行为问题儿童的智力水平配对研究

目的：探讨行为问题儿童的智力水平及特征。方法：采用Achenbach儿童行为问卷（CBCL）（父母问卷）和中国联合型瑞文测验第二版（CRT－C2）在小学1－5年级学龄儿童中筛选行为问题儿童。从同性别非行为问题儿童中选择与问题儿童年龄最接近的儿童组成对照组，配对比例为1：2。采用韦氏儿童智力量表（WISC－CR）测验儿童智力水平。结果：（1）行为问题儿童的IQ基本在正常范围，与对照组水平接近。译码是儿童行为问题的保护因素，智力不平衡是危险因素。（2）智力不平衡是内向行为问题的危险因素；CRT－C2IQ是外向行为问题的保护因素；译码是混合问题的保护因素。结论：行为问题儿童虽然智力发育在正常水平，但智力不平衡者较多，提示行为问题儿童半球功能不平衡，有脑功能损伤的可能。     

注意缺陷多动障碍儿童精神运动功能与记忆能力

目的:探讨注意缺陷多动障碍(Attentiondeficithyperactivitydisorder,ADHD)儿童和正常儿童精神运动功能与记忆能力的差异。方法:采用1:1病例对照研究,对38例ADHD儿童和38例正常儿童进行津医精神运动成套测验(JPB)与韦氏记忆测验(部分内容)。结果:(1)ADHD组儿童JPB连接数字、符号计入及总成绩均低于对照组(51·37±14·19/57·73±7·30,44·29±7·23/49·82±7·31,336·0±42·1/359·3±43·1,t=2·47、4·64、2·55,均P<0·05);(2)ADHD儿童JPB总分显著低于全国大样本常模;(3)ADHD儿童背诵数目测试成绩显著低于对照组(9·21±3·51/11·37±3·57,t=2·61,P<0·05)。结论:ADHD儿童精神运动功能低于正常儿童,在精细运动的准确性、灵活性及协调性等方面均存在问题,其工作记忆能力受到损害。     

注意缺陷多动障碍儿童行为问题的对照研究

目的：比较注意缺陷多动障碍（Attention Deficit Hyperactivity Disorder，ADHD）临床亚型和正常儿童的行为问题。方法：将符合DSM—Ⅳ ADHD诊断标准的男童70例分为注意障碍为主型（PI）44例，以多动／冲动为主型（HI）6例、混合型（CT）20例，采用儿童行为量表（Child Behavior Checklist，CBCL）比较各亚型和正常儿童的行为问题。结果：ADHD组行为问题发生率（48．57％）明显高于对照组（12．70％），P〈0．01；ADHD各亚型行为问题发生率存在统计学差异（P〈0．01）。混合型最高；ADHD亚型与对照组CBCL因子分的4组间比较显示分裂性、强迫性、体诉、多动、攻击性、违纪因子及CBCL总分存在统计学差异；分裂性因子PI〉HI，攻击性因子CT，HI〉PI，违纪因子HI〉PI，CT。结论：ADHD男童行为问题发生率高于正常儿童，其中混合型行为问题发生率最高；ADHD临床亚型行为问题特点不同。     

136例4-6岁儿童行为问题危险因素研究

为了探讨学龄前期儿童行为问题发生危险因素，本文以4－6岁2138名儿童为调查对象，采用Achenbach行为量表（简称CBCL），对其中136例有行为问题儿童进行单因素分析。结果提示母孕期不利因素、母亲文化程度、父母教育方式、教育态度及双亲关系等，都是儿童行为问题的高危因素，说明防治儿童行为问题，必须从围生期着手，同时也应引起儿科工作者、教育工作者及家长的高度重视。     

