重点中学初中一年级学生孤独感调查分析及综合干预

目的研究重点中学初一学生孤独感状况及其影响因素，并观察干预效果。方法随机抽取重点中学初一学生925名，分别采用自编的一般情况调查表和儿童孤独量表进行评定，对其孤独感及相关因素进行多元逐步回归分析，以此制定干预措施进行综合干预。结果在925名学生中，有孤独感的学生142名，占15．35％。单亲与双亲家庭学生、走读与住宿学生、男女生之间存在非常显著性差异（P〈0．01）。经多元逐步回归分析，影响学生孤独感的的主要影响因素依次为同学关系、健康状况、老师惩罚严厉、学习成绩、父母教育方式一致性、父母婚姻关系、学生年龄、经济状况。进行综合干预后孤独感检出率为8％，较干预前明显降低。结论重点中学初一学生孤独感受自身素质、家庭状况及学校环境等多因素的影响，早期进行综合干预，可减少孤独感的发生。     

开放式叙事疗法在农村特殊家庭留守儿童心理干预中的应用

目的 探讨开放式叙事疗法在解决农村特殊家庭留守儿童心理问题中的作用.方法 采用艾森克个性调查问卷（7～15岁）、儿童孤独量表、儿童自我意识量表,对南充市阆中金城中心校四到六年级的在校农村特殊家庭（包括单亲、父母双亡、父母离异、父母服刑、父母丧失劳动力、养父母的家庭等）留守儿童和非留守儿童进行心理测量.其中49例为农村特殊家庭留守儿童设为干预组,75例非留守儿童设为对照组.干预组给予为期30周开放式叙事心理治疗（以作文结对交流为主）,对照组仅给予一般支持性心理辅导,随后两组重测上述心理测验,并对所得结果进行对比分析.结果 农村特殊家庭留守儿童心理卫生问题明显多于非留守儿童,表现为社会行为问题、个性情绪问题显著增多,差异有统计学意义（P＜0.01）;经开放式叙事治疗后干预组儿童的社会行为问题、个性情绪问题明显减少、自我意识水平有所提高.结论 农村特殊家庭留守儿童存在较多的心理卫生问题,开放式叙事心理治疗可显著改善农村特殊家庭留守儿童的社会行为、缓解焦虑抑郁情绪、重塑个性,促进儿童身心健康发展.     

儿童行为问题的研究

儿童行为问题(Childhood behavior disorders),国外报道其检出率已达到5％～30％。随着我国家庭结构和人们价值观念的改变,核心家庭及独生子女家庭的父母抚养儿童与教育儿童的方式的变化,以及某些不良社会风气、环境污染的影响等,儿     

小学生心理卫生调查及其相关因素分析

目的探讨牡丹江市小学生心理卫生现状及其相关因素。方法采用CONNERS儿童行为父母问卷（PSQ）对6994名小学生进行问卷调查,用卡方检验、单因素方差分析、两两比较及Logistic多元回归分析。结果心理行为问题的检出率为40.66%,其中冲动—多动4.29%、多动指数9.04%、焦虑7.28%、品行问题9.48%、心身障碍21.13%、学习问题23.41%;其中心理行为问题主要以学习障碍和心身障碍最为突出。结论牡丹江市小学生心理行为问题检出率高于同期国内其它城市,其中家庭因素对小学生心理状况影响较大。     

120例失足青少年的社会心理因素调查结果分析

青少年违法犯罪已成为社会十分关注的问题。本文对１２０例失足青少年的社会心理因素调查发现：失足类型男性以盗窃案居首（４３．３％），女性以卖淫为多（４７．５％）．所处环境相比，乡区高于县市（１：４）；失足者及其父母文化素质均较低，其家庭教养方式大多是先溺爱、放任，而后转为严管型；失足因素：家庭经济困难和待业居首位，其次为受歧视，失恋，看黄色书刊与淫秽录像；失足动机：一时性冲动，哥们义气占首位，其它依次为追求物质享乐、好奇和报复。预防青少年失足犯罪的关键是对社会不良现象进行综合治理，提高青少年的文化素质，以及在学校早期开设心理卫生课程。     

