Achenbach T M, Howell C T, Quay H C, Conners C K
University of Vermont, Department of Psychiatry.
Monogr Soc Res Child Dev. 1991;56(3):1-131.
We compared parent-reported problems and competencies for national samples of 2,600 4-16-year-olds assessed at intake into mental health services and 2,600 demographically matched nonreferred children assessed in a home interview survey. Parents responded to the ACQ Behavior Checklist, which includes 23 competence items, three competence scales, 216 problem items, eight syndrome scales, Internalizing, Externalizing, and total competence and problem scores. Most items and scales discriminated significantly (p less than .01) between referred and nonreferred samples. There were important sex and age differences in problem patterns, but regional and ethnic differences were minimal. Somewhat more problems and fewer competencies were reported for lower- than upper-socioeconomic-status children. Referral rates were similar in the most urban and rural areas, but they were significantly higher in areas of intermediate urbanization. Correlations of problem scores with those obtained 10 years earlier in a regional survey and with surveys in other countries showed considerable consistency in the rank order of prevalence rates among specific problems. Apparently owing to its more differentiated response scales, the ACQ was susceptible to respondent characteristics that reduced its discriminative power below that of the Child Behavior Checklist. Comparisons of procedures for discriminating between the normal and the clinical range supported the value of a borderline category for children who are neither clearly normal nor clearly deviant. Interview data from the survey sample yielded significantly higher ACQ problem scores for children who had fewer related adults in their homes, those who had more unrelated adults in their homes, those whose biological parents were unmarried, separated, or divorced, those whose families received public assistance, and those whose household or family members had received mental health services. Children who scored higher on Externalizing than Internalizing problems tended to have unmarried, separated, or divorced parents and to come from families receiving public assistance. However, among children whose household or family members had received mental health services, there were greater proportions of both Externalizing and Internalizing patterns than among other children.
我们比较了家长报告的问题和能力，对象是心理健康服务机构收纳评估的2600名4至16岁儿童的全国样本，以及通过家庭访谈调查评估的2600名人口统计学特征匹配的未被转介儿童。家长对《ACQ行为清单》做出回应，该清单包括23项能力项目、三个能力量表、216项问题项目、八个综合征量表、内化、外化以及总的能力和问题得分。大多数项目和量表在转介样本和未被转介样本之间有显著差异（p小于0.01）。问题模式存在重要的性别和年龄差异，但地区和种族差异极小。社会经济地位较低的儿童比社会经济地位较高的儿童报告的问题略多、能力略少。城市和农村地区的转介率相似，但在中等城市化地区显著更高。问题得分与10年前在一项地区调查中获得的得分以及与其他国家调查得分的相关性表明，特定问题患病率的排名顺序具有相当的一致性。显然，由于其反应量表更具区分性，ACQ易受受访者特征的影响，其区分能力低于《儿童行为清单》。区分正常和临床范围的程序比较支持了为既不明显正常也不明显异常的儿童设立临界类别的价值。调查样本的访谈数据显示，家中相关成年人较少、家中非亲属成年人较多、亲生父母未婚、分居或离婚、家庭接受公共援助以及家庭或家庭成员接受过心理健康服务的儿童，其ACQ问题得分显著更高。外化问题得分高于内化问题得分的儿童往往父母未婚、分居或离婚，且来自接受公共援助的家庭。然而，在家庭或家庭成员接受过心理健康服务的儿童中，外化和内化模式的比例均高于其他儿童。
