上学恐怖症临床特征及诊断初探

目的:探讨上学恐怖症的临床特征及诊断。方法:采用自编一般人口学问卷、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、症状自评量表(SCL-90)对心理门诊58名上学恐怖症患者进行施测。结果:1上学恐怖症患者躯体症状主要有睡眠障碍、头痛、头晕、胸闷、心悸等;2上学恐怖症患者诊断依次为童年情绪障碍23人(39.66%);心境障碍19人(32.76%);神经症9人(15.52%);精神分裂症4人(6.90%);应激相关障碍3人(5.17%);3上学恐怖症患者HAMA总分及各因子得分显著大于对照组(P0.01);除体重、日夜变化因子外,上学恐怖症患者的HAMD总分、焦虑/躯体化、认识障碍、迟缓、睡眠障碍、绝望感因子得分显著高于对照组(P0.01);4上学恐怖症患者研究组在SCL-90总分、躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性因子上的得分高于正常对照组,差异有统计学意义(P0.01)。结论:上学恐怖症患者普遍存在情绪障碍及躯体症状,了解其相关特点,为上学恐怖症的干预和治疗提供理论指导。     

儿童情绪障碍相关因素的病例对照研究

本文对儿童情绪障碍发生的相关因素进行病例对照调查。对象和方法1.1对象2001年1月至2003年12月在本中心门诊或住院的情绪障碍患儿。符合中国精神疾病分类方案与诊断标准第3版(CCMD-3)和ICD-10关于儿童情绪障碍的诊断标准。据Achen bach儿童行为量表(CBCL)年龄分段分为儿童组(6     

首发精神分裂症儿童少年的共患病

目的:了解首发精神分裂症儿童少年共患病发生情况,探讨有共患病的首发儿童精神分裂症的临床特征及共患病发生的危险因素。方法:采用横断面研究和回顾式调查,对门诊及住院的52例首发符合美国精神障碍诊断与统计手册4版(DSM-IV)中精神分裂症诊断标准的儿童少年进行调查和评定。内容包括:一般状况调查、阳性与阴性症状量表(PANSS)评定、学龄儿童情感障碍和精神分裂症问卷(K-SADS-PL)和简明儿童少年国际神经精神访谈(MINI Kid)(父母版)中文版调查、儿童总评问卷(GAS)及社会功能缺陷筛查量表(SDSS)评定。结果:本样本精神分裂症患儿57.7%有共患病(30/52)。其中14人(26.9%)现有共患病,10人(19.2%)曾有共患病,6人(11.5%)曾有并现有共患病;24人(46.2%)患有1种共患病,4人(7.7%)患有2种共患病,2人(3.8%)患有3种共患病;共患病包括抑郁障碍19人(4人有自杀行为);惊恐障碍1人,广泛性焦虑障碍5人,强迫障碍4人,社交恐怖症2人;注意缺陷多动障碍5人;抽动障碍7人,包括短暂性抽动障碍5人,Tourette综合征2人;广泛性发育障碍2人,均为Asperger’s综合征。曾患共患病包括抑郁障碍5人(9.6%),惊恐障碍1人(1.9%),强迫障碍2人(3.8%),社交恐怖症1人(1.9%),注意缺陷多动障碍2人(3.8%);抽动障碍7人(13.5%)。现患共患病包括抑郁障碍14人(26.9%),广泛性焦虑障碍5人(9.6%),强迫障碍2人(3.8%),社交恐怖症1人(1.9%);注意缺陷多动障碍3人(5.8%);广泛性发育障碍2人(3.8%)。伴有共患病组PANSS量表总分、阳性量表评分、一般精神病理量表评分较无共患病组高(均P<0.05)。现患共患病组病程长于曾患共患病组(P<0.05)。结论:共患病在首发精神分裂症儿童少年中较为常见,伴有共患病的患儿症状更重,阳性症状和一般精神病理表现更突出,提示积极治疗共患病非常重要。     

