儿童行为问题与儿童被忽视、心理弹性的关系

目的探析儿童行为问题与儿童被忽视、心理弹性的关系。方法采用分层整群随机抽样法抽取某县430名小学生为研究对象,采用《Rutter儿童行为问卷(父母版)》、《儿童被忽视量表》(CNS)、《青少年心理弹性量表》(RSCA)分别测查儿童问题行为、儿童被忽视程度以及儿童心理弹性能力。结果儿童行为问题的检出率为25.2%。Rutter总分与安全忽视、交流忽视、躯体忽视、情感忽视呈显著正相关(r=0.163～0.350),与情绪控制、家庭支持、人际协助呈显著负相关(r=-0.243～-0.134)。结论儿童行为问题与儿童被忽视、心理弹性密切相关,尊重儿童、同时培养其抗压能力可能会减少行为问题的发生。     

南充某地农村留守儿童的个性心理情绪特征及行为干预对策探讨

目的分析农村留守儿童的个性心理和行为特征并探讨相应的护理对策。方法选取我医院所在辖区附近的2所农村小学,抽取1000名儿童接受调查,根据儿童是否为留守儿童分为留守组(n=310)和对照组(n=690),使用艾克森个性问卷儿童版(EPQ)、流调用儿童抑郁量表(CESDC)、儿童自我意识量表(PHCSS)、Rutter儿童行为教师问卷对这1000名儿童进行调查,比较两组儿童的调查结果。结果 EPQ调查结果显示,留守组儿童的P分和N分均显著高于对照组儿童(P0.05);CES-DC调查结果显示,留守组儿童的评分显著高于对照组儿童(P0.05),留守组儿童的抑郁症状检出率显著高于对照组儿童(P0.05);Rutter调查结果显示,留守组儿童A评分显著低于对照组(P0.05);PHCSS量表调查结果显示,留守组儿童躯体外貌和幸福与满足的得分显著低于对照组儿童(P0.05)。结论农村留守儿童的心理卫生状况要比同龄非留守儿童要差,要动员学校、家庭和社会共同参与农村留守儿童的教育和监护,促进农村留守儿童的心理健康状况良好。     

外来与留守小学生心理行为问题的对照研究

目的:了解昆明市小学生的心理健康状况及特征,并对外来儿童、留守儿童等特殊群体的心理健康状况进行分析,为制订干预措施提供依据。方法:运用Rutter儿童行为量表(教师用)对昆明市2所小学的380名儿童进行调查,分析留守儿童、外来儿童的心理健康状况,并与其他儿童及昆明市儿童常模进行比较。结果:2所小学儿童行为问题检出率为18.5%,不同性别儿童检出率差异有统计学意义(χ2=136.903,P0.05);不同年级检出率差异无统计学意义(χ2=4.273,P0.05);外来儿童、留守儿童总体检出率明显高于普通家庭儿童,在检出有行为问题的儿童中,外来儿童以神经质行为为主,留守儿童以反社会行为为主。结论:昆明市外来儿童、留守儿童心理健康状况不容乐观,应该引起重视。     

基层行政管理人员抑郁情绪与精神卫生知识知晓度及精神疾病态度的关系

目的 了解基层行政管理人员抑郁情绪与精神卫生知识知晓度及精神疾病态度的关系,为进一步提高精神卫生服务和建设社会心理服务体系提供参考。方法 于2020年10月选取济南市历城区690名街道办事处基层行政管理人员为研究对象,采用自编一般情况调查表、精神卫生与心理保健知识问卷、精神疾病有关态度问卷和抑郁自评量表(SDS)进行评定。采用多因素线性逐步回归分析探讨基层行政管理人员精神卫生知识知晓度及精神疾病态度的影响因素。结果 共检出248人(37.07%)存在抑郁情绪,不同年龄(χ²=16.110)、受教育程度(χ²=18.949)、婚姻状况(χ²=8.611)、职务(χ²=11.584)者抑郁情绪检出率差异均有统计学意义(P<0.05或0.01)。基层行政管理人员精神卫生与心理保健知识问卷评分为(15.20±2.77)分,知晓率为75.99%,精神疾病有关态度问卷评分为36(31～38)分。抑郁情绪严重程度与精神卫生与心理保健知识问卷评分呈负相关(r=-0.379,P<0.01),与精神疾病有关...     

