108例电子游戏痴迷儿童的心理行为及相关因素分析

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 Achen-bach儿童行为量表(CBCL),家庭环境量表(FES CV)分别对108例电子游戏依赖性儿童及 100 名正常儿童进行评定。结果　电子游戏依赖性儿童在四量表的 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<0.05)。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<0.05),而在家庭的矛盾性得分显著高于对照组(P<0.05)。结论　电子游戏依赖性儿童有较多的心理行为问题。     

双相障碍患者童年期行为问题的临床研究

目的探讨双相障碍(BPD)患者在儿童早期的行为特征及其与注意缺陷多动障碍(ADHD)的关系。方法使用美国精神障碍诊断与统计手册第4版中ADHD诊断标准、Achenbach儿童行为量表(CBCL)对64例BPD患者(BPD组)儿童期的行为进行诊断和评估,并与64例内科疾病患者(对照组)进行对照。结果(1)BPD组有12例(19%)童年期符合ADHD诊断标准,高于对照组(2例,3%；χ~2=8.020,P=0.005)。(2)BPD组中,有无精神病家族史的患者童年期发生ADHD者分别为4例(25%)和8例(17%),差异无统计学意义(P＞0.05)。(3)BPD组中有无ADHD者的发病年龄分别为(18±4)岁和(20±5)岁,差异无统计学意义(P＞0.05)。(4)童年期CBCL得分,BPD组的退缩、焦虑/抑郁、思维问题、违纪行为、攻击性行为、内化性问题、外化性问题、行为问题总分均高于对照组(P＜0.01)；BPD组中有ADHD病史组(12例,19%)的注意问题、攻击性行为、外化性问题、行为问题总分高于无ADHD病史组(52例,81%；P＜0.05和P＜0.01)。结论BPD患者在童年期有更高的ADHD发生率和较多的行为问题；有ADHD病史者童年期可能存在更多的注意力受损和外化性问题。     

注意缺陷多动障碍患儿冲动行为研究

目的:探讨注意缺陷多动障碍(attention-deficit/hyperactivity disorder, ADHD)患儿冲动行为评估。方法:200例ADHD患儿按症状分为注意缺陷组(IA组)和冲动组(IP组),同时期100名健康儿童为对照组;采用儿童行为量表(child behavior checklist, CBCL)评估儿童行为方式,Go/No-go任务评估反应抑制功能。结果:(1)3组在CBCL中攻击行为、破坏行为、总分差异有统计学意义;组内比较显示IP组攻击行为、破坏行为、总分大于IA组和对照组(P均0.01);(2)3组在No-go反应时方面差异有统计学意义;组内比较显示IP组和IA组No-go反应时长于对照组(P均0.05);(3)IP组3个月内冲动次数与CBCL总分与社交退缩、焦虑/抑郁、睡眠问题、攻击行为、破坏行为因子分及No-go错误数呈正相关(P0.05或P0.01);No-go错误数与CBCL中破坏行为呈正相关(P0.05);(4)线性回归显示No-go错误数是IP组冲动行为影响因子(P0.05)。结论:ADHD儿童存在反应抑制功能损伤;冲动型ADHD患儿较注意缺陷型ADHD患儿具有更高的冲动性,其冲动行为与反应抑制密切相关。     

儿童青少年焦虑与抑郁障碍共病的临床研究

目的了解焦虑和抑郁障碍患儿中焦虑与抑郁共病的发生率和行为特点。方法在门诊收集符合中国精神障碍分类与诊断标准第3版中焦虑障碍和抑郁障碍诊断标准的5～17岁儿童青少年,其中单纯焦虑障碍41例(焦虑组),单纯抑郁障碍31例(抑郁组),焦虑与抑郁共病31例(共病组)。由父母、儿童、医师分别采用自编一般资料表、Achenbach儿童行为量表(CBCL)、儿童焦虑性情绪障碍筛查表(SCARED)、儿童抑郁障碍自评量表和儿童大体评定量表,评定三组儿童。结果(1)焦虑障碍患儿有16%(8例)合并抑郁;抑郁障碍患儿有42%(23例)合并焦虑。(2)CBCL焦虑组的活动情况及社会能力总分[(15.74±3.65)分]优于共病组[(12.98±4.00)分]和抑郁组[(14.02±3.67)分],均P<0.01和<0.05;共病组行为问题总分[(61.74±28.96)分]高于焦虑组[(43.44±22.54)分]和抑郁组[(47.74±25.99)分;F=4.62,P<0.05]。(3)SCARED共病组的总分高于焦虑组和抑郁组(P<0.05)。(4)儿童抑郁障碍自评量表抑郁组和共病组总分高于焦虑组(P<0.01)。(5)儿童大体评定量表焦虑组[(67.71±9.54)分]优于抑郁组[(58.55±8.08)分]和共病组[(61.16±7.60)分;F=11.10,P<0.001]。结论儿童焦虑、抑郁共病现象常见,共病患儿比单纯焦虑或抑郁患儿的内化性问题、外化性问题更严重,社会功能损害更明显。     