多动儿童焦虑抑郁自评与父母他评一致性研究

目的探讨注意缺陷多动障碍(ADHD)伴情绪问题儿童自我情绪评价与父母他评在临床诊断中的一致性。方法41例ADHD伴情绪问题儿童及父母分别完成儿童焦虑性情绪障碍筛查诊断量表(SCARD)、儿童抑郁障碍自评量表(DSRSC)。结果儿童焦虑性情绪障碍筛查诊断量表(SCARD)、儿童抑郁障碍自评量表(DSRSC),儿童自评与父母他评之间差异有显著性(P0.01),两者诊断一致性程度不高,存在差异性(Kappa0.4,P0.05)。结论重视ADHD儿童对自身情绪问题的表达,对早期发现ADHD儿童共病情绪障碍有一定价值。     

乌鲁木齐市焦虑障碍现况调查

目的:描述乌鲁木齐市社区居民焦虑障碍的患病率及其分布。方法:用现况调查多阶段分层抽样方法,2013年抽取乌鲁木齐市18岁及以上社区居民2178名,采用复合性国际诊断交谈表-3.0(CIDI-3.0)进行入户访谈,根据美国精神障碍诊断与统计手册第4版标准对焦虑障碍进行诊断。计算各类焦虑障碍12月患病率及终生患病率,采用χ²检验比较焦虑障碍患病率在不同性别、年龄、婚姻状态、受教育程度及收入水平分布的差异。结果:共1782人完成CIDI访谈,焦虑障碍加权终生患病率和12月患病率分别为6.50%和5.23%。患病率居前3位的类别分别为强迫障碍(4.77%)、特殊恐怖症(0.46%)和社交恐怖症(0.01%)。焦虑障碍终生患病率和12月患病率的性别、年龄、婚姻状态、受教育程度、收入水平分布的差异无统计学意义。结论:乌鲁木齐市社区居民焦虑障碍12月患病率较高。     

广州地区综合医院门诊抑郁/焦虑障碍流行病学调查

目的:对广州地区综合医院门诊就诊病人进行抑郁、焦虑障碍的流行病学调查.方法:通过随机抽样从广州市卫生局抽取15家综合医院,对门诊就诊病人随机抽样调查;首先采用医院焦虑抑郁量表(HADS)作为筛查工具,然后对筛查阳性者进一步用贝克抑郁量表(BDI)及焦虑自评量表自评(SAS),同时由精神心理科医生用汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表(HAMA)对筛查为阳性的调查对象进行评定,最后由精神心理科医生作出明确诊断.结果:1842例研究对象中,筛查为阳性的人数为701人(占38.1%),其中240人(34.2%)愿意接受进一步的精神心理科检查;抑郁,焦虑筛查阳性率者平均年龄(41.0±17.8)比阴性者年龄(52.9±18.7)年轻(P<0.05);女性就诊者中,筛查为阳性人群的比例为66.3%(P<0.01).结论:广州地区综合医院门诊就诊病人较多存在抑郁,焦虑障碍情绪,同时,中青年患者和女性患者是抑郁,焦虑障碍情绪出现的高发人群.     

认知领悟疗法治疗恐怖症疗效观察

恐怖症是一种常见神经症，在我国神经症专科门诊中占6．7％[1]。迄今病因不明，疗效不甚满意。本文应用钟氏认知领悟疗法[2]治疗22例恐怖症．取得了一定的疗效（痊愈27．27％，显著进步45％，进步13．64％），治疗后SCL－90焦虑、恐怖、偏执、抑郁和躯体化因于分明显改善。1对象和方法1．1对象来自1994～1997年我院恐怖症病人·人组标准：符合CCMD—Ⅱ—R恐怖症诊断标准；无躯体疾病和其它精神障碍；无酒精依赖和药物滥用；至少近两周未采用心理和药物治疗。共22例．男18冽．女4例；年龄17～48岁．平均274土62岁；病期回～11年·平均5．…     

儿童焦虑性情绪障碍筛查表的中国城市常模

目的建立儿童焦虑性情绪障碍筛查表的中国城市常模并检验其信度和效度.方法在全国14个城市采样2019例(男1012例,女1007例),平均年龄11.29 ±2.34岁,由学生及其父母分别填写儿童焦虑性情绪障碍筛查表.结果量表的重测信度为0.567～0.608,半分信度为0.88,Crobach a系数0.43～0.89,项目与总分的相关在0.43～0.74之间.本量表与Achenbach CBCL 、PH 自我意识量表的相应分量表显著相关.对焦虑症性障碍诊断的灵敏度为0.74,特异度为0.79.结论儿童焦虑性情绪障碍筛查表可用于我国儿童焦虑症状的评估.     

