武汉市4～16岁儿童青少年行为问题发生情况的调查与分析

Occurrence of behavioral problems among 4 to 16-year-old children and teenagers in Wuhan city

目的:了解儿童青少年行为问题的流行病学情况,探讨行为问题发生的相关因素。方法:采取整群随机抽样方式于2003-09/12在武汉市随机抽取2所幼儿园、2所小学、2所初中、2所高中。选取其中幼儿园中班、大班,小学1～6年级,初中1～3年级,和高中一年级共12个年级,按年级名册各随机选取男50名,女50名,共2400名。均为年龄4～16岁儿童,监护人同意参加。调查工具为行为问题调查量表。该量表包括:①一般项目:有性别、年龄、儿童生活主要照顾者、父母职业等。②环境量表:有亲子关系、父母经济状况、家庭大小、父母心理知识认知、教育认知、环境、父母对自己与孩子相处是否需要建议等项目(对各项目进行同趋势化处理,转换为低优即分越低越好,按1～5分共5个等级进行评分,并采用合计方式计算各纬度的得分,按人数计算各维度的平均分)。③应用Achenbach儿童行为量表中国标准化版做父母调查(113条行为问题,每条有0,1或2分称为粗分,113条粗分加起来称总粗分,再归纳为8～9个因子,计量其因子分),将该量表因子分与Achenbach儿童行为量表中国标准化版(父母用)诊断标准对照,判断该儿童是否具有该项行为异常。由各班主任将调查表分发给所选调查对象的家长,并负责向家长讲解调查表内容和填写方法,在发表1周后负责回收表格。结果:纳入儿童2400名,发放调查表2400份,回收调查表2205份,其中内容完整的2199份。由于年龄不符合的有71名,对2128名符合年龄条件和填写完整符合要求的调查表进入结果分析。①男童行为问题发生率明显高于女童(χ2CMH=1722.6350,P<0.01)。不同年龄段儿童行为异常发生率相似(P>0.05)。②12～16岁行为异常儿童中非父母照顾者所占百分比明显高于行为正常儿童(17.07%,3.64%,χ2CMH=15.7005,P<0.01)。③4～5岁行为异常男童父母的精神心理认知、家周围噪音污染和亲子关系评分和正常儿童相近(P>0.05);6～16岁行为异常儿童上述3项指标平分普遍高于正常儿童(t=-2.06～-6.77,P<0.05～0.01),随着年龄的增加,呈上升趋势。④4～5岁行为异常女童父母的精神心理认知和亲子关系评分均明显高于正常儿童(t=-2.26,-2.10,P<0.05)。结论:①儿童行为问题发生率存在性别差异,男性高于女性。②12～16岁行为异常儿童中非父母照顾者多于由父母照顾的正常儿童。③行为问题发生率可能与儿童的生活照顾者、亲子关系、父母的精神心理认知及家周围的噪音有关。④4～5岁儿童行为异常的发生与父母的精神心理认知、家周围噪音污染和亲子关系无关,但与性别有关。

AIM： To investigate the prevalence of behavioral problems in children and teenagers, and probe into the factors related to the occurrence of behavioral problems.METHODS： From September to December 2003, 2 kindergartens （middle class and older class）, 2 primary school （Grade 1 to 6）, 2 middle schools（Grade 1 to 3） and 2 senior high schools （Grade 1） in Wuhan city were selected by means of cluster random sampling. Fifty male and 50 female children in every class of every school were extracted randomly according to the list of class, and totally 2 400 children, aged 4 to 16 years old, were investigated with the permission of their caretaker by using the behavioral problem inventory, including ① general information： gender, age, main favorer of the children＇s daily life, jobs of parents, etc.. ② environmental scale： paternity, parental economic status, size of the family, parental psychological knowledge cognition, educational cognition, environment,whether the parents needed advice to get along with their children （each item received tendency treatment, and were transformed to low excellence,thai was, the lower score the better; The scores were divided into 5 degrees according to 1 to 5 points; The score of each dimension was calculated by means of summation, and then the average score was calculated according the number of subjects,） ③ All the parents were investigated with the Chinese standardized version of Achenbach＇s child behaviour checklist（including 113 items of behavioral problems, each item marked as 0, 1 or 2 points called raw score, and the summation of the raw scores of the 113 items was the total raw score, and then summed up into 8 to 9 factors, and the factor scores were calculated.）, and then the factor scores of this scale was compared with the diagnostic standard of the Chinese standardized version of Achenbach＇s child behaviour checklist for parents to judge whether the children was abnormal for this behavior. The inventories were sent out to the parents of the subjects by the teachers, who explained the contents and the filling method of the inventory to the parents, and the inventories were taken back by the teachers after one week,RESULTS： Totally 2 400 children participated, 2 400 inventories were sent out, and 2 205 of them were taken back, and 2 199 of them were complete in content, there were 71 subjects not in accordance with the standard of age, so finally 2128 inventories met the standards of age and filling were involved in the analysis of results. ① The occurrence rate of behavioral problems was higher in boys than in girls （ x^2 CMH= 1722.635 0, P〈 0.01）, and the occurrence rote of abnormal behavior was similar among children in different age groups （P 〉 0.05）. ② The percentage of children who were not taken care by their parents was obviously higher in boys at 12 to 16 years older with abnormal behavior than in those with normal behavior （17.07%, 3.64%, x^2CMH=15.700 5, P 〈 0.01）. ③ The scores of parental mental and psychological cognition, noise pollution around house and paternity in 4 to 5-year-old boys with abnormal behavior were close to those in normal children （P 〉 0.05）; Those were higher in 6 to 16-year-old boys with abnormal behavior （t=-2.06 to -6.77, P 〈 0.05 to 0.01）; It showed an rising tendency with the increase of age. ④ The scores of parental mental and ps~,chological cognition and paternity in 4 to 5-yearold girls with abnormal behavior were obviously higher than those in normal children （t=-2.26. -2.10. P 〈 0.05）.CONCLUSION： ①The occurrence rate of behavioral problems has gender difference, and it is higher in boys than in girls. ② More children at 12 to 16 years of age with abnormal behavior are not taken care by their parents.③ The occurrence rate of behavioral problem may be correlated with the main favorer of the children＇s daily life, paternity, parental mental and psychological cognition and noise pollution around house. ④ The occurrence of abnormal behavior in 4 to 5-year-old children has no association with parental mental and psychological cognition, noise pollution around house and paternity, but is correlated with gender.