一次偶发劫持事件后对儿童心理卫生状况影响的对照研究

目的了解劫持事件对儿童心理卫生状况的影响。方法在上海某小学发生学生被劫持事件后的一月，对被劫持事件发生班级中暴露于劫持事件的全体39名学生使用Achenbach儿童行为量表（CBCL），儿童焦虑性情绪障碍筛查量表（SCARED），Rutter父母及教师问卷进行评估。选取同年级的另外一个班级的所有45名学生作为对照组，采用同样方法进行评估。结果除研究组女生CBCL社交退缩因子与对照组之间有统计学差异外（分别为1．4±1．8，3．1±2．6；t=2．218，P=0．033），研究组与对照组在其他CBCL因子、SCARED和Rutter父母及教师问卷得分差异无统计学意义。结论本次研究未发现偶发劫持事件对儿童心理卫生状况的影响。     

对立违抗性障碍儿童的临床特征及血清单胺类神经递质水平的研究

目的探讨对立违抗性障碍（ODD）患儿的临床特征及血清单胺类神经递质水平的变化。方法对31例ODD儿童（研究组）和36名正常儿童（对照组）测评Piers—Harris儿童自我意识量表（PHCSS）、儿童焦虑性情绪障碍筛查表（SCRED）、儿童抑郁障碍自评量表（DSRSC）及儿童冲动量表（BIS），测量其血清5-羟色胺（5-HT）、多巴胺（DA）等生物胺神经递质的含量。结果（1）研究组PHCSS中的合群性分[（7．36±1．81）分]、幸福与满足感分[（5．45±1．69）分]低于对照组[（8．56±2．50）分和（6．31±1．72）分；P=0．030，P=0．045]。（2）两组SCRED和DSRSC评分的差异无统计学意义（P〉0．05）。研究组BIS的冲动总分[（51．81±9．97）分]、运动分[（8．77±4．11）分]高于对照组[（48．30±11．57）分和（5．19±2．46）分；P=0．020，P：0．000]。（3）研究组血清高香草酸水平[中位数（M）=59nmol／L]、5-HT水平（M=20nmoI／L）低于对照组（M：130nmol／L和168nmoI／L；P=0．024，P=0．033）。（4）血清5-HT水平与冲动总分（r=-0．650）、注意凶子分呈负相关（r=-0．688）；血清DA水平与广泛焦虑冈子呈正相关（r=0．591）；血清5-羟吲哚乙酸水平与分离焦虑因子、社交恐怖因子均呈负相关（r=-0．593，r=-0．535）；血清高香草酸水平与抑郁（r=-0．694）、冲动吲子呈负相关（r=-0．608），均P〈0、05和P〈0．01。结论ODD儿童不合群，缺乏愉快感，冲动性高；其血清5-HT水平降低，而血清儿茶酚歧水平变化不明显。     