哮喘患者的情绪障碍调查

支气管哮喘 (简称哮喘 )是临床上一组常见疾病 ,早在二十世纪二十年代就把哮喘作为心身疾病进行研究。心身医学的研究认为不仅生化因素在哮喘的发病中起到重要作用 ,包括情绪因素在内的心理社会因素在疾病的发生、发展及预后中也起到一定作用。情绪变化可诱发或加重哮喘。哮喘患者情绪障碍的发生率较高 ,以焦虑和抑郁多见。本研究旨在调查哮喘患者的焦虑、抑郁等情绪障碍的发病情况 ,并对有关因素进行分析 ,以期为该疾病的全面认识和治疗提供资料。1　研究对象与方法1.1　对象1998年 2月至 1999年 12月本院门诊及住院的哮喘患者 10 0例。诊…     

合理情绪疗法对广泛性焦虑障碍药物治疗效果的影响

目的:探讨并研究合理情绪疗法对广泛性焦虑障碍药物治疗效果影响。方法:选取我院自2013年6月-2014年4月我院心理咨询门诊的广泛性焦虑障碍患者120例,随机分为两组,每组60例,治疗期8周。对照组采用药物进行治疗,试验组在对照组的基础上同时进行合理情绪疗法治疗。结果:试验组采用药物治疗联合合理情绪疗法明显优于对照组,在对于患者治疗前后的SAS、HAMA评分中进行比较,发现试验组治疗后较治疗前SAS、HAMA分明显降低(t=6.6496,8.9374;P0.05),具有统计学意义。结论:合理情绪疗法在对广泛性焦虑障碍患者的治疗中,能够有效提高患者的生活质量,减少患者的不良情绪。     

What dimensions do young children's trait concepts have for peers?

This study investigated what dimensions young children's trait concepts have for real peers at their nursery school. Teachers of nursery school rated children's personality characteristics in terms of each dimension of the Big Five, and children were selected who showed different behavioral characteristics in those the five dimensions. Five- and six-year-old children (26 participants: 14 boys and 12 girls) evaluated those selected peers' personality. It was found that young children made different evaluations between extroversion and the other four traits (agreeableness, conscientiousness, emotional stability, and intellect), and between agreeableness and intellect. The results suggested that young children's trait concepts have a dimension of extroversion, in addition to a general dimension of goodness-badness.     

Quality of life in children surviving cancer: a personality and multi-informant perspective

OBJECTIVE: To describe quality of life (QoL) of children surviving cancer in relation to their personality, using self- and maternal reports and examining differences with healthy referents. METHOD: Sixty-seven children who survived childhood cancer were compared with eighty-one healthy children on QoL and personality characteristics. RESULTS: Children who survived cancer reported higher QoL than healthy children, whereas there were no differences for personality. Two main effects emerged for informant with children rating themselves as less neurotic and more conscientious than their mothers. The correspondence between mothers and children was substantially higher for survivors for QoL and personality ratings. QoL and trait measures share substantial variance, and personality traits significantly predict QoL. Parental personality ratings explained child QoL beyond children's personality ratings. CONCLUSIONS: Personality traits contribute to quality of life, indicating that personality significantly influences child's quality of life beyond the experience of a negative life event such as surviving cancer and its treatment. From a diagnostic perspective, parental trait ratings are informative in addition to children's ratings of personality to understand children's QoL.     

家庭环境与学习障碍儿童行为、自我意识、个性的相关性

目的 :探讨学习障碍 (learningdisorders ,LD)儿童的家庭环境特点及其与儿童行为、自我意识、个性特征的相关性。方法 :选用家庭环境量表中文版 (FES -CV)、Rutter儿童行为问卷 (父母问卷 )、艾森克个性问卷 (EPQ -儿童版 )和Piers -Harris儿童自我意识量表分别对 110名LD和 110名学习优秀 (对照 )组儿童进行评定。结果 :资料齐全的LD组儿童 91名 ,对照组 98名。LD组儿童的家庭在FES量表的亲密度、情感表达、成功性、知识性的评分低于对照组 (P <0 0 5 ) ,而矛盾性则高于对照组 (P <0 0 1) ;LD组儿童的行为和自我意识总分显著低于对照组 (均P <0 0 0 1) ,在EPQ的精神质和神经质得分高于对照组(P <0 0 5 ) ,内外向得分低于对照组 (P <0 0 0 1)。FES的某些环境因素分别与LD和对照组儿童的行为、自我意识、个性特点有关。结论 :LD儿童处在相对不良的家庭环境中 ,家庭环境因素对LD组和对照组儿童行为、自我意识、个性的影响不同。     

