9、78、7,P均〈0．01）;上海地区6—18岁儿童青少年血压与BMI独立正相关。结论在校儿童青少年超重和肥胖者高血压的危险性明显增加,上海地区6—18岁在校学生血压与BMI独立相关。防治儿童青少年超重和肥胖是预防高血压的重要措施。     

Association between maternal job burnout and adolescent depression: the chain mediating effect of maternal depression and parenting style北大核心CSCD

目的研究母亲职业倦怠与青少年抑郁的关系,以及母亲抑郁、教养方式在其中的中介作用。方法采用横断面研究设计,于2021年4—5月在上海市7所初中进行整群随机抽样,对7所初中2572名青少年及其母亲进行问卷调查。研究工具包括一般资料调查表、职业倦怠量表、流调中心抑郁量表、简式父母教养方式问卷及儿童抑郁量表。建立结构方程模型,使用Bootstrap法进行中介效应检验。结果青少年抑郁症状检出率为12.71%(327/2572)。母亲职业倦怠得分、母亲抑郁得分、消极教养方式得分与青少年抑郁得分呈显著正相关(P<0.05),而积极教养方式得分与青少年抑郁得分呈显著负相关(P<0.05)。母亲抑郁、教养方式在职业倦怠与青少年抑郁间起中介作用,包括母亲抑郁的独立中介、积极教养方式的独立中介及抑郁-消极/积极教养方式的链式中介。结论母亲的职业倦怠可通过抑郁、教养方式、抑郁-教养方式3条中介路径影响青少年抑郁,提示降低母亲职业倦怠、改善母亲的抑郁情绪、增加积极教养行为、减少消极教养行为,有助于减少青少年抑郁症状的发生。     

广州地区患儿感染幽门螺杆菌vacA、cagA及iceA基因研究

目的探讨广州地区患儿感染幽门螺杆菌（Hp）的vacA、cagA、iceA的基因亚型和优势基因亚型。方法105例胃、十二指肠疾病患儿的胃窦处取3块胃黏膜,分别进行快速尿素酶反应、病理检查和聚合酶链反应（PCR）。抽提胃黏膜基因组DNA,用11对引物,检测HpureA、vacA、cagA和ieeA基因,分析HpvacA、cagA、iceA基因亚型。结果快速尿素酶反应、病理检查和PCR三者均阳性的标本52例,其中感染Hp vacA s1as1c／m2、s1as1c／m1T亚型菌株的阳性率分别是82．7％（43／52）、9．6％（5／52）,m区不能分型占7．7％（4／52）,Hp vacA s1as1c／m2与其他基因亚型相比较,差异有统计学意义。Hp vacA s1a和s1c亚型总是同时检出,未发现Hp vacA s1b、s2、m1亚型。HpcagA^＋菌株检出率是90．4％（47／52）,cagA^-菌株检出率9、6％（5／52）,二者比较,差异有统计学意义。Hp iceA1亚型菌株单独检出率78．8％（41／52）,Hp iceA2亚型菌株单独检出率是1．9％（1／52）,Hpi ceA1和ieeA2亚型均阳性是3．8％（2／52）,iceA1和iceA2亚型均阴性的比率是15．4％（8／52）,Hp iceA1亚型阳性率与其他基因亚型相比较,差异有统计学意义。结论Hp的Hp vacA s1as1c／m^2、cagA^＋、iceA1亚型是广州地区患儿感染的Hp的优势基因亚型,Hp vacA s1as1c／m^2、cagA。和iceA1基因组合是广州地区患儿感染的Hp的优势基因亚型组合。     

儿童脑肿瘤30例诊断分析

目的：分析儿童脑肿瘤的特点,探讨其诊断和鉴别诊断方法。方法回顾性分析30例脑肿瘤患儿的临床资料。结果30例患儿中,男女比例为1．56∶1,平均年龄为5．20岁,肿瘤生长部位多见于后颅窝（53．6％）,其中星形细胞瘤最常见,临床表现为头痛、呕吐等颅高压症状,肢体活动障碍或功能失调,惊厥,病理征阳性和颅神经损害。CT检出率为93．3％,MRI检出率为100％。术前CT定性准确率为65．8％,MRI为77．6％。结论儿童脑肿瘤发病率男多于女,发生部位以后颅窝多见,早期症状及体征不典型,易漏诊误诊。MRI是儿童脑肿瘤重要的诊断方法,对儿童脑肿瘤的早期诊断尤为重要。     