中学生互联网过度使用的影响因素

目的 了解中学生互联网过度使用（IOU）状况，探讨中学生IOU的影响因素。方法 采用Beard修订的Young的诊断问卷、长处和困难问卷（SDQ）、儿童焦虑性情绪障碍筛查表（SCARED）、艾森克个性问卷（EPQ）和青少年时间管理倾向量表（ATMD）对2620名中学生进行调查。对筛查出的IOU学生（IOU组，64例）及其下一学号的学生（对照组，64名）进行诊断性访谈。结果 （1）中学生IOU的发生率为2．4％（64例）。（2）SDQ：IOU组的情绪症状、品行问题、多动注意不能及困难总分高于对照组，而社会行为评分低于对照组（均P〈0．05～0．01）。（3）SCARED：IOU组的躯体似惊恐、广泛性焦虑、分离性焦虑、社交恐怖、学校恐怖及焦虑总分均高于对照组（均P〈0．01）。（4）EPQ：IOU组的精神质、神经质评分高于对照组，而掩饰评分低于对照组（均P〈0．01）。（5）ATMD：IOU组的时间监控观、时间效能感、时间价值感及时间管理倾向总分均低于对照组（均P〈0．05～0．01）。（6）条件Logistic回归分析显示多动注意不能和广泛性焦虑是IOU的危险因素，而社会行为是IOU的保护因素。结论 IOU学生存在着更多的行为、情绪问题，可能是互联网过度使用的影响因素。     

5-羟色胺转运体基因多态性对儿童期虐待与青少年攻击行为的调节作用

目的探讨5-羟色胺转运体（5-hydroxy tryptamine transporter,5-HTT）基因多态性与儿童期虐待对青少年攻击行为的调节作用。方法使用CTQ（儿童创伤经历问卷）评定儿童期虐待,用YSR（儿童行为量表CBCL自我报告版）评定攻击行为,运用线性回归模型对600名中国青少年检验其儿童期虐待、5-HTTLPR基因多态性对攻击行为的主效应及两者问的基因-环境交互作用。结果儿童期躯体虐待,性虐待,情感虐待对攻击行为始终有预测效应（P〈0．01）,5-HTTLPR基因型无主效应（P〉0．05）;此外,男性青少年5-HTTLPR与性虐待对攻击行为有交互作用（P〈0．05）,SS基因型个体在受到性虐待后较SL、LL基因型个体更易出现攻击行为;女性则无任何交互作用。结论儿童期虐待经历与青少年攻击行为受到5-HTTLPR的调节,不同性别青少年对不同虐待类型存在敏感性差异。     

初中生行为问题与父母教养方式的相关分析

目的探讨初中生行为问题与父母教养方式的相关性。方法运用父母养育方式问卷(EMBU)、Achenbach儿童行为量表(CBCL)对上海市区一所普通中学288名11~13岁初中学生进行调查,并对结果进行相关分析、回归分析。结果初中生行为问题各因子:分裂样、抑郁、社交问题、强迫性、体诉、社交退缩、多动、攻击行为、违纪行为与父母教养方式各因素;情感温暖、理解,惩罚、严厉,过分干涉,偏爱,拒绝、否认,过度保护、偏爱显著相关。结论初中生行为问题与父母教养方式显著相关,父母应该对子女多加关注、爱护、理解、信任和鼓励,加强亲子之间的交流,避免采用惩罚、严厉,过分干涉,拒绝、否认等养育方式。     

长沙市中小学生对立违抗性障碍的现况及对照研究

目的 了解长沙市中小学生中罹患对立违抗性障碍（ODD）的现况及临床特征。方法 应用自制儿童行为学习调查表、Conners父母问卷（PSQ）、教师问卷（TRS）及Pieers-Harris儿童自我意识量表（CSCS）,于2000年6－7月对长沙市某中学及某小学（ 其中有效人数为589人）的47例ODD儿童（研究组）和47名非0DD儿童（对照组）进行评定和病例－对照分析。结果 （1）ODD发生率：在589人中符合ODD者为47例（8．0％）,其中男性为11％（31例）,女性为5％（16例）;发生率超过50％的症状中：经常发脾气（92％）,常与大人争吵（81％）,常拒绝服从大人的要求或违反规则（68％）,常因自己的错误或所做的坏事责备旁人（68％）,常发怒或怨恨他人（62％）。（2）ODD合并其他疾病的发生率：合并注意缺陷多动障碍为51％（24例）,合并学习障碍为38％（18例）,与对照组[分别为17％（8例）和15％（15例）]比较差异有非常显著性（均P＜0．01）。（3）各量表评分：经t检验,PSQ中品行问题、学习问题、冲动－多动、焦虑及多动指数,以及CSCS中的行为、焦虑及总分两组比较,差异有非常显著性或显著性（P＜0．01或P＜0．05）。结论 在长沙市某中学及某小学的学生中存在ODD,这些患儿的自我评价低,存在更多的行为、情绪问题和学习障碍。     

