Verhulst F C, Althaus M
Department of Child Psychiatry, Academic Hospital Rotterdam - Sophia Children's Hospital, The Netherland.
Acta Psychiatr Scand Suppl. 1988;339:1-28. doi: 10.1111/j.1600-0447.1988.tb10567.x.
Crucial to our understanding of psychopathology in children is information on the stability and change of behavioral/emotional problems and competencies across time. Existing studies, reviewed in this article, provide only limited answers due to one or more of the following factors: restriction of the sample to a single locality, the use of selected samples, large sample attrition, the use of different assessment instruments at different times, the small number of specific behavioral/emotional problems or the use of very broad categories of functioning. The present study was designed to test the persistence and change of behavioral/emotional problems and competencies as reported by parents of 1,412 children aged 4-14 over a two-year period in a representative sample of the general population. At both points, standardized parents' reports were obtained using the Achenbach Child Behavior Checklist (CBCL). A recovery rate of 80.2% was obtained. Our study is the only one, as far as we known, to present follow-up data separately for ages covering the preschool period to adolescence, making it possible to compare stabilities in the occurence of behavioral/emotional problems across various developmental levels. Over the two-year follow-up period, there was a significant decrease in problem scores. Although possible, it is unlikely that the mental health of children in our sample increased very much. A decrease in problem scores over time has been demonstrated for clinical as well as general population samples in other studies as well. No satisfactory explanations are available for this phenomenon. It is important, however, that studies employing a retest design take account of this phenomenon. Irrespective of changes in the magnitude of group scores over time, stability coefficients can tell us whether individual children tend to preserve their rank orders. The stability coefficients between Time 1 and Time 2 total problem scores ranged from .62 (girls, aged 4-5) to .71 (boys, aged 6-11). No significant differences between stability coefficients for different age-groups and for both sexes could be demonstrated. The changes in scores across time for individual items were consistent with the cross-sectional data of our earlier study (Verhulst et al. Acta Psychiatrica Scandinavica, 1985, 72, suppl. 323). Stability coefficients for social competence scores at both times of assessment were generally somewhat weaker than those found for problem scores.(ABSTRACT TRUNCATED AT 400 WORDS)
对于我们理解儿童精神病理学而言，有关行为/情绪问题及能力随时间推移的稳定性和变化情况的信息至关重要。本文所综述的现有研究，由于存在以下一个或多个因素，仅提供了有限的答案：样本局限于单一地区、使用选定样本、样本大量流失、在不同时间使用不同评估工具、特定行为/情绪问题数量较少或使用非常宽泛的功能类别。本研究旨在测试1412名4至14岁儿童的父母报告的行为/情绪问题及能力在两年期间的持续性和变化情况，该样本具有一般人群的代表性。在两个时间点，均使用阿肯巴克儿童行为量表（CBCL）获取标准化的父母报告。回收率为80.2%。据我们所知，我们的研究是唯一一项分别给出涵盖学龄前到青春期各年龄段随访数据的研究，这使得比较不同发育水平上行为/情绪问题发生情况的稳定性成为可能。在两年的随访期内，问题得分显著下降。虽然有可能，但我们样本中儿童的心理健康状况不太可能有很大改善。在其他研究中，临床样本和一般人群样本也都显示问题得分随时间下降。对于这一现象尚无令人满意的解释。然而，采用重测设计的研究考虑到这一现象很重要。无论群体得分随时间的变化幅度如何，稳定性系数都能告诉我们个体儿童是否倾向于保持其排名顺序。时间1和时间2的总问题得分之间的稳定性系数范围从0.62（4至5岁女孩）到0.71（6至11岁男孩）。不同年龄组和男女之间的稳定性系数没有显著差异。各个项目得分随时间的变化与我们早期研究（Verhulst等人，《斯堪的纳维亚精神病学学报》，1985年，72卷，增刊323）的横断面数据一致。两个评估时间点的社会能力得分的稳定性系数通常比问题得分的稳定性系数略弱。（摘要截取自400字）
