单纯性肥胖儿童心理行为问题、自我意识及家庭因素研究

Behavioral problems,self-awareness and family factors in children with simple obese

目的调查单纯性肥胖儿童心理行为问题和自我意识水平及其相关家庭因素,为单纯性肥胖儿童的临床心理干预提供科学依据。方法选取50例单纯性肥胖儿童(肥胖组)和50例正常儿童(对照组)为研究对象,采用Piers-Harris儿童自我意识量表、Achenbach儿童行为量表、家庭环境量表中文版和父母教养方式评价量表对两组儿童进行评定,并运用相关性分析,探讨影响肥胖儿童的心理行为问题的高危家庭因素。结果与对照组相比,肥胖组儿童存在多项行为问题(P<0.05);自我意识水平低下。肥胖组儿童家庭环境中的情感表达[(3.16±1.93)分,(4.65±1.02)分]、知识性[(5.31±1.28)分,(6.10±1.83)分]和娱乐性[(2.78±1.36)分,(4.84±1.72)分]因子得分显著低于对照组,而矛盾性[(4.11±1.45)分,(3.32±1.27)分]、控制性[(6.42±1.37)分,(5.09±1.65)分]因子得分则较对照组明显升高(P<0.05);父母教养方式结果显示肥胖组儿童的父母情感温暖得分低于对照组(P<0.01),而父母拒绝否认、父惩罚严厉、父过分干涉、母过份干涉与保护因子得分均明显高于对照组(P<0.05)。相关性分析显示肥胖组儿童行为问题中的社会退缩与家庭环境中的情感表达呈负相关(r=-0.62,P<0.01),攻击问题与家庭环境中的矛盾性呈正相关(r=0.39,P<0.05),内化性行为问题与父母教养方式中母过分干涉与过度保护呈正相关(r=0.60,P<0.01);自我意识水平低与父母教养方式中的父、母的拒绝否认、父惩罚严厉呈正相关(r分别为0.46,0.51,0.44,均P<0.05)。结论单纯性肥胖儿童存在心理行为问题,自我意识水平下降,家庭因素是肥胖儿童心理、行为问题的重要影响因素。

Objective To investigate the the association between psychological behavior and self-awareness of obese children and family factors,in order to provide scientific basis for clinical intervention in obese children.Methods Fifty children with obesity(obesity group)and fifty healthy children(control group)were included in the study.All children were evaluated with the Achenbach Child Behavior Checklist(CBCL),Piers-Harris Child's self-concept Scale(PHCSS),Family Environment Scale-Chinese Version(FES-CV)and Egma Minnen av Bardndosnauppforstran(EMBU).Moreover,correlation analysis was applied in the study to explore family factors affecting behavioral problems and self-awareness of obese children.Results Compