Rettew David C, van Oort Floor V A, Verhulst Frank C, Buitelaar Jan K, Ormel Johan, Hartman Catharina A, Veenstra René, Althoff Robert R, Hudziak James J
Vermont Center for Children, Youth, and Families, University of Vermont College of Medicine, Burlington, Vermont 05400, USA.
J Child Adolesc Psychopharmacol. 2011 Oct;21(5):389-97. doi: 10.1089/cap.2010.0153.
A commonly encountered situation for evaluating clinicians is a history of significant problems in one setting with little or no difficulties in another. This study aims to describe this phenomenon and to examine its relations with other child and family characteristics.
A total of 1,730 children (mean age 11.05 years) was studied from the first wave of the Tracking Adolescents' Individual Lives Survey (TRAILS), a large population-based study of Dutch youth. Parent and teacher ratings of aggression, rule breaking, inattention, and hyperactivity were obtained. Children were assigned to groups according to the presence of clinically relevant problems at home only, at school only, or in both settings. The rate of setting specific problems was calculated and comparisons between groups were made.
Setting specific, especially home-specific, problems were quite common. Among children whom parents rated as having at least borderline-clinical problems, teachers reported clear or very clear behaviors at school at the following rates: aggression (22%), rule breaking (12.5%), inattention (55%), and hyperactivity/impulsivity (33%). Compared with the school-specific group, the home-specific group contained a significantly higher percentage of girls with regard to inattention or hyperactivity and a significantly lower percentage of girls with regards to rule breaking. Logistic regression analyses revealed that home- versus school-specific problems were related to sex, child effortful control, and parental stress.
Externalizing problems are frequently encountered only in one setting between home and school and are related to sex, child effortful control, and parental stress.
对于评估临床医生而言，一种常见的情况是，儿童在一种环境中存在严重问题，而在另一种环境中几乎没有或完全没有问题。本研究旨在描述这一现象，并探讨其与其他儿童及家庭特征的关系。
从追踪青少年个体生活调查（TRAILS）的第一波数据中选取了1730名儿童（平均年龄11.05岁）进行研究，TRAILS是一项基于荷兰青年人群的大型研究。获取了家长和教师对攻击行为、违规行为、注意力不集中和多动的评分。根据儿童仅在家中、仅在学校或在两种环境中均存在临床相关问题，将其分组。计算特定环境问题的发生率，并对组间进行比较。
特定环境问题，尤其是家庭特定问题相当普遍。在家长评定为至少有临界临床问题的儿童中，教师报告在学校出现明显或非常明显行为的比例如下：攻击行为（22%）、违规行为（12.5%）、注意力不集中（55%）和多动/冲动（33%）。与学校特定组相比，家庭特定组中注意力不集中或多动的女孩比例显著更高，而违规行为的女孩比例显著更低。逻辑回归分析显示，家庭特定问题与学校特定问题与性别、儿童努力控制和父母压力有关。
外化问题经常仅在家庭和学校中的一种环境中出现，并且与性别、儿童努力控制和父母压力有关。
