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荷兰儿童的心理健康:(二)。精神障碍的患病率及测量指标之间的关系。

Mental health in Dutch children: (II). The prevalence of psychiatric disorder and relationship between measures.

作者信息

Verhulst F C, Berden G F, Sanders-Woudstra J A

出版信息

Acta Psychiatr Scand Suppl. 1985;324:1-45. doi: 10.1111/j.1600-0447.1985.tb10513.x.

Abstract

This study concerns the second, more clinically oriented, part of our epidemiological project. The prevalence of child psychiatric disorders in random samples of 8- and 11-year-old children is assessed by using standardized parent- and child-interviews. The relationships between different measures of child psychopathology are determined. Furthermore, additional validity measures of the Child Behavior Checklist (CBCL) and Teacher Report Form (TRF) developed by Achenbach, are provided. Of the 153 8- and 11-year-old children selected through a two-stage sampling procedure, 116 (76%) children and their parents were intensively clinically assessed. The correlation between CBCL and direct child assessment is .42, whereas the correlation between the TRF and direct child assessment is .28. The correlation between TRF and CBCL is .26. The implications of the low correlation between raters who saw children is different situations are emphasized. The weight given to reports from different sources varies with the kind of problem the child exhibits. It is concluded that more research is needed to investigate the relative value of different types of data for different conditions. Seven percent of the 8- and 11-year-olds were judged severely disordered, whereas for 26% the clinicians judged the child to be moderately or severely disordered. The high prevalence rates found in our study compared with others is partly attributed to the arbitrary nature of clinical judgement. ANOVAs and discriminant function analysis were performed to obtain those CBCL items that showed the best discrimination between children who were clinically judged disordered and children from the normative comparison group. Many items found to be good discriminators of clinical status in this study were among the best discriminators of referral status in the earlier reported part of the study. A number of family and social factors were found to be associated with psychiatric disorder. These findings support those in other studies.

摘要

本研究关注我们流行病学项目中更具临床导向性的第二部分。通过使用标准化的家长访谈和儿童访谈,评估8岁和11岁儿童随机样本中儿童精神障碍的患病率。确定儿童精神病理学不同测量方法之间的关系。此外,还提供了由阿肯巴克编制的儿童行为量表(CBCL)和教师报告表(TRF)的其他效度测量方法。在通过两阶段抽样程序选取的153名8岁和11岁儿童中,有116名(76%)儿童及其家长接受了深入的临床评估。CBCL与儿童直接评估之间的相关性为0.42,而TRF与儿童直接评估之间的相关性为0.28。TRF与CBCL之间的相关性为0.26。强调了在不同情况下观察儿童的评估者之间低相关性的影响。给予不同来源报告的权重因儿童表现出的问题类型而异。得出的结论是,需要更多研究来调查不同类型数据在不同情况下的相对价值。8岁和11岁儿童中有7%被判定为严重障碍,而临床医生判定26%的儿童为中度或重度障碍。与其他研究相比,我们研究中发现的高患病率部分归因于临床判断的随意性。进行了方差分析和判别函数分析,以获得那些在临床判定为障碍的儿童与正常对照组儿童之间表现出最佳区分度的CBCL项目。在本研究中发现的许多对临床状态有良好区分度的项目,是该研究早期报告部分中对转诊状态最佳区分度的项目之一。发现一些家庭和社会因素与精神障碍有关。这些发现支持了其他研究中的发现。

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