34名沉缅电子游戏儿童的心理行为及相关因素调查分析

目的 :探讨电子游戏依赖性儿童的心理、行为及家庭环境特点。方法 :选择用艾森克问卷(EPQ) ,Achenbach儿童行为量表 (CBCL) ,家庭环境量表 (FES)分别对 3 4例电子游戏依赖性儿童及 3 4例正常儿童进行评定。结果 :电子游戏依赖性儿童在EPQ量表的P分、L分 ,CBCL量表的社交情况、学校情况、退缩、焦虑 抑郁、社会问题、违纪问题、攻击性行为、内向性行为问题、外向性行为问题、行为问题总分的得分均显著高于对照组 (P <0 0 5 )。在FES -CV量表中的亲密度、情感表达、娱乐性、组织性、控制性得分均低于对照组 (P <0 0 5 ) ,而在家庭的矛盾性得分显著高于对照组 (P <0 0 5 )。结论 :电子游戏依赖性儿童有较多的心理、行为问题 ,某些家庭环境因素可能是儿童电子游戏依赖性的原发和促动因素之一。     

神经心理学测验与亚临床肝性脑病的检测

目的：探讨年龄、性别、教育、职业等因素对神经心理测验结果的影响及检测肝硬化病人的神经心理学异常。方法：采用连线测验、数字符号测验、积木图测验、相似性测验、第四例外测验、威斯康星卡片分类测验（WCST）对69例肝硬化患者和62例正常健康者进行测试。二者被试在年龄、性别、职业、受教育年限等方面进行匹配。结果：多元逐步回归分析结果显示，本研究引用的大多数神经心理学测验受教育、年龄的影响较大，受性别、职业的影响相对较小。对正常对照组和肝硬化组进行的逐步判别分析显示，连线测验和数字符号测验对鉴别正常健康者和肝硬化患者的分辨性最高。连线测验采用不同年龄组划界分，数字符号测验采用不同教育程度划界分对肝硬化患者进行划分，结果24例（34．78％）肝硬化患者连线测验划为异常，9例（14．29％）数字符号测验结果异常。结论：本研究提示肝硬化病人存在明显神经心理学异常，进一步随访研究可证实这些异常与肝性脑病的关系；神经心理学测验为亚临床肝性脑病的诊断提供了筛查工具。     

弱视少年心理行为问题的临床研究

目的：探讨弱视患儿的心理行为问题，方法：采用Achenbach儿童行为量表（CBCL），抑郁自评量表（SDS）和焦虑自评量表（SAS），对78例弱视患儿和82例正常对照组患儿进行评定分析。结果：与正常对照组相比，弱视患者CBCL家长用表和学生用表的异常率以及SDS，SAS评分明显增高，差异显著（P＜0．01），结论：弱视患得存在明显的心理行为问题。     

三种常用行为评价量表应用于北京中学生的结果比较

目的：探讨Achenbach编制的测查儿童行为问题最著名的三份量表，即：儿童行为问题父母评价量表（CBCL）、青少年自我评价量表（YSR）和教师评价量表（TRF）之间的相关性及适用性。方法：采用CBCL、YSR、TRF量表，对北京市6所中学1410名12～18岁青少年进行调查，并对结果进行统计分析。结果：CBCL、YSR、TRF量表的条目与总分的Cronbach α系数分别为0.96、0.95、0.99，分半信度系数分别为0．93、0．89、0.97，说明三份量表均具有很好的内部一致性。YSR的得分普遍高于其它两个量表，CBCL得分次之，TRF得分最低（少数个别因子除外）。CBCL与YSR的得分在全部样本、不同性别、初、高中生均相关（r=0.35～0．60，P〈0．01）；CBCL与TRF在注意力问题和攻击性行为得分上有一定相关（r=0.13～-0，25，P〈0．05）。CBCL量表中学习成绩与各分量表因子均呈负相关（r=-0.13～-0．39，P〈0．01），TRF量表中适应能力和学习成绩与各分量表因子均呈负相关（r=-0．23～0.51，P〈0．01；r=-0.21～0.49，P〈0.01），YSR量表中学习成绩也与多项因子得分呈负相关（r=-0.11～-0．28，P〈0，01）。结论：建议在应用CBCL父母评价量表和TRF教师评价量表时，与YSR青少年自评量表结合使用，能够更加全面地反映青少年的行为问题。     

