Undheim Anne Mari, Lydersen Stian, Kayed Nanna Sønnichsen
Faculty of Medicine, Regional Centre for Child and Youth Mental Health and Child Welfare-Central Norway, Norwegian University of Science and Technology (NTNU), PB 8905, MTFS, 7491 Trondheim, Norway.
Child Adolesc Psychiatry Ment Health. 2016 Jun 29;10:19. doi: 10.1186/s13034-016-0109-4. eCollection 2016.
Studies show that adolescents living in residential youth care (RYC) institutions experience more mental health problems than others. This paper studies how well teachers and primary contacts in RYC institutions recognize adolescents' mental health problems as classified by The Child and Adolescent Psychiatric Assessment diagnostic interviews (CAPA).
All residents between 12 and 23 years of age living in RYC institutions in Norway and enrolled in school at the time of data collection were invited to participate in the study. Of the 601 available children, 400 participated in the study, namely 230 girls, mean age = 16.9 years, SD = 1.2 and 170 boys, mean age = 16.5 years, SD = 1.5. The Child Behavior Checklist (CBCL) and Teacher's Report Form (TRF) were used. The sensitivity and specificity of these instruments were studied.
We observed a significant gap between the mental health problems diagnosed by the CAPA interviews and the problems reported by primary contacts on the CBCL and by teachers on the TRF. The CBCL showed a higher sensitivity than the TRF, whereas the TRF showed a higher specificity than the CBCL. Both primary contacts and teachers classified externalizing problems fairly well such as ADHD in both genders and conduct disorder in girls. Both teachers and primary contacts, however, had more problems detecting internalizing problems. Teachers may have a tendency to view most students as healthy and to underestimate the severity of their problems, whereas primary contacts may tend to overestimate the number of problems and view adolescents as sicker than they really are.
The Child Welfare System should revise their intake procedures to detect possible problems early on and to introduce the necessary treatment. It is important to identify factors that increase healthy school adaption in order for these adolescents to accomplish school in a proper way since education is important for a successful adult life.
研究表明，生活在青少年寄宿照料（RYC）机构中的青少年比其他人经历更多心理健康问题。本文研究RYC机构中的教师和主要联系人对青少年心理健康问题（按照《儿童与青少年精神病学评估》诊断访谈（CAPA）分类）的识别程度。
邀请挪威RYC机构中所有年龄在12至23岁之间且在数据收集时已入学的居民参与研究。在601名符合条件的儿童中，400名参与了研究，即230名女孩，平均年龄 = 16.9岁，标准差 = 1.2；170名男孩，平均年龄 = 16.5岁，标准差 = 1.5。使用了儿童行为量表（CBCL）和教师报告表（TRF）。研究了这些工具的敏感性和特异性。
我们观察到，CAPA访谈诊断出的心理健康问题与主要联系人在CBCL上报告的问题以及教师在TRF上报告的问题之间存在显著差距。CBCL的敏感性高于TRF，而TRF的特异性高于CBCL。主要联系人与教师对诸如男女双方的注意力缺陷多动障碍（ADHD）以及女孩的品行障碍等外化问题的分类都相当不错。然而，教师和主要联系人在发现内化问题方面都存在更多困难。教师可能倾向于将大多数学生视为健康，低估其问题的严重性，而主要联系人可能倾向于高估问题数量，将青少年看得比实际情况更病态。
儿童福利系统应修订其接纳程序，以便尽早发现可能的问题并引入必要的治疗。识别促进健康学校适应的因素很重要，这样这些青少年才能以适当方式完成学业，因为教育对于成功的成年生活很重要。
