Department of Psychiatry, Faculty of Medicine, University of Peradeniya, Sri Lanka.
Department of Psychiatry, Faculty of Medicine, University of Peradeniya, Sri Lanka.
Child Abuse Negl. 2020 May;103:104435. doi: 10.1016/j.chiabu.2020.104435. Epub 2020 Feb 28.
Child care institutions (CCIs) in Sri Lanka (SL) provide residence to over 14,000 children. These children have a high risk of developing psychological problems. However, there has been no prior scientific inquiry into mental health issues of institutionalized children in SL.
To investigate the emotional and behavioral problems of children living in CCIs in Kandy District, and to explore associated factors.
Ten CCIs in Kandy District were selected and all children aged 6-18 years were recruited.
Child Behavior Checklist (6-18) -Sinhala version (CBCL-S) was filled by the caregivers, and pertinent problem scores were derived. Relevant socio-demographic data were also collected.
A total of 259 children participated. Of them, 66.8 % were female. The mean age was 13.9 years. The average duration in care was 4.3 years. Clinical levels of behavioral problems were found in 14 % of children, whereas 7% were borderline. Externalizing problems like rule-breaking and aggression were more common (23.3 %) than internalizing problems (6.6 %). Male children exhibited more behavioral problems (p = 0.034). Present age, age on admission, duration in care, history of sexual abuse, institutional transfers and frequency of family contact were not associated with behavioral problems.
Institutionalized children showing high levels of externalizing problems may be a reflection of disturbed psychosocial development. However, internalizing problems may not be readily recognized, partly due to the shortage of trained caregivers in SL. Educating caregivers to detect and refer children with behavioral problems to psychiatric services is recommended.
斯里兰卡（SL）的儿童保育机构（CCIs）为超过 14000 名儿童提供住宿。这些儿童有很高的心理问题风险。然而，之前没有对 SL 机构化儿童的心理健康问题进行过科学研究。
调查居住在康堤地区儿童保育机构的儿童的情绪和行为问题，并探讨相关因素。
从康堤地区选择了 10 家儿童保育机构，并招募了所有 6-18 岁的儿童。
由照顾者填写儿童行为检查表（6-18 岁）-僧伽罗语版（CBCL-S），并得出相关问题得分。还收集了相关的社会人口统计学数据。
共有 259 名儿童参与。其中，66.8%是女性。平均年龄为 13.9 岁。平均照顾时间为 4.3 年。14%的儿童存在行为问题的临床水平，而 7%的儿童处于边缘状态。违规和攻击等外化问题比内化问题更常见（23.3%比 6.6%）。男童表现出更多的行为问题（p=0.034）。当前年龄、入院年龄、照顾时间、性虐待史、机构转移和家庭联系频率与行为问题无关。
表现出高水平外化问题的机构化儿童可能反映了心理社会发展的紊乱。然而，内化问题可能不容易被识别，部分原因是 SL 缺乏受过训练的照顾者。建议教育照顾者识别和转介有行为问题的儿童到精神科服务。