温州地区托养儿童行为问题调查

目的：了解温州市6-16岁托养儿童行为问题发生情况。方法：根据分层整群抽样的原则,对温州地区8340名6-16岁学生采用自制问卷和Achenbach儿童行为量表（CBCL）进行调查。结果：温州市6-16岁的儿童行为问题检出率为14.4%（1202/8340）略高于中国常模13.0%,但无统计学意义（P〉0.05）。2520名为托养儿童,占30.2%（2520/8340）,6-11岁托养儿童840位,行为问题检出率18.6%（156/840）高于非托养普通儿童检出率13.4%（396/2960,χ2=14.2,P〈0.05）;12-16岁托养儿童1680位,行为问题检出率19.2%（322/1680）高于非托养普通儿童检出率11.5%（328/2860,χ2=51.1,P〈0.05）。托养儿童行为问题的危险因素有出生时患病、学前所处环境（单亲）、性别（男）、托养家庭结构（矛盾）、托养方式（全天）、托养人受教育程度（小学）及教育方式（专制、放任）（OR=1.287～2.582）,保护因素有托养人数（3人以上）、居住地（城镇）,（0R=0.412～0.499）。结论：6-16岁托养儿童行为问题检出率较高,心理健康状况应引起关注。     

儿童注射缺陷多动障碍DSM—Ⅳ亚型的临床特比比较研究

目的：比较DSM－Ⅳ注意缺陷多动障碍（AD／HD）以注意障碍为主型（PI）、以多动／冲动为主型（HI）和混合型（CT）的临床特征，方法：将门诊儿童符合DSM－ⅣADHD诊断标准者126例分为PI型61例；HI型9例、CT型56例，比较三型合并障碍的诊断、父母、教师量表评分；韦氏儿童智力检测（C－WISC）和注意测验。结果：CT组合并品行障碍的发生率，父母，教师评定违纪行为和攻击性行为分量表、外向性行为问题及行问题显著高于PI组。WISC填图，划销测验净分低于PI组。教师评定学校情况PI组优于HI组和CT组。结论：ADHD混合型的外向性行为问题。学业问题，注意力缺陷最严重，注意障碍为主型则在各方面损害较轻。     

行为问题儿童听觉事件相关电位P300对照研究

目的:探讨行为问题儿童听觉事件相关电位P300特点.方法:用Achenbach儿童行为问卷(CBCL)和中国联合型瑞文测验(CRT-C2)筛选行为问题儿童,并按同性别、同年龄进行1:2配对;采用odd模式测试听觉事件相关电位.结果:①问题组儿童的P300各项指标与对照组儿童无显著差异;②混合问题组P300潜伏期较单一问题组延迟(P<0.05),Pz点P300的基线波幅混合问题组与单一问题组的差异接近有统计学意义.③行为问题儿童Pz点P300基线波幅与行为问卷总分呈显著负相关(P<0.05).结论:行为问题较为严重的儿童可能有认知功能损害.     

社会技能训练对儿童行为问题的干预研究

目的:建立社会技能训练的方法,并探讨社会技能训练对儿童行为问题的干预效果.方法:应用社会技能训练对30例儿童行为问题患儿进行为期8周的干预,采用Rutter儿童行为问卷,Conners儿童行为问卷,Achenbach儿童行为量表进行干预前后评价,并进行临床疗效评定.结果:干预后,Rutter儿童行为问卷总分、A分和N分均较治疗前显著下降(P<0.001,P<0.05,P<0.01),临床评定总有效率达76.67%;Conners儿童行为问卷总分及因子分行为、学习、多动、多动指数较治疗前显著下降(P<0.05～0.01),总有效率63.33%;Achenbach儿童行为量表显示因子分违纪显著下降(P<0.05),总有效率60%.结论:社会技能训练的方法切实可行,并对儿童行为问题的改善有效.     

