Laucht M, Esser G, Schmidt M H, Ihle W, Marcus A, Stöhr R M, Weindrich D
Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters des Zentralinstituts für Seelische Gesundheit in Mannheim.
Z Kinder Jugendpsychiatr Psychother. 1996 Jun;24(2):67-81.
The present investigation was concerned with the impact of prenatal and perinatal complications (biological risks) and of family adversity (psychosocial risks) on developmental status at age 4 1/2. In a prospective study the developmental course of 362 children (including 210 high-risk children) was followed from birth to age 4 1/2 years. A multilevel approach was used to assess all relevant domains of functioning (i.e. motor, cognitive and social-emotional development). The goal was to obtain information about the effects of biological and psychosocial risks alone and together on outcome in the different domains of functioning. The results show that psychosocial risk factors posed the greatest threat to normal development. Children with psychosocial risks were significantly behind those without such risks in all areas of functioning. Biological risks mainly affected motor development, their negative effects on cognitive and social-emotional functioning having been largely compensated for by age 4 1/2. The extent of an adverse outcome was related to both the degree of risk load and the number of risk factors, whereas interactions among risks were of only minor relevance. An adverse outcome is not inevitable, however: Despite the risks most of the at-risk children showed normal development at age 4 1/2.
本研究关注产前和围产期并发症（生物学风险）以及家庭逆境（心理社会风险）对4岁半儿童发育状况的影响。在一项前瞻性研究中，对362名儿童（包括210名高危儿童）从出生到4岁半的发育过程进行了跟踪。采用多层次方法评估所有相关功能领域（即运动、认知和社会情感发展）。目的是获取关于生物学和心理社会风险单独及共同对不同功能领域结果影响的信息。结果表明，心理社会风险因素对正常发育构成最大威胁。有心理社会风险的儿童在所有功能领域明显落后于无此类风险的儿童。生物学风险主要影响运动发育，到4岁半时，其对认知和社会情感功能的负面影响在很大程度上已得到补偿。不良后果的程度与风险负荷程度和风险因素数量均有关，而风险之间的相互作用相关性较小。然而，不良后果并非不可避免：尽管存在风险，但大多数高危儿童在4岁半时仍表现出正常发育。
