Wlodarczyk Olga, Pawils Silke, Metzner Franka, Kriston Levente, Klasen Fionna, Ravens-Sieberer Ulrike
Institute and Outpatients Clinic of Medical Psychology, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52 (Building W26), 20246 Hamburg, Germany.
Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Research Division "Child Public Health", Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52 (Building W26), 20246 Hamburg, Germany.
Child Adolesc Psychiatry Ment Health. 2017 Mar 8;11:12. doi: 10.1186/s13034-017-0149-4. eCollection 2017.
Mental health problems (MHPs) in preschoolers are precursors of mental disorders which have shown to be associated with suffering, functional impairment, exposure to stigma and discrimination, as well as enhanced risk of premature death. A better understanding of factors associated with MHPs in preschoolers can facilitate early identification of children at risk and inform prevention programs. This cross-sectional study investigated the association of risk and protective factors with MHPs within a German representative community sample.
MHPs were assessed in a sample of 391 preschoolers aged 3-6 years using the Strength and Difficulties Questionnaire (SDQ). The effects of parental MHPs, children's temperament, parental socioeconomic status (SES), social support and perceived self-competence on MHPs were assessed using bivariate and multivariate logistic regression analyses that controlled for sociodemographic characteristics.
Overall, 18.2% of preschoolers were classified as 'borderline or abnormal' on the total difficulties score of the SDQ. Bivariate analyses showed that parental MHPs, children's difficult temperament, and parental low SES increased the likelihood, whereas high perceived parental competence decreased the likelihood of preschool MHPs. In the multivariate analyses, only difficult child temperament remained significantly associated with preschool MHPs when other variables were controlled.
The results underline the importance of children's difficult temperamental characteristics as a risk factor for mental health in preschoolers and suggest that these may also be an appropriate target for prevention of preschool MHPs. More research on specific aspects of preschool children's temperament, the socioeconomic environment and longitudinal studies on the effects of these in the development of preschool MHPs is needed.
学龄前儿童的心理健康问题（MHPs）是精神障碍的先兆，已表明与痛苦、功能损害、遭受污名化和歧视以及过早死亡风险增加有关。更好地了解与学龄前儿童心理健康问题相关的因素有助于早期识别有风险的儿童并为预防计划提供信息。这项横断面研究调查了德国代表性社区样本中风险和保护因素与心理健康问题之间的关联。
使用优势与困难问卷（SDQ）对391名3至6岁学龄前儿童的样本进行心理健康问题评估。使用双变量和多变量逻辑回归分析评估父母心理健康问题、儿童气质、父母社会经济地位（SES）、社会支持和自我感知能力对心理健康问题的影响，并对社会人口学特征进行了控制。
总体而言，在SDQ的总困难得分上，18.2%的学龄前儿童被归类为“临界或异常”。双变量分析表明，父母心理健康问题、儿童难养气质和父母低社会经济地位增加了学龄前儿童出现心理健康问题的可能性，而父母高自我感知能力则降低了这种可能性。在多变量分析中，当控制其他变量时，只有难养儿童气质仍与学龄前儿童心理健康问题显著相关。
结果强调了儿童难养气质特征作为学龄前儿童心理健康风险因素的重要性，并表明这些特征也可能是预防学龄前儿童心理健康问题的合适目标。需要对学龄前儿童气质的具体方面以及社会经济环境进行更多研究，并对这些因素在学龄前儿童心理健康问题发展中的影响进行纵向研究。
