Wolchik Sharlene A, Sandler Irwin N, Millsap Roger E, Plummer Brett A, Greene Shannon M, Anderson Edward R, Dawson-McClure Spring R, Hipke Kathleen, Haine Rachel A
Department of Psychology, Program for Prevention Research, Prevention Research Center, Arizona State University, PO Box 876005, Tempe, AZ 85287-6005, USA.
JAMA. 2002 Oct 16;288(15):1874-81. doi: 10.1001/jama.288.15.1874.
Compared with their peers with nondivorced parents, adolescents with divorced parents are more likely to have mental health problems, drop out of school, and become pregnant. The long-term effects of intervention programs for this population are unknown.
To evaluate the long-term effectiveness of 2 programs designed to prevent mental health problems in children with divorced parents.
Six-year follow-up of a randomized controlled trial of 2 intervention programs (mother program: 11 group and 2 individual sessions; mother plus child program: mother program and 11 group sessions for children) and a control condition (books on postdivorce adjustment), which was conducted in a large metropolitan US city from April 1998 through March 2000.
A total of 218 families (91% of the original sample) with adolescents aged between 15 and 19 years were reinterviewed.
Externalizing and internalizing problems, diagnosed mental disorders, drug and alcohol use, and number of sexual partners.
Eleven percent of adolescents in the mother plus child program (95% confidence interval [CI], 3.8%-18.2%) had a 1-year prevalence of diagnosed mental disorder compared with 23.5% (95% CI, 13.8%-33.2%) of adolescents in the control program (P =.007). Adolescents in the mother plus child program had fewer sexual partners (mean [SE], 0.68 [0.16]) compared with adolescents in the control program (1.65 [0.37]; P =.01). Adolescents with higher initial mental health problems whose families were in the mother plus child program had lower externalizing problems (P =.007) and fewer symptoms of mental disorder (P =.02) compared with those in the control program. Compared with controls, adolescents whose mothers participated in the mother program and who had higher initial mental health problems had lower levels of externalizing problems (P<.001); fewer symptoms of mental disorder (P =.005); and less alcohol (P =.005), marijuana (P =.02), and other drug use (P =.01).
In adolescents of divorced parents, the mother program and the mother plus child program reduced symptoms of mental disorder; rates of diagnoses of mental disorder; levels of externalizing problems; marijuana, alcohol, and other drug use; and number of sexual partners.
与父母未离异的同龄人相比，父母离异的青少年更易出现心理健康问题、辍学及怀孕。针对这一群体的干预项目的长期效果尚不清楚。
评估两项旨在预防父母离异儿童心理健康问题的项目的长期效果。
对两项干预项目（母亲项目：11次小组会议和2次个人会议；母亲加儿童项目：母亲项目及11次儿童小组会议）和一种对照情况（关于离婚后适应的书籍）进行为期六年的随机对照试验随访，该试验于1998年4月至2000年3月在美国一个大城市进行。
共对218个家庭（占原始样本的91%）进行了重新访谈，这些家庭中的青少年年龄在15至19岁之间。
外化和内化问题、确诊的精神障碍、药物和酒精使用情况以及性伴侣数量。
母亲加儿童项目中11%（95%置信区间[CI]，3.8%-18.2%）的青少年确诊精神障碍的1年患病率，而对照项目中的这一比例为23.5%（95%CI，13.8%-33.2%）（P = 0.007）。与对照项目中的青少年（1.65[0.37]）相比，母亲加儿童项目中的青少年性伴侣较少（均值[标准误]，0.68[0.16]；P = 0.01）。与对照项目相比，家庭参与母亲加儿童项目且初始心理健康问题较高的青少年外化问题较少（P = 0.007），精神障碍症状也较少（P = 0.02）。与对照组相比，母亲参与母亲项目且初始心理健康问题较高的青少年外化问题水平较低（P<0.001）；精神障碍症状较少（P = 0.005）；酒精（P = 0.005）、大麻（P = 0.02）及其他药物使用也较少（P = 0.01）。
在父母离异的青少年中，母亲项目和母亲加儿童项目减轻了精神障碍症状；精神障碍诊断率；外化问题水平；大麻、酒精及其他药物使用；以及性伴侣数量。
