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患有严重发育障碍的青少年中精神疾病诊断及适应不良行为的社会心理相关因素。

Psychosocial correlates of psychiatric diagnoses and maladaptive behaviour in youth with severe developmental disability.

作者信息

Weiss J A, Ting V, Perry A

机构信息

York University, Department of Psychology, Toronto, ON, Canada.

出版信息

J Intellect Disabil Res. 2016 Jun;60(6):583-93. doi: 10.1111/jir.12278. Epub 2016 Apr 13.

Abstract

BACKGROUND

We know little about the correlates of mental health problems in youth with severe and profound intellectual disability (ID), as most research includes these youth within larger samples that include greater proportions of mild and moderate disability. The purpose of the current study was to identify the child, family and psychosocial characteristics that were associated with the presence of psychiatric diagnoses and maladaptive behaviour in youth with severe ID.

METHODS

Participants were 141 parents of youth with severe or profound levels of ID, 4 to 18 years of age. The mean age of children was 11.04 years (SD = 3.38), with 68% male and 39% with autism spectrum disorder (ASD). Parents completed a primarily online survey of child and family characteristics, negative life events, family quality of life and their own mental health.

RESULTS

Logistic regression analyses revealed that youth with a psychiatric diagnosis had higher levels of adaptive behaviour and experienced more negative life events than youth without psychiatric diagnosis, while the presence of clinically significant maladaptive behaviour was related to higher levels of adaptive behaviour, parents' mental health problems and lower family quality of life. Child age, gender, ASD status and financial hardship were not related to either outcome variable.

CONCLUSIONS

Youth with severe and profound ID who experience psychosocial stressors are more likely reported to have mental health problems than youth without such stressors. It is likely that a combination of child and family based interventions, along with with policies that address larger systemic issues of social adversity, are needed to promote mental health and treat psychopathology when it arises.

摘要

背景

我们对重度和极重度智力残疾(ID)青少年心理健康问题的相关因素知之甚少,因为大多数研究将这些青少年纳入了更大的样本中,而这些样本中轻度和中度残疾的比例更高。本研究的目的是确定与重度智力残疾青少年精神疾病诊断和适应不良行为存在相关的儿童、家庭和社会心理特征。

方法

参与者为141名4至18岁重度或极重度智力残疾青少年的父母。儿童的平均年龄为11.04岁(标准差=3.38),其中68%为男性,39%患有自闭症谱系障碍(ASD)。父母完成了一项主要关于儿童和家庭特征、负面生活事件、家庭生活质量以及他们自身心理健康的在线调查。

结果

逻辑回归分析显示,患有精神疾病诊断的青少年比未患精神疾病诊断的青少年具有更高水平的适应性行为,并且经历了更多的负面生活事件,而具有临床显著适应不良行为的情况与更高水平的适应性行为、父母的心理健康问题以及更低的家庭生活质量相关。儿童年龄、性别、ASD状态和经济困难与任何一个结果变量均无关联。

结论

与没有此类社会心理压力源的青少年相比,经历社会心理压力源的重度和极重度智力残疾青少年更有可能报告存在心理健康问题。当出现心理病理学问题时,可能需要结合基于儿童和家庭的干预措施以及解决更大社会逆境系统性问题的政策,以促进心理健康并进行治疗。

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