抗中性粒细胞胞浆抗体特异性靶抗原的检测在儿科临床中的应用

目的了解抗中性粗细胞胞浆抗体(ANCA)特异性靶抗原在儿科相关疾病中的检出率。方法用酶联免疫法(ELISA)对近年来临床送检的297份不同患者的血清进行靶抗原蛋白酶3(PR3)、髓过氧化物(MPO)的检测。结果总的阳性检出率为8．75％(26／ 297),其中川崎病阳性检出率为5．05％(15／297),8例识别PR3,7例识别MPO。过敏性紫癜阳性检出率为1．35％(4／297),3例识别 PR3,1例识别MPO。红斑性狼疮阳性检出率为1．01％(3／297),2例识别PR3,1例识别MPO。原发性肾病综合征阳性检出率为0．67％ (2／297),1例识别PR3．1例识别MPO。另有原发性小血管炎和Wegener’s肉芽肿各1例,分别识别PR3和MPO,结论 MPO和PR3- ELISA法具有较好的敏感性和特异性,对儿科相关疾病的临床诊断,对了解发病机制具有辅助作用,为预测疾病的愈后提供有价值的参考。     

574例患儿血清维生素A测定结果分析

目的 了解患病儿童维生素A（VA）营养状况。方法 对574例患儿血清VA含量进行分析。结果 维生素A缺乏（VAD）总检出率79．8％。新生儿、1个月－、1a-、3a-、6a-组VAD检出率分别为81．9％、82．4％、76．7％、70．7％、80．0％。各年龄组血清VA有显著差异（P＜0．01）。男女患儿VAD检出率分别为81．6％和76．2％，两者差别无显著性（P＞0．05）。呼吸道感染、消化道感染、血液系统疾病、眼部疾病、支气管哮喘、健康体检儿VAD检出率分别为84．9％、100．0％、91．0％、88．9％、90．0％、51．5％，各组血清VA有显著性差异（P＜0．01）。结论 患病儿童VA营养状况不良十分严重，VAD可导致或影响多种疾病发生。     

Prediction of sexual, emotional, and physical maltreatment and mental health outcomes in a longitudinal cohort of 290 adolescent women

A longitudinal study of 290 Canadian females measured factors at ages 3, 6, 9, and 13 that predicted emotional, physical, and sexual maltreatment occurring up to the age of 16. Significant factors predicting maltreatment were early neurological status and difficult temperament, cognitive status, maternal stress, chronic poverty, negative family climate, weak bonding, and family disruption. There was complex interplay between these factors in predicting both maltreatment status and poor mental health at age 17. Sexual abuse retained a significant link with emotional (but not conduct) problems when effects of physical and emotional abuse were controlled for. Adolescents with a combination of prolonged rather than brief sexual abuse combined with other types of abuse, with a background of family disruption and poverty, and child's impaired coping skills (reflecting poorer cognitive capacity and central nervous system problems) were most likely to have markedly impaired emotional functioning at age 17.     

Association Among Maltreatment,Bullying and Mental Health,Risk Behavior and Sexual Attraction in Chinese Students

ObjectiveTo identify the association between sexual attraction, childhood maltreatment and bullying victimization, and mental and behavioral health problems among Chinese adolescents.MethodsA cross-sectional study among Chinese high school students by multistage stratified cluster sampling was conducted using a self-reported questionnaire. Participants who were same- or both-sex attracted were identified as sexual minorities, and those who were opposite-sex attracted were identified as heterosexuals. Childhood maltreatment was assessed as physical, emotional, and sexual abuse, and bullying was assessed as traditional and cyberbullying. Psychological distress was assessed as depressive and anxiety symptoms, and self-destructive behavior was assessed as suicidal behavior and nonsuicidal self-injury. Logistic regression and path analysis were conducted to analyze the data.ResultsThere were 1360 sexual minority and 15,020 heterosexual respondents. Sexual minority status was associated with increased risk of maltreatment (adjusted odds ratio [AOR] range: 1.25–2.46) and bullying (AOR range: 1.38–1.77) victimization, and a series of health problems (AOR range: 1.85–3.69). Furthermore, childhood maltreatment could partially explain the association of sexual minority status with psychological distress (indirect effect: β = 0.026 for boys; β = 0.086 for girls) and self-destructive behavior (β = 0.056 for boys; β = 0.125 for girls), and bullying could partially explain the association between sexual minority status and psychological distress (β = 0.040 for boys; β = 0.031 for girls).ConclusionsSexual minority adolescents were more likely than heterosexuals to experience different forms of childhood victimization, which may put them at higher risk for mental and behavioral health problems. Interventions based on both family and school are essential.     

Health concerns of university women with a history of child physical and sexual maltreatment

Three health symptom checklists were used to measure physical health concerns among university women in relation to prior child physical maltreatment (CPM) (20%, n = 153) and child sexual abuse (CSA) (19%, n = 143). A history of CPM was related to all three general areas of health concerns as well as to many of the specific subscales comprising the measures (e.g., muscular-skeletal symptoms and gynerological problems), whereas an interaction between CSA and CPM was linked to greater premenstrual distress subscale scores (particularly emotional and behavioral symptoms). Overall, although CSA was not related to health symptoms, within the CSA subgroup, greater duration and severity of CSA was predictive of higher premenstrual distress even after controlling for CPM. This study emphasizes the need for greater awareness of the physical health-related correlates of both physical and sexual maltreatment in childhood and their associated implications for women's health care needs.     