Behavioral correlation with television watching and videogame playing among children in the United Arab Emirates

Objective. Television viewing and videogame use (TV/VG) appear to be associated with some childhood behavioral problems. There are no studies addressing this problem in the United Arab Emirates. Methods. One hundred ninety-seven school children (mean age, 8.7 ± 2.1 years) were assessed. Child Behavior Checklist (CBCL) subscale scores and socio-demographic characteristics were compared between children who were involved with TV/VG more than 2 hours/day and those involved less than 2 hours/day (the recommended upper limit by The American Academy of Pediatrics). Results. Thirty-seven percent of children who were involved with TV/VG time of more than 2 hours/day scored significantly higher on CBCL syndrome scales of withdrawn, social problems, attention problems, delinquent behavior, aggressive behavior, internalizing problems, externalizing problems and the CBCL total scores compared with their counterparts. Moreover, these children were younger in birth order and had fewer siblings. After controlling for these confounders using logistic regression, we found that TV/VG time more than 2 hours/day was positively associated with withdrawn (p = 0.008), attention problem (p = 0.037), externalizing problems (p = 0.007), and CBCL total (p = 0.014). Conclusion. Involvement with TV/VG for more than 2 hours/day is associated with more childhood behavioral problems. Counteracting negative effects of the over-involvement with TV/VG in children requires increased parental awareness.     

Patterns of agreement among parent, teacher and youth ratings in a referred sample

ObjectiveThe purpose of this study was to investigate the degree of agreement among parents, teachers and adolescents with respect to the Child Behavior Checklist (CBCL), the Teacher's Report Form (TRF), and the Youth Self Report (YSR). In addition we evaluated the suitability of these three forms (CBCL, TRF and YSR) in terms of their contribution to understanding internalizing and externalizing disorders in youths being referred to a child and adolescent unit of a psychiatric care facility.MethodsA total of 611 patients aged 11–18 years (mean age 13.0, SD 1.6) were assessed using the CBCL, the TRF and the YSR.ResultsIntraclass coefficients (ICC) showed low to moderate agreement among informants. Furthermore, the level of agreement was generally less among patients suffering from internalizing disorders than for young patients who displayed externalizing disorders. Logistic regression revealed that the TRF internalizing syndrome scale, the CBCL internalizing syndrome scale and gender were relevant prognostic factors for the occurrence of internalizing disorders in youth. The YSR internalizing syndrome scale, on the other hand, was not a relevant factor among adolescents of a clinical target population. Likewise, only the TRF externalizing syndrome scale, the CBCL externalizing syndrome scale and gender were relevant prognostic factors for the occurrence of externalizing disorders in youth.ConclusionsParticularly the CBCL and TRF are useful instruments in assessing internalizing and externalizing disorders in adolescents referred to a mental health setting.     

Effects of internal displacement and resettlement on the mental health of Turkish children and adolescents.

AIMS: To evaluate the effects of internal displacement and resettlement within Turkey on the emotional and behavioral profile of children, age 5-18 after controlling for possible confounding and demographic variables. METHOD: We conducted a national population survey using a self-weighted, equal probability sample. We compared the CBCL, TRF and YSR responses regarding children with (n = 1644) and without (n = 1855) experience of internal displacement. We examined the effects of gender, age, paternal employment, resettlement, urban residence and physical illness. RESULTS: The children and adolescents with internal displacement had significantly higher internalizing, externalizing and total problem scores on the CBCL and YSR, and higher internalizing scores on the TRF. The effect of displacement was related to higher internalizing problems when factors like physical illness, child age, child gender and urban residence were accounted. The overall effect was small explaining only 0.1-1.5% of the total variance by parent reports, and not evident by teacher reports. DISCUSSION: To our knowledge the present study is the first to examine Turkish children and adolescents with and without experience of internal displacement. The results are consistent with previous immigration studies: child age, gender, presence of physical illness and urban residence were more important predictors of internalization and externalization problem scores irrespective of informant source.     