Cardiac vagal regulation differentiates among children at risk for behavior problems

A sample of 335 five-year-old children participating in an ongoing longitudinal study was the focus of a study on the effects of emotional and behavioral challenge on cardiac activity in children with different patterns of early childhood behavior problems. The children were placed in one of three behavior problem groups (low behavior problems, risk for externalizing problems, risk for mixed externalizing/internalizing problems) based on their scores on the Child Behavior Checklist for 4-18-year-olds [Achenbach, T.M., 1991. Integrative guide for the 1991 CBCL/4-18, YSR & TRF profiles. University of Vermont Department of Psychiatry, Burlington, VT], completed by their mothers. To assess cardiac vagal regulation, resting measures of respiratory sinus arrhythmia (RSA) and RSA change (vagal withdrawal) to five emotionally and behaviorally challenging tasks were derived. In addition, heart period (HP) and heart period change (HR acceleration) was examined. Results indicated that the behavior problem groups did not differ in terms of resting measures of either RSA or HP. Analyses of the challenge tasks indicated that the children at risk for mixed problems displayed greater cardiac vagal withdrawal across the five tasks than did the other two groups of children. There was a trend for the children at risk for externalizing problems to display less vagal withdrawal than the control group. In addition, the children at risk for mixed problems displayed greater heart rate acceleration to the tasks than did the other two groups of children. Follow-up analyses indicated that the greater cardiac acceleration observed in the mixed group was largely a function of greater vagal withdrawal. These findings are discussed in terms of the emotion regulatory function of cardiac vagal regulation, and its implications for patterns of risk for behavior problems in young children.     

Behavior problems in postinstitutionalized internationally adopted children

Using the Child Behavior Checklist (CBCL), the rate and type of behavior problems associated with being reared in an institution prior to adoption were examined in 1,948, 4- through 18-year-old internationally adopted children, 899 of whom had experienced prolonged institutional care prior to adoption. The children's adoptions were decreed between 1990 and 1998 in Minnesota. Binomial logistic regression analyses revealed that early institutional rearing was associated with increased rates of attention and social problems, but not problems in either the internalizing or externalizing domains. Independent of institutional history, children who were adopted >or=24 months had higher rates of behavior problems across many CBCL scales, including internalizing and externalizing problems. In general, time in the adoptive home, which also reflected age at testing, was positively associated with rates of problem behavior. Thus, there was little evidence that the likelihood of behavior problems wane with time postadoption. Finally, children adopted from Russia/Eastern Europe appeared at greater risk of developing behavior problems in several domains compared to children adopted from other areas of the world.     

Glycemic control in youth with type 1 diabetes: family predictors and mediators

OBJECTIVE: This study examined predictive and mediated relationships among youth perception of critical parenting, Child Behavior Checklist Externalizing Subscale (CBCL) externalizing problem scores, adherence, and (hemoglobin A(1c) HbA(1c)), in youth with type 1 diabetes from low socioeconomic status families. METHODS: Caregiver/youth dyads (n = 120) completed diabetes specific measures of family functioning regarding diabetes management and structured adherence interviews. Parents completed the CBCL, while assays of youth HbA(1c) were performed. Analyses were conducted using hierarchical linear regression. RESULTS: Combined measures predicted 44% of the variance in HbA(1c). Adherence partially mediated critical parenting and HbA(1c), while critical parenting and adherence mediated CBCL externalizing problem scores and HbA(1c). CBCL externalizing problem scores did not mediate critical parenting and HbA1(c). CONCLUSIONS: The presence of youth perceptions of critical parenting and youth externalizing behavior problems may interfere with adherence, leading to increases in HbA(1c).     

The Korean Version of the Pediatric Symptom Checklist: Psychometric Properties in Korean School-aged Children

Psychosocial problems increase the risk for mental health problems and increase the need for health care services in children and adolescents. Primary care practice is a valuable avenue for identifying the need for more specialized mental health care. We hypothesized that Korean version of the pediatric symptom checklist (PSC) would be a useful tool for early detection of psychosocial problems in children and adolescents in Korea and we aimed to suggest cut-off scores for detecting meaningful psychosocial problems. A total of 397 children with their parents and 97 child patients with their parents were asked to complete the PSC Korean version and the child behavior checklist (CBCL). The internal reliability and test-retest reliability of the PSC as well as the cut-off score of the PSC was determined via receiver operating characteristic analysis of the CBCL score, clinical group scores and non-clinical group scores. The internal consistency of the PSC-Korean version was excellent (Cronbach''s alpha = 0.95). The test-retest reliability was r = 0.73 (P < 0.001). Using clinical CBCL scores (total score, externalizing score, internalizing score, respectively ≥ 60) and presence of clinical diagnosis, the recommended cut-off score of the PSC was 14. Using 494 Korean children aged 7-12 yr, the current study assessed the reliability and validity of a Korean version of the PSC and suggested a cut-off for recommending further clinical assessment. The present results suggest that the Korean version of the PSC has good internal consistency and validity using the standard of CBCL scores.