Traumatic stress and gender differences in relationship to substance abuse,mental health,physical health,and HIV risk behavior in a sample of adolescents enrolled in drug treatment

Research on traumatic stress (TS) among adolescent substance users is limited, with research indicating that not all adolescents who experience trauma are substance users and not all adolescent substance users report symptoms of TS. In the general adolescent population, research on TS symptoms indicates gender differences, with more females reporting traumatic life events and more symptoms associated with traumatic stress. A gap in research exists, however, with regard to gender differences among adolescent substance users who report low versus acute levels of TS symptoms. This study included 274 male and 104 female adolescents enrolled in four drug treatment programs in Arizona. Comparisons between males and females and those with low versus acute levels of TS symptoms were examined with regard to substance use, mental health, physical health, and HIV risk-taking behavior. Results indicate significant differences between males and females and between those reporting low versus acute TS. In general, females and those with acute levels of TS symptoms had higher levels of substance use, mental health, and physical health problems as well as greater HIV risk behaviors when compared to males and those with low levels of TS symptoms. Results of this study indicate the need to assess adolescents for TS, including victimization and maltreatment histories, when entering substance abuse treatment and the need to simultaneously address issues of substance use, TS, and related mental health, physical health, and HIV sex risk behavior while in treatment.     

Physical activity might not be the protective factor for health risk behaviours and psychopathological symptoms in adolescents

AIM: This study aims to examine the effect of physical activity (PA) intensity on tobacco or alcohol abuse, suicide behaviours and psychopathological symptoms in junior and senior high school students in China. METHODS: A total of 5453 students from nine middle schools participated in a self-administered anonymous survey to report their frequency of moderate and vigorous PA at a normal learning week. Tobacco or alcohol use in the past 30 days, suicide behaviours during the past 12 months were asked. The Symptoms Checklist 90 was used to assess general mental problem and nine special psychopathological symptoms. The Rosenberg's Self-esteem Scale and School Life Satisfaction Rating Questionnaire for Adolescent were selected to rate the respondents' self-esteem and school life satisfaction. RESULTS: Percentage of high-, low-moderate- and very-low-intensity PA was 22.0%, 37.0% and 41.0%, respectively. By using multivariable multinomial logistic regression, it was indicated that low-moderate-intensity PA was a protective factor of depression (odds ratio (OR) was 0.61, 95% confidence interval (CI) was 0.40-0.91) and psychotic symptoms (OR 0.54, 95% CI 0.31-0.93), while high-intensity PA was a risk factor of binge drinking (OR: 1.81, 95% CI: 1.29-2.54), suicide ideation (OR: 1.26, 95% CI: 1.04-1.54), general psychological disorders (OR: 1.43, 95% CI: 1.11-1.84), and hostile symptoms (OR: 1.46, 95% CI: 1.03-2.07). CONCLUSION: Different intensity PA in adolescents had different association with risk health behaviours and psychopathological symptoms. The reasons are worth further researching.     

Attributions and behaviours of parents abused as children: a mediational analysis of the intergenerational continuity of child maltreatment (Part II)

BACKGROUND: This study extends previous research (Dixon, Browne, & Hamilton-Giachritsis, 2004) by exploring the mediational properties of parenting styles and their relation to risk factors in the intergenerational cycle of child maltreatment. Families with newborns where at least one of the parents was physically and/or sexually abused as a child (AP families) were compared, in terms of parents' attributions and behaviour, to families where the parents had no childhood history of victimization (NAP families). METHODS: Information was collected from 4351 families (135 AP families) by community nurses as part of the 'health visiting' service. The same health visitor visited each family twice at home when the child was 4 to 6 weeks and 3 to 5 months of age, to assess behavioural indicators of positive parenting. RESULTS: Within 13 months after birth, 9 (6.7%) AP families were referred for maltreating their own child in comparison to 18 (.4%) NAP families. Assessments found a significantly higher number of risk factors and measures indicating poor parenting for AP families. Mediational analysis found that intergenerational continuity of child maltreatment was explained to a larger extent (62% of the total effect) by the presence of poor parenting styles together with the three significant risk factors (parenting under 21 years, history of mental illness or depression, residing with a violent adult). The three risk factors alone were less explanatory (53% of the total effect). CONCLUSION: This study provides an explanation for why a minority of parents abused in childhood go on to maltreat their own infant, evidencing poor parenting styles and mediating risk factors. Hence, prevention may be enhanced in AP families by the promotion of 'positive parenting' in addition to providing additional support to young parents, tackling mental illness/depression and domestic violence problems.     

