摘要
背景:我国儿童心理问题不断增多,因此能够有效评估儿童行为和情绪问题的筛选工具对于促进我国儿童身心健康和预防儿童精神疾病有重要的意义。目的 :在来源于中国不同地区城市和农村的大样本儿童中对国际公认的长处和困难问卷(SDQ)中文版的使用进行评估,包括情绪症状、品行问题、多动/注意缺陷、同伴交往问题和亲社会行为。方法 :采用分层随机抽样选取8省份22,108名小学生(年龄在5岁至13岁)的法定监护人(父母为主)进行SDQ(父母版)中文版问卷调查。本研究评估了SDQ评分与社会人口学特征之间的关联性,并比较了中国与日本和英国在"异常","临界"和"正常"标准的百分位划界分。结果 :SDQ(父母版)5个分量表中有4个内部一致性尚可,但是"同伴关系问题"分量表则较差(alpha=0.22)。监护人反映男孩比女孩的多动/注意力缺陷问题更多,而女孩比男孩的情感症状问题突出。男孩和女孩的多动/注意力缺陷问题都会随着年龄的增长而减少,而同伴交往问题随着年龄增长而增多。农村地区和监护人不是父母(即祖父母或其他亲属)的孩子中,情绪症状、品行问题和同伴交往问题较为普遍。中国儿童中判定为"异常"的90%百分位划界分(19-40)要高于日本和英国报道的儿童划界分。讨论:此项研究提示,对男孩的多动/注意缺陷问题应在10岁之前开始预防,并且在青春期早期就要开始训练如何减轻与同伴交往带来的压力。进一步的研究需要注重于提高SDQ在中国文化背景下的信效度,并确定SDQ对于识别孩子是否需要心理健康服务的敏感性和特异性。
Background：A valid screening tool for behavioral and emotional problems in children and adolescents is needed to promote psychological wellbeing and to prevent mental disorders in China’s children. Aim：Assess the use of the Chinese version of the internationally recognized Strengths and Difficulties Questionnaire （SDQ）-which assesses emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems and prosocial behaviors-in a large sample of urban and rural children from different parts of China. Methods：The Chinese version of the parent-reported SDQ was administered to legal guardians （primarily parents） of a stratified random sample of 22,108 primary school children 5 to 13 years of age from eight provinces in China. The association between SDQ scores and socio-demographic characteristics was assessed and the percentile cutoff scores for‘abnormal’,‘borderline’ and‘normal’ results in China were compared with those for Japan and the United Kingdom. Results：The internal consistency of the 4 of the 5 SDQ subscales were satisfactory but that for the‘peer relationships problems’ subscale was quite poor （alpha=0.22）. Guardians reported that boys were more likely than girls to have hyperactivity/inattention problems and that girls were more likely than boys to have problems with emotional symptoms. For both boys and girls hyperactivity/inattention problems decreased with age while peer relationship problems increased with age. Emotional symptoms, conduct problems and peer relationship problems were more common in children from rural areas and in children whose identified guardian was not a parent （i.e., a grandparent or other relative）. The 90th percentile cutoff score for abnormal results was higher in Chinese children than the cutoff scores reported for children in Japan and the United Kingdom. Conclusions：This study suggests that prevention programs for hyperactivity/inattention problems in boys need to start before the age of 10 and that training in methods of reducing the stress associated with peer relationships should start in early adolescence. Further work is needed to improve the cultural validity of the SDQ in China and to determine its sensitivity and specificity for identifying children who are in need of mental health services.
出处
《上海精神医学》
2013年第6期364-374,共11页
Shanghai Archives of Psychiatry
基金
funded by Chinese Center for Disease Control and Prevention Youth Funding(2010A205)