The continuity of psychopathology from early childhood to preadolescence

Objective To study the continuity of psychopathology from the age of 3–12 years. Methods In a population-based birth cohort, children’s emotional and behavioral problems were assessed at age 3 using the Child Behavior Checklist 2–3 (CBCL 2–3), and at age 12 by parents using the CBCL 11–18, and the Youth Self Report (YSR) completed by the children. Behavioral ratings were obtained from 800 subjects at both time points. Results externalizing problems at age 3 predicted both externalizing and internalizing problems among both genders in preadolescence. In girls, internalizing behavior at age 3 predicted parent-reported internalizing behavior, and associated negatively with externalizing behavior in self-reports at age 12. Aggressive behavior was found to be remarkably stable, and both aggressive and destructive behavior independently predicted a wide range of later externalizing and internalizing problems. Parent ratings of withdrawal showed stability from early childhood to preadolescence in both genders. Somatic complaints of 3-year-old girls independently predicted both externalizing and internalizing problems. Conclusions The results show the complexity of pathways in psychopathology from early childhood to preadolescence. In particular, aggressive and destructive behaviors in very early childhood predict later problems and necessitate early recognition and possible intervention at an early age. An instrument like the CBCL 2–3 is valuable in the early detection of children at risk of long-term problems.     

Aggression and threat perception abnormalities in children with learning and behavior problems

The current study investigated the connection between aggression and the perception of threat in a group of children with learning and behavior problems (N = 103). Aggression was assessed by means of the aggressive behavior subscales of the Child Behavior Checklist (CBCL), Teacher Report Form (TRF), and Youth Self-Report (YSR). Perception of threat was measured by studying children's reactions to a series of stories depicting ambiguous social situations. Results demonstrated small but significant correlations between self-reported aggression (as indexed by the YSR) and threat perception abnormalities. That is, high levels of aggression were associated with a high frequency of threat perception, high ratings of threat, high levels of negative feelings and cognitions, and an early detection of threat. Furthermore, no substantial connections emerged between children's level of aggression as rated by parents (CBCL) and teachers (TRF) and threat perception indices. Finally, regression analyses revealed that in particular YSR social problems was a better predictor of most threat perception abnormalities than YSR aggressive behavior. Implications of these findings are briefly discussed.     

Risk factors for problem behavior in adolescents of parents with a chronic medical condition

A wide array of risk factors for problem behavior in adolescents with chronically ill parents emerges from the literature. This study aims to identify those factors with the highest impact on internalizing problem behavior (anxious, depressed and withdrawn behavior, and somatic complaints) and externalizing problem behavior (aggressive and rule-breaking behavior) as measured by the Youth Self-Report (YSR). The YSR was filled in by 160 adolescents (mean age = 15.1 years) from 100 families (102 chronically ill parents and 83 healthy spouses). Linear mixed model analyses were used, enabling separation of variance attributable to individual factors and variance attributable to family membership (i.e., family cluster effect). Predictors were child, parent, illness-related and family characteristics. The results showed that almost half of the variance in internalizing problem scores was explained by family membership, while externalizing problems were mainly explained by individual factors. Roughly 60 % of the variance in internalizing problems was predicted by illness duration, adolescents' feeling of isolation, daily hassles affecting personal life and alienation from the mother. Approximately a third of the variance in externalizing problems was predicted by adolescents' male gender, daily hassles concerning ill parents and alienation from both parents. In conclusion, the variance in adolescent problem behavior is largely accounted for by family membership, children's daily hassles and parent-child attachment. To prevent marginalization of adolescents with a chronically ill parent, it is important to be alert for signs of problem behavior and foster the peer and family support system.     

Agreement between youth-reported and parent-reported psychopathology in a referred sample

Objective  The study examined parent-youth agreement regarding reports on psychopathology among adolescents suffering from psychiatric disorders. Method  A total of 1,718 patients between the age of 11 and 18, as well as their parents, were assessed using the child behavior checklist (CBCL), and the youth self-report (YSR). Results  Poor to low agreement between parent- and adolescent-reported problem behavior on the internalizing scale, the total problem scale and moderate agreement concerning the externalizing scale of the CBCL and the YSR were found. Independent from the amount of psychiatric diagnoses, adolescents reported significantly less behavioral problems than their parents. Concerning externalizing problems, parent-youth disagreement was stronger for patients suffering from comorbid psychiatric disorders, than for adolescents displaying only one psychiatric disorder. Conclusion  In clinically referred children, parents are likely to emphasize the severity of the difficulties, whereas adolescents’ under-report symptoms.     