在校中小学生心理卫生状况抽样调查

探索城市工业区在校中小学生的心理卫生状况。方法采用随机抽样方法，应用Ａｃｈｅｎｂａｃｈ’ｓ儿童行为量表（ＣＢＣＬ家长卷）问卷调查分析。结果发现被调查学生在劳动意识，生存能力及独立性等方面存在较多问题，８～１１岁女孩中抑郁及多体诉占６２．７％，１２～１４岁男孩在攻击性和多动问题较突出。结论中小学生确实存在较多心理卫生及学习困难问题，应注意纠正中小学生心理卫生问题和培养他们的健全人格。     

宁波市青少年学生的心理状况调查

目的了解宁波市青少年学生心理卫生状况,为开展健康教育提供依据。方法应用儿童青少年长处和困难问卷（学生版）（Strength and difficulties Questionnaire,SDQ）对宁波市区1175名青少年学生进行调查,了解其心理健康状况及影响因素。结果青少年学生心理问题的检出率约为45％,但毕业班与非毕业班之间,男女生之间均无显著性差异。多因素分析表明,学习成绩、住校与否、父母关系、家庭创伤等因素对青少年学生的心理健康影响较大。结论青少年学生的心理健康状况不容乐观,心理健康教育工作急待加强。     

家庭与初中生行为问题的相关研究

目的：了解初中学生家庭亲密度及适应性与行为问题的关系。方法：采用整群、分层、随机抽样方法，抽取珠海市4所中学的初一至初三学生l223名，男638名，女585名，采用Achenbach儿童行为量表(CBCL)，对家长或监护人进行调查，以及采用家庭亲密度和适应性量表中文版(FACESⅡ-CV)对初中学生进行调查。结果：初中生行为问题总检出率为13．7％，有行为问题学生的家庭亲密度及适应性得分比无行为问题学生显著为低，行为问题因子与家庭亲密度及适应性间存在相关性。结论：家庭亲密度及适应性是初中学生的行为问题的重要影响因素，在进行预防及干预时不应忽视。     

初中生违纪行为的相关因素研究

目的：探讨初中生违纪行为的相关因素。方法：随机抽取本市两所普通中学 1585名在校初中生,应用Achenbach儿童行为量表,自编相应因素问卷,父母养育方式评价量表,家庭亲密度及适应性量表进行调查,资料采用单因素及多元逐步回归分析,结果：初中生违纪行为检出率2．96％,单因素及多元逐步回归分析揭示母孕期不利因素,父母养育方式不当,亲子关系不良,父母关系,家庭附近风气,家庭环境等均对初中生违纪行为有显著影响。结论：初中生违纪行为的发生系多因素综合作用所致。     

重庆市独生子女心理健康调查

目的：了解重庆市城乡９￣１６岁独生子妇心理卫生情况。方法：采用Ａｃｈｅｎｂａｃｈ儿童行为量表（ＣＢＣＬ）,艾森克个性问卷（ＥＰＱ）幼年版进行调查。结果：城市儿童心理卫生问题的发生率为１１．９％,农村为１４．５％;城市儿童孤独、胆小、兴奋、焦虑、社交不良、品行不良、强迫行为、偏食等心理卫生问题明显高于农村儿童;农村儿童的注意障碍、神经质等多于城市儿童。结论：在干预独生子女心理卫生问题的同时,要注意城市与农村儿童的区别,以及性格特征的差异。     

Mother's early perception of her infant's difficult temperament, parenting stress and early mother-infant interaction

The current study investigated factors contributing to mother's early perception of her infant's difficult temperament. One hundred and twenty-four mother-infant dyads participated in the study. Mother's perception of the infant's temperament was assessed with the Infant Characteristics Questionnaire (ICQ). The influence of mother-infant interaction, mother's mental health and parenting stress were investigated. Mother-infant interaction was videotaped during a face-to-face interaction and analysed using the Global Rating Scale. Mother's mental health was assessed through a structured interview (Structured Clinical Interview for DSM-IV, SCID) and parenting stress was examined by a questionnaire (Parenting Stress Index). First, the difficulty scale of the ICQ was used as a continuous variable and factors contributing to mother's perception of her infant's temperament as more or less difficult were examined. Secondly, infants were categorized into difficult and non-difficult, and factors increasing the infant's risk of being perceived as difficult were examined. The model including mother's mental health and parental distress accounted for 24% of the variance in perceived infant difficulty, with parental distress in particular being an influential contributor. When infants categorized as difficult were examined, mother's intrusiveness and infant's poor interactive behaviour in early mother-infant interaction as well as parental distress significantly increased the infant's risk of being perceived as difficult.     