Problem Behaviors and Personality of Children and Adolescents With Prader-Willi Syndrome

Objective: Compare behavioral and emotional problems of childrenand adolescents with Prader-Willi Syndrome (PWS) and clientsconsulting mental health centers (MHC) and related behavioraland emotional problems to the children's personality in thePWS group. Methods: Participants were 39 children with PWS and 585 matchedMHC dlents. Child Behavior Checklist (CBCL) syndromes were relatedto the Big-Five personality factors measured with the CaliforniaChild Q-sort (CCQ). Results: Mean CBCL Total Problems scores were not differentfor the PWS and MHC groups, but differences were found for severalof the CBCL subscales. Patterns of correlations among CBCL scaleswere similar In both groups, although coefficients were generallyhigher in the PWS group, indicating higher comorbidity or co-absenceof CBCL syndromes in children and adolescents with PWS. Personalityprofiles were specific for Internalizing and Externalizing problemsof children and adolescents with PWS.     

家庭情绪气氛对儿童依恋行为类型的影响

目的：研究父母的情绪气氛对儿童依恋行为类型的影响。方法：采用中文版的儿童依恋行为分类卡（Q-set分类），对本地区-市级示范幼儿园的40名日托幼儿和在本院儿保门诊系统保健建卡的幼儿40名，进行了儿童依恋行为类型的问卷调查。结果：母亲积极的情绪表达有利于儿童形成安全型依恋风格（β=0．729），消极的情绪表达不利于儿童形成安全依恋类型（β=-0．448），父亲和母亲的结果一样。同时发现父、母亲的情绪表达存在交互作用。结论：为了儿童形成安全性依恋风格，父、母亲能够针对自己和对方的情绪表达方式形成良好的匹配。     

Depressed mothers coming to primary care: maternal reports of problems with their children

BACKGROUND: Studies of depressed mothers have generally been conducted in psychiatric settings with non-minority, middle-class women. Primary care has an increasing role in early detection and treatment, especially for the poor who have less access to specialized mental health services. Data on the relationship between maternal depression and problems in the offspring in a primary care context could help physicians to more effectively identify children in need of psychiatric help. METHODS: All mothers aged 25 to 55 from a systematic sample of consecutive adults (response rate, 80%) in an urban general medicine practice were screened using the PRIME-MD Patient Health Questionnaire (PHQ). Mothers who screened positive for major depression (n=85); other psychiatric disorders, but not major depression (n=67); or no psychiatric disorders (n=191) were compared on their children's history of emotional problems, unmet need for mental health treatment, parent-child discord, maternal functional status and mental health treatment. RESULTS: Compared to non-psychiatric controls, depressed mothers reported a three-times greater risk of serious emotional problems in their children (95% confidence interval [CI], 1.7-6.1); a four-times greater risk of having their children's problems left untreated (95% CI, 2.3-8.2), and a 10-times greater risk of having poor mother-child relations within the past month (95% CI, 3.9-29.4). Depressed mothers reported more functional disability, more psychiatric treatment and more problems in their offspring than mothers with non-depressive psychiatric disorders. Although a majority of mothers (regardless of psychiatric status) believed that counseling (96%) or medication (84%) should be offered to those with serious emotional problems, only about half (49%) of the depressed mothers had received mental health treatment in the past month. LIMITATIONS: Children were not assessed directly. CONCLUSIONS: The children of low-income depressed women at a general medicine practice were reported to have a greatly increased risk for emotional problems. Many mothers had not received treatment for their own emotional problems. By enquiring about the emotional health of children of adult primary care patients, primary care providers have an opportunity to promote early detection and to facilitate appropriate treatment for both the mothers and their children.     