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Behavioral problems in relation to intelligence in children with 22q11.2 deletion syndrome: a matched control study

The 22q11.2 deletion syndrome (22q11DS) is a genetic disorder associated with palatal abnormalities, cardiac defects, a characteristic facial appearance, learning difficulties, and delays in speech and language development. Various behavioral disorders and psychiatric illnesses have also been reported. There is much debate as to whether the behavioral problems are caused by factors such as medical discomfort, facial abnormalities or a lower intelligence, or whether they are independently related to the genetic abnormality ("behavioral phenotype"). We examined the relationship between intelligence level and behavioral problems. A group of 69 children with 22q11DS was compared with 69 children with craniofacial anomalies (CFA) using the child behavior checklist (CBCL). The matches between individual children were based on their total IQ scores. Use of the CBCL norm scores covered the corrections for age and sex. The group of 22q11DS children showed significantly more behavioral problems than the CFA group: this was especially apparent on the CBCL subscales "withdrawn," "anxious/depressed," "delinquent behavior," "aggressive behavior," "somatic complaints," and "social problems." We found no correlation between IQ score and behavioral problems in the 22q11DS group, which was remarkable because, comparable with the general population, intellectual disabilities were a predictor of behavioral problems in the CFA group. 22q11DS children with relatively higher IQs showed more problems of an internalizing than an externalizing nature, whereas the 22q11DS children with lower IQs showed various behavioral problems. The absence of a statistically significant correlation between intelligence and behavior problems in the group of 22q11DS children is tentative evidence for a 22q11DS behavioral phenotype.     

父母生活质量对城乡学龄儿童行为的影响

目的 :探讨父母生活质量对学龄儿童行为的影响。方法 :采用Achenbach儿童行为量表(CBCL)对 1961名学龄儿童进行行为测评 ;采用WHO生活质量简表 (WHOQOL -BREF)对其父母生活质量进行问卷调查。结果 :农村父母生活质量明显低于城市 (生理领域t=5 2 7,心理领域t =7 3 3 ,环境领域t=6 0 4,P均 <0 0 1)。农村儿童行为问题检出率 (110 5 71,19 2 6% )高于城市 (13 3 1169,11 3 8% ,χ2 =19 86,P <0 0 1) ,行为问题类型分布趋势一致。行为问题儿童父母生活质量低于正常儿童 (P <0 0 1)。父母生理领域生活质量是儿童行为问题的主要影响因素。结论 :父母生活质量对学龄儿童行为发育有重要影响     

Internalizing and externalizing problem behavior in children with nocturnal and diurnal enuresis: a five-factor model perspective

OBJECTIVES: To describe personality traits, internalizing, and externalizing problems of 6- to 12-year-old children with nocturnal and diurnal enuresis, examining differences from healthy referents, and investigating the association between personality traits and problem behavior. METHODS: Eighty-five children with combined nocturnal and diurnal enuresis were compared with 56 children with nocturnal enuresis and 155 healthy children on personality characteristics and problem behavior. RESULTS: Post hoc analyses of multivariate analyses indicated that parents of children with combined nocturnal and diurnal enuresis reported on average lower conscientiousness and higher neuroticism scores in their children than parents of healthy children, although the magnitude of these differences was moderate. Considerable differences in mean scores were found for the Child Behavior Checklist (CBCL) total problem scale and moderate differences for internalizing, externalizing, and attention deficit hyperactivity disorder (ADHD) problems in children with nocturnal and diurnal enuresis compared with healthy referents. Regression analyses across enuretic and healthy groups demonstrated that personality trait and problem behavior scales share substantial variance. CONCLUSION: Moderate to substantially higher levels of problem behavior is demonstrated in children with nocturnal and diurnal enuresis, who also display slightly higher neuroticism and lower conscientiousness scores.