Mother-infant mental health from viewpoint of relationship disturbance]

Infants can adapt themselves and their relationship with their caregivers in a way incomparable to any other stage in life. Infants are innately motivated to communicate with people and to actively take part in human social interaction. The question is how to provide an environment that facilitates such potentials for each particular infant and its family. Japan strove to improve the physical aspect of maternal and infant care after the second World War and yielded a nation-wide perinatal and infant screening system that produced a world minimum infant mortality rate and more than 80% compliance rate of infant checkups. Instead, infant abuse and infants with development disorders and psychosomatic symptoms has alerted the professionals to improve their approach. In addition, the increasing incidence of child abuse, juvenile crimes, eating disorders and other emotional and behavioral problems of children and adolescents has alerted the government and public to reconsider the importance of early intimate relationship. Creating a secure base for families to enjoy nurturing companionship with their infants is now common goal of infant mental health in Japan. As professionals we try to introduce a more dynamic, natural, non-judgmental empathic approach to support troubled infant care-giving systems. Whichever problem an infant may suffer, whether a problem of body or mind, its mother is bound to suffer and much more so in Japan with its old values for divine motherhood, stigmas associated with abnormality and new demands for perfect mothering. It should be acknowledged more and more that a well-meant effort on the side of infant workers cannot yield beneficial outcomes for mothers and infants unless we take into full account the importance of the complex intertwining of diverse factors, including the infant's predisposition, the mother's upbringing and past trauma and quality of the attachment system supporting the mother and family interaction. It is here that an urgent need to introduce infant mental health exists. Health professionals exchange, having shown their clinical attitudes and knowledge to their trainees, mutual nurturing companionship among workers, infants and families, which is the spirit of infant mental health. The dawn of infant mental health is steadily breaking in Japan.     

Precursors of mental health problems for low birth weight children: the salience of family environment during the first year of life

The purpose of this study was to determine the contributions of infant characteristics and early family environment to the incidence of emotional and behavioral problems for low birth weight children. Data were collected from ethnically diverse families of 110 children who had a birth weight of less than 2500 grams. Results of stepwise regression analysis indicated that inadequate family income, troubles with family cohesion and adaptability, and an infant's insecure attachment to the mother accounted for 48% of the variance in the incidence of emotional-behavioral problems for children. None of the infants' characteristics, including birth weight, perinatal morbidity, cognitive ability and social competence, entered the regression model. Findings suggest that family environment is a key factor in the low birth weight child's risk for early mental health problems.     

Parental mental disorder and early child development

In a prospective longitudinal study of 354 parents and their first-born infants the association between parental psychopathology and risk for maladjustment in the offspring was investigated. At age two infants of disturbed parents displayed significantly poorer language performance and had higher scores of behaviour problems as compared to infants of healthy parents. While maternal disorder affected both cognitive and social-emotional outcome, the impact of paternal disorder was confined to cognitive functioning. The poorest outcome was found in infants of mothers with a personality disorder or with alcohol abuse. The relationship was maintained even after accounting for a number of family risk factors associated with parental psychopathology. One mediating factor between maternal disorder and infant maladjustment was found in disturbed mother-infant interaction. Maternal mental health did not only affect infant outcome, but was itself influenced by infant adaptation.     

医学生心理健康状况及其与个性特征的关系

目的了解医学大学生的心理健康状态,探讨医学大学生的个性特征与心理健康的关系。方法应用症状自评量表(SCL90)和艾森克成人个性问卷(EPQ)对507名医学大学生进行心理卫生评估。结果三年级医学生心理健康水平高于全国常模和大学生样本,精神医学专业学生心理健康水平高于临床医学专业学生,心理健康水平与个性外倾和对精神卫生知识的了解程度呈正相关,与个性不稳定呈负相关。结论医学大学生心理健康状况与个性特征相关,高等院校应加强精神卫生知识的普及,有针对性地进行健康教育。     

Impact of maternal depression on infant nutritional status and illness: a cohort study