小学五、六年级学生自我控制的发展及与问题行为、亲社会行为的关系

目的 探讨小学五、六年级学生自我控制与行为的关系.方法 采用儿童自我控制学生自陈表、长处与困难问卷对318名学生进行调查.结果 自我控制总分与问题行为总分呈负相关(r=-0.216,P＜0.01),与亲社会行为无相关性(r=0.081,P＞0.05);学习行为能显著预测问题行为(β=0.200,P＜0.01);性别和年级对亲社会行为的预测作用显著(β分别为-0.157,0.112,P＜0.05);自我控制不同维度对行为的各个维度预测作用不同.结论 提高小学生自我控制能力水平对减少问题行为、激发亲社会行为有积极作用.     

成都市学龄前儿童情绪行为问题现状调查

目的 了解成都市学龄前儿童情绪行为问题的现状.方法 应用长处和困难问卷(SDQ)(家长版),采用整群分层随机抽样,对成都市5个辖区17所幼儿园的949名3~7岁学龄前儿童进行调查.结果 21.3%的学龄前儿童存在情绪问题.其中24.9%的女童有情绪问题,17.3%的男童有情绪问题,女童情绪问题的发生率高于男童(χ2=7.298,P=0.007).女童在情绪问题方面的得分高于男童(t=-2.770,P=0.006).分别有13.0%,19.7%,18.6%,19.2%的学龄前儿童存在品行、多动、同伴交往、亲社会行为问题,但其发生率均不存在性别差异.男童在同伴交往问题方面的得分高于女童(t=2.442,P=0.015),女童在亲社会行为方面的得分高于男童(t=2.940,P=0.003).综合年龄、性别、家庭状况等因素对于学龄前儿童情绪障碍具有61.3%的预测准确性.结论 部分学龄前儿童存在明显的情绪及行为问题,女童的情绪问题更多及发生率更高,同伴关系和亲社会性发展更好.学龄前儿童的情绪障碍与多种因素有关.     

癫癎患儿睡眠结构与认知行为关系的研究

目的探讨特发性癫患儿睡眠结构改变与认知行为异常的关系。方法对64例特发性癫患儿(癫疒间组)进行全夜睡眠多导监测、日间注意力测定及Achenbach儿童行为量表评估情感行为状态;应用秩相关系数分析睡眠与注意力、行为的相关性,并与20名正常儿童(正常对照组)进行比较。结果与正常对照组相比,癫疒间组睡眠Ⅰ期百分比和快速眼动期(REM)潜伏期显著延长(均P<0.05);部分性发作患儿入睡后觉醒次数较全身性发作患儿显著增多(P<0.05);应用丙戊酸钠的患儿睡眠总记录时间较未服用抗疒间药者延长(P<0.05);记录到疒间性电发放的患儿睡眠总记录时间、REM潜伏期延长,睡眠效率降低(均P<0.05);癫疒间组患儿划消试验总参数较正常对照组明显升高(P<0.05);Achenbach儿童行为量表总体行为问题评分升高(P<0.05),秩相关分析示划消试验总参数与睡眠Ⅰ期百分比成正相关(r=0.68,P<0.05),儿童行为量表评分与REM百分比呈正相关(r=0.57,P<0.05)。结论特发性癫疒间患儿睡眠结构异常,其与患儿的日间注意力及行为异常有关。     