厦门市儿童智测（C—WYCSL）结果分析

为了解厦门市学龄前儿童智能开发情况,探讨对影响智能发展的因素,采用整群分层抽样法,抽取不同类型的幼儿园及散居儿童,应用龚耀先、戴晓阳主编的C－WYCISI手册测试,结果显示,儿童的智能发展及智商分布构成比呈正态分布,符合儿童智能发育规律;男女童间的智能发展无明显差异;集体儿童得分明显优于散居儿童,其中公办园得分高于单位办、民办幼儿园。在极超常、边界、智力缺损儿童中,其智力发育与父母的文化层次、职业状况有一定的关系,与母孕状况、出生时异常及过早与父母分离有重要关系。提示早期教育及学龄前教育对儿童的智能开发具有显著的促进作用,为了儿童的身心健康,既要重视智力因素也不能忽视非智力因素。     

大学生人格障碍病例对照研究

目的 :了解北京市某重点大学一年级学生的人格特点并探讨父母养育方式及有关因素对大学生人格形成的影响。方法 :使用“一般资料问卷”、“人格诊断问卷”、“父母养育方式问卷”调查北京市某重点大学一年级学生共 2 2 0 5人 ,对“人格诊断问卷”阳性者进一步用IPDE按ICD -10诊断系统进行临床诊断 ,对确诊的 5 5名病例和 2 2 0名对照进行 1∶4配比的病例对照研究 ,通过单因素和多因素条件Logistic回归分析 ,筛选人格障碍的可疑危险因素。结果 :与人格障碍形成有关的危险因素有父母的拒绝、单亲家庭、父母关系不和睦、家庭经济收入低、独生子女。本研究未见父母的过度保护、父母的偏爱、父母的情感温暖、父母的文化程度、居住地区、民族与人格障碍之间有显著关联。结论 :大学生特别是独生子女的心理健康问题应引起家长、学校和社会的普遍重视。父母们应改善不良的养育方式 ,创造良好的家庭环境 ,使子女的人格健康地发育。对有人格障碍的学生应给予干预性指导和治疗 ,提高他们的社会适应性及对困难和挫折的心理承受能力。     

Pathways and processes of risk in associations among maternal antisocial personality symptoms, interparental aggression, and preschooler's psychopathology

Two studies examined the nature and processes underlying the joint role of interparental aggression and maternal antisocial personality as predictors of children's disruptive behavior problems. Participants for both studies included a high-risk sample of 201 mothers and their 2-year-old children in a longitudinal, multimethod design. Addressing the form of the interplay between interparental aggression and maternal antisocial personality as risk factors for concurrent and prospective levels of child disruptive problems, the Study 1 findings indicated that maternal antisocial personality was a predictor of the initial levels of preschooler's disruptive problems independent of the effects of interparental violence, comorbid forms of maternal psychopathology, and socioeconomic factors. In attesting to the salience of interparental aggression in the lives of young children, latent difference score analyses further revealed that interparental aggression mediated the link between maternal antisocial personality and subsequent changes in child disruptive problems over a 1-year period. To identify the family mechanisms that account for the two forms of intergenerational transmission of disruptive problems identified in Study 1, Study 2 explored the role of children's difficult temperament, emotional reactivity to interparental conflict, adrenocortical reactivity in a challenging parent-child task, and experiences with maternal parenting as mediating processes. Analyses identified child emotional reactivity to conflict and maternal unresponsiveness as mediators in pathways between interparental aggression and preschooler's disruptive problems. The findings further supported the role of blunted adrenocortical reactivity as an allostatic mediator of the associations between parental unresponsiveness and child disruptive problems.     

The influence of developmental factors on behaviors relevant to shame and guilt in young children

The present study explored developmental factors that would contribute to individual differences in behaviors relevant to shame and guilt of young children. The children's behaviors relevant to shame and guilt were observed by an experimental procedure. The children were led to happen to destroy an experimenter's doll, and their behavioral variables relevant to shame and guilt were measured. Their mothers answered the questionnaire tapping developmental factors: children' s temperament, the frequency of maternal disciplines, and the frequency of maternal emotional experiences. A factor analysis of children's behavioral variables revealed that there were apologizing traits and repairing traits. Moreover, children who received more physical punishment were likely to apologize to the experimenter for destroying the doll. Children whose mothers experienced more shame were less likely to repair the broken doll rapidly. Boys who were temperamentally more insistent and expressing more positive emotions were likely to apologize to the experimenter for destroying the doll.