Rasmussen Cathrine Skovmand, Nielsen Louise Gramstrup, Petersen Dorthe Janne, Christiansen Erik, Bilenberg Niels
Child and Adolescent Psychiatric Department, Mental Health Hospital and University Clinic, Region of Southern Denmark, University of Southern Denmark , Sdr. Boulevard 29, DK-5000 Odense C , Denmark.
Nord J Psychiatry. 2014 Apr;68(3):189-95. doi: 10.3109/08039488.2013.794473. Epub 2013 May 22.
The aim of the study was to identify risk factors for significant changes in emotional and behavioural problem load in a community-based cohort of Danish children aged 9-16 years, the risk factors being seven parental and two child-related adverse life events.
Data on emotional and behavioural problems was obtained from parents filling in the Child Behavior Checklist (CBCL) when the child was 8-9 and again when 15 years old. Data on risk factors was drawn from Danish registers. Analysis used was logistic regression for crude and adjusted change.
Parental divorce significantly raised the odds ratio of an increase in emotional and behavioural problems; furthermore, the risk of deterioration in problem behaviour rose significantly with increasing number of adverse life events. By dividing the children into four groups based on the pathway in problem load (increasers, decreasers, high persisters and low persisters), we found that children with a consistently high level of behavioural problems also had the highest number of adverse life events compared with any other group.
Family break-up was found to be a significant risk factor. This supports findings in previous studies. The fact that no other risk factor proved to be of significance might be due to lack of power in the study. Children experiencing high levels of adverse life events are at high risk of chronic problem behaviour. Thus these risk factors should be assessed in daily clinical practice.
本研究旨在确定丹麦9至16岁社区儿童群体中情绪和行为问题负荷显著变化的风险因素，这些风险因素包括七个与父母相关以及两个与儿童相关的不良生活事件。
通过父母填写儿童行为量表（CBCL）获取儿童8至9岁以及15岁时的情绪和行为问题数据。风险因素数据来自丹麦登记处。采用逻辑回归分析进行粗略和调整后的变化分析。
父母离异显著提高了情绪和行为问题增加的比值比；此外，问题行为恶化的风险随着不良生活事件数量的增加而显著上升。通过根据问题负荷的变化路径将儿童分为四组（增加组、减少组、高持续组和低持续组），我们发现与其他任何组相比，行为问题持续处于高水平的儿童不良生活事件数量也最多。
家庭破裂被发现是一个重要的风险因素。这支持了先前研究的结果。没有其他风险因素被证明具有显著性这一事实可能是由于研究的效能不足。经历大量不良生活事件的儿童存在慢性问题行为的高风险。因此，在日常临床实践中应评估这些风险因素。