BACKGROUND: The risk for emotional and behavioral problems is known to be high among children of depressed mothers, but little is known about the impact of prenatal and postnatal depression on the physical health of infants. OBJECTIVE: To determine whether maternal depression is a risk factor for malnutrition and illness in infants living in a low-income country. DESIGN: Prospective cohort study. SETTING: Rural community in Rawalpindi, Pakistan. PARTICIPANTS: Six hundred thirty-two physically healthy women were assessed in their third trimester of pregnancy to obtain at birth a cohort of 160 infants of depressed mothers and 160 infants of psychologically well mothers. MAIN OUTCOME MEASURES: All infants were weighed and measured at birth and at 2, 6, and 12 months of age, and they were monitored for episodes of diarrhea and acute respiratory infections. The mothers' mental states were reassessed at 2, 6, and 12 months. Data were collected on potential confounders of infant outcomes, such as birth weight and socioeconomic status. RESULTS: Infants of prenatally depressed mothers showed significantly more growth retardation than controls at all time points. The relative risks for being underweight (weight-for-age z score of less than -2) were 4.0 (95% confidence interval [CI], 2.1 to 7.7) at 6 months of age and 2.6 (95% CI, 1.7 to 4.1) at 12 months of age, and the relative risks for stunting (length-for-age z score of less than -2) were 4.4 (95% CI, 1.7 to 11.4) at 6 months of age and 2.5 (95% CI, 1.6 to 4.0) at 12 months of age. The relative risk for 5 or more diarrheal episodes per year was 2.4 (95% CI, 1.7 to 3.3). Chronic depression carried a greater risk for poor outcome than episodic depression. The associations remained significant after adjustment for confounders by multivariate analyses. CONCLUSIONS: Maternal depression in the prenatal and postnatal periods predicts poorer growth and higher risk of diarrhea in a community sample of infants. As depression can be identified relatively easily, it could be an important marker for a high-risk infant group. Early treatment of prenatal and postnatal depression could benefit not only the mother's mental health but also the infant's physical health and development.     

A curriculum for the psychiatric training of family physicians

Recognizing the important role of family physicians in mental health care, psychiatry and family medicine faculty developed a psychiatric curriculum for family medicine residents. The collaborative effort utilized graduate interviews, literature review, and specialized group techniques to develop a competency-based curriculum that begins early in the residency, is integrated longitudinally into the remainder of the curriculum, and utilizes seminars, clinical experience, and liaison with a mental health team in the training design.     

Parent-infant interaction in infant siblings at risk of autism

Recent models of the early emergence of autism spectrum disorder (ASD) propose an interaction between risk susceptibility and the infant's social environment, resulting in a progressively atypical developmental trajectory. The infant's early social environmental experience consists mostly of interaction with caregivers, yet there has been little systematic study of early parent-infant interaction in infants at risk of ASD. This study examined the global characteristics of parent-infant interaction in 6- to 10-month-old infants with an older sibling diagnosed with ASD (at-risk sibs), in comparison with a group of infants with no family history of ASD (low-risk sibs). As part of the British Autism Study of Infant Siblings (BASIS), 6-min videotaped unstructured play interactions of mother-infant dyads (45 at-risk sibs and 47 low-risk sibs) were rated on global aspects of parent-infant interaction, blind to participant information. Differences in global characteristics of interaction were observed in both infant and parent contributions in the at-risk group compared to low-risk controls. In analyses adjusted for age and developmental level, at-risk sib infants were less lively, and their parents showed higher directiveness, and lower sensitive responding (as a trend after adjustment). Level of infant liveliness was independent of other interactive behaviour. Consistent with reports in previous literature in older children with autism and in other neurodevelopmental disorders, our findings may suggest that infants at genetic risk are exposed to a more directive interactive style relatively early in infancy. We discuss possible explanations for these findings and implications for further developmental study and intervention.     

Clinical Problems in Community Mental Health Care for Patients with Severe Borderline Personality Disorder

The objective of this research was to assess the problems that professionals perceive in the community mental health care for patients with severe borderline personality disorder that do not fit into specialized therapy. A group of national experts (n = 8) participated in a four-phase Delphi-procedure to identify and prioritize the problems. A total of 36 problems reflecting five categories was found: patient-related, professional-related, interaction-related, social system-related, and mental health care-related. Problems with attachment and dependency and social issues were important patient problems while a lack of skills was an important professional problem. Support from the patient’s social system and the mental health system were identified as limited, which resulted in both the patient and the professional feeling isolated. Patient, professional, and organisational characteristics of community care differ substantially from those of specialized care. The field is thus in need of a more tailored approach that takes these differences into account.