父母教养方式和3岁学龄前儿童品行问题的关系

目的以学龄前3岁儿童为对象,探讨父母教养方式与品行问题的关系。方法对深圳市龙华区新入园儿童进行调查,采用一般情况问卷、父母教养方式(Egna Minnen Betraffande Uppfostran-Parents,EMBU-P)问卷、Conners父母用症状量表中品行问题因子向主要照护人收集儿童一般情况、父母教养方式和儿童品行问题等资料。共发放10972份问卷,回收9289份有效问卷。使用logistic回归分析教养方式与儿童品行问题的关系。结果 349名(3.8%)儿童品行问题因子得分高于临界值。在控制父母年龄、父母教育水平、家庭收入等混杂因素后,儿童品行问题与父母拒绝(OR=1.17,P0.01)、控制/过度保护(OR=1.03,P0.01)和情感温暖(OR=0.98,P0.01)的关联有统计学意义。分层分析结果显示,父母拒绝(OR_父=1.16,P0.01;OR母=1.17,P0.01)、父亲的情感温暖(OR_父=0.96,P0.01)和母亲的控制/过度保护(OR_母=1.04,P0.01)与品行问题存在统计学关联,该关联在不同性别、独生与非独生儿童中基本相同。结论父母教养方式可能是学龄前儿童品行问题的影响因素,在预防和治疗儿童品行问题时应给予关注。     

强迫症患者的治疗依从性及其影响因素研究

目的探讨强迫症患者的治疗依从性及其影响因素。方法使用个人情况及治疗意愿问卷、HAMD、HA-MA、Y-BOCS量表对心理门诊的强迫症患者进行调查、测试,并分析影响治疗依从性的相关因素。结果初次就诊时接受治疗及就诊2次、4次、6次以上者的比例分别为78.6%、70.2%、60.1%、45.8%;未接受治疗组经济状况差于接受治疗组(χ2=14.432,P<0.001),学生的比例明显低于接受治疗组(χ2=14.090,P<0.001),而在受教育程度方面,两组的差异无显著性意义(χ2=0.764,P>0.005);接受治疗组与未接受治疗组在年龄与病程两方面的差异都无显著性意义(t=0.864、1.826,P>0.05),未接受治疗组的HAMD、HAMA评分均明显低于接受治疗组,差异都有极显著性意义(t=8.163、13.446,P<0.01)。Y-BOCS评分未接受治疗组低于接受治疗组,差异有显著性意义(t=2.304,P<0.05)。结论强迫症患者的治疗依从性与经济状况、职业或身份、HAMD、HAMA和Y-BOCS评分有关。     

留守对儿童行为问题影响的Meta分析

目的探讨中国留守儿童行为问题状况,为留守儿童的心理干预及心理健康教育提供参考。方法计算机检索CNKI、万方、维普、Cochrane Library及PubMed,收集公开发表的关于我国留守儿童行为问题的病例对照研究,由两位研究者独立进行文献筛选、资料提取和方法学质量评价后,采用Rev Man 5.3软件进行数据分析。结果共纳入病例对照研究9篇,NOS文献质量评价7~9分,均为高质量文献。Achenbach儿童行为量表(CBCL)荟萃分析:6~11岁男童体诉因子得分留守组高于非留守组(MD=0.99,95%CI:0.20~1.77,P=0.01);6~11岁女童分裂强迫因子得分留守组高于非留守组(MD=1.52,95%CI:1.44~1.60,P0.01)。儿童长处与困难问卷(SDQ)荟萃分析:留守组的情绪症状、品行问题、多动/注意不能、同伴交往及困难总分得分均高于非留守组(P均0.01),而亲社会行为得分低于非留守组(P0.01)。Rutter儿童行为问卷(Rutter)荟萃分析:留守组行为问题的发生率高于非留守组(OR=3.94,95%CI:2.30~8.43,P0.01)。结论留守可增加儿童行为问题的发生;留守可能是通过影响儿童的情绪、行为方式及人格特征,从而导致留守儿童行为问题的发生,且留守对低龄儿童的影响可能更大。     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.     

Summary of Legislation of 1933 of interest to the Department of Mental Hygiene

Psychiatric Quarterly -