Risk factors of parents abused as children: a mediational analysis of the intergenerational continuity of child maltreatment (Part I)

BACKGROUND: This study provides an exploration of factors implicated in the intergenerational cycle of child maltreatment. Families with newborns where at least one of the parents was physically and/or sexually abused as a child (AP families) were compared in terms of risk factors to families where the parents had no childhood history of victimization (NAP families). The mediational properties of risk factors in the intergenerational cycle of maltreatment were then explored. METHODS: Information was collected by community nurses as a part of the 'health visiting' service. Data was collated across 4351 families, of which 135 (3.1%) had a parent who self-reported a history of abuse in childhood. The health visitor visited each family at home when the child was 4 to 6 weeks of age to assess the presence of risk factors. RESULTS: Within 13 months after birth, 9 (6.7%) AP families were referred for maltreating their own child in comparison to 18 (.4%) NAP families. Assessments found a significantly higher number of risk factors for AP families. Mediational analysis demonstrated that the presence of three significant risk factors (parenting under 21 years, history of mental illness or depression, residing with a violent adult) provided partial mediation of the intergenerational continuity of child maltreatment, explaining 53% of the total effect. CONCLUSION: Prevention may be possible, once a history of parental childhood abuse has been identified, by offering services in priority to those families where a parent is under 21 years, has a history of mental illness/depression and/or there is a violent adult residing in the household. However, it must also be acknowledged that these factors do not provide a full causal account of the intergenerational transmission and consideration should be given to additional factors, such as parenting styles (see Part II of this mediational model, Dixon, Hamilton-Giachritsis, and Browne, 2004).     

Recognizing and managing long-term sequelae of childhood maltreatment

Childhood maltreatment is a serious public health problem and represents a significant challenge to pediatricians. Maltreated children present with a variety of emotional and behavioral problems. Pediatricians should screen for risk factors associated with maltreatment and psychiatric sequelae associated with maltreatment. Because of the complexity of psychiatric sequelae in childhood maltreatment, children who have been maltreated will likely require multidisciplinary treatment in mental health care settings. Therefore, pediatricians need to be knowledgeable about mental health services in their communities and actively assist the family in obtaining services. Although we are gaining a more sophisticated understanding of the impact that maltreatment has on the mental health of children and adolescents, much remains to be done. It is critical for pediatricians to work within their professional organizations and their individual communities to address the systemic issues that create barriers to care for patients who have suffered maltreatment. It is also critical for pediatricians to encourage their professional organizations to establish good working relationships with other organizations in areas where they share interest, need, and commitment. Such collaborative relationships at local, state, and national levels can facilitate governmental policy changes that are needed to protect and care for children and adolescents. Only through such efforts can we bring about lasting changes that will support the health and well-being of children and adolescents.     

An analysis of the impact of diverse forms of childhood psychological maltreatment on emotional adjustment in early adulthood

Recent research has documented the long-term mental health consequences of childhood psychological maltreatment; however, this research is limited in that it typically fails to recognize the qualitative differences of the various behaviors labeled as psychological maltreatment. This study examines the predictive ability of caregiver terrorizing, degradation, ignoring, and isolating during childhood on the self-reported occurrence of anxiety, depression, somatic complaints, and features of borderline personality disorder (BPD) in a sample of 256 university students between the ages of 18 and 22. Witnessing violence and childhood physical abuse are included in the analyses. Simultaneous regression analyses reveal that different forms of maltreatment emerge as predictors of the variables of emotional adjustment. Terrorizing predicted anxiety and somatic concerns, ignoring predicted scores of depression and features of BPD, and degradation predicted BPD features only. Findings suggest psychological maltreatment is a multifaceted construct requiring further research to investigate the long-term impact of various subtypes.     

Borderline personality disorder features and history of childhood maltreatment in mothers involved with child protective services

This study examines the history of childhood maltreatment and Borderline Personality Disorder (BPD) symptoms in mothers whose children were removed from the home by Child Protective Services (CPS) to identify potential targets for future intervention efforts. Forty-one mothers of children removed from the home due to abuse and/or neglect and 58 community-control mothers without CPS involvement were assessed for history of childhood maltreatment, alcohol and drug use, and BPD features. CPS-involved mothers scored significantly higher on measures of childhood maltreatment history and BPD features than did control mothers. The highest BPD scores were associated with the most severe histories of mothers' childhood maltreatment. In total, 50% of CPS-involved mothers reported elevated BPD features, compared with 15% of control mothers. Further, 19% of CPS-involved mothers had self-reported scores consistent with a BPD diagnosis, compared with 4% of control mothers. BPD features rather than maltreatment history per se predicted maternal involvement with CPS, controlling for alcohol and drug use predictors. The present data suggest that evidence-based treatments to address BPD symptoms may be indicated for some CPS-involved parents.