Behavioural and emotional symptoms of preschool children with cerebral palsy: a population‐based study

Aim To describe behavioural and emotional symptoms among Icelandic preschool children with cerebral palsy (CP). Method Children with congenital CP, assessed with the Child Behavior Checklist/1½–5 (CBCL/1½–5) and Caregiver‐Teacher Report Form (C‐TRF), were enrolled in the study. A comparison group was recruited from the general population. Thirty‐six children (53% males) with CP were assessed at a mean age of 4 years 11 months (SD 5mo, range 4–6y); 26 (72%) had bilateral distribution of symptoms and 32 (89%) had spastic CP. Thirty (83%) were at Gross Motor Function Classification System levels I or II and six at levels III or IV. For comparison, 110 (43% males) and 120 (48% males) children were assessed with the CBCL/1½–5 and the C‐TRF respectively, at a mean age of 4 years 6 months (SD 6mo, range 4–6y). Results Sixteen children (48%) with CP had high scores on total problems scale of the CBCL/1½–5 and 20 (65%) on the C‐TRF compared with 18% of the comparison group, both on the CBCL/1½–5 and the C‐TRF (p<0.001). Children with CP had higher scores on all subscales of the CBCL/1½–5 and the C‐TRF, except somatic complaints. Attention difficulties, withdrawn, aggressive behaviour, and anxious/depressed symptoms were most pronounced among children with CP. Interpretation A large proportion of preschool children with CP have substantial behavioural and emotional difficulties, which need to be addressed in their treatment.     

Child Behavior Checklist Profiles of Children and Adolescents with and at High Risk for Developing Bipolar Disorder

In order to recognize behavioral patterns in children and adolescents at risk for developing bipolar disorder, this study examined Child Behavior Checklist (CBCL) profiles of bipolar offspring both with (BD group) and without (“at-risk” or AR group) bipolar disorder themselves. The BD youth had three CBCL subscale T scores ≥70 (attention problems, delinquent behavior, and aggression) and scored significantly higher than healthy comparison youth on all CBCL subscales. AR youth did not have any T scores ≥70; however, they scored higher than healthy comparisons in the anxiety/depression, attention problems, aggression, and withdrawal subscales. AR and BD youth differed significantly on all scales except somatic complaints and anxiety/depression.     

QEEG-Guided Neurofeedback for Children with Histories of Abuse and Neglect: Neurodevelopmental Rationale and Pilot Study

ABSTRACT

Background. Poor self-regulation of arousal is central to the behavioral difficulties experienced by children with traumatic caretaker attachment histories. EEG biofeedback teaches children to self-regulate brain rhythmicity, which may in turn affect global improvements in the areas of attention, aggression, impulse control, and trust formation. Research literature reports successful use of neurofeedback for children with ADHD, autism, asthma, stroke, and migraine. This study extends current research by investigating the effectiveness of neurofeedback in reducing behavioral problems commonly observed in abused/neglected children.

Methods. Treatment records of twenty adopted children with histories of removal from their biological home by Child Protective Services were obtained from a private neurofeedback practice. All of the children were assessed prior to treatment using the Child Behavior Checklist (CBCL) and the Test of Variables of Attention (TOVA) and again after 30 sessions of individualized, qEEG-guided neurofeedback.

Results. T-test analysis of pre- and post-scores on the CBCL showed significant changes in the areas of externalizing problems, internalizing problems, social problems, aggressive behavior, thought problems, delinquent behavior, anxiety/depression, and attention problems (p < .05). TOVA omission error, commission error, and variability scores also improved significantly following neurofeedback training (p < .05). Some pre-treatment qEEG patterns common to this group of children were identified.

Conclusions. The CBCL and TOVA score improvements observed in this study indicate that neurofeedback is effective in reducing behavioral, emotional, social, and cognitive problems in children with histories of neglect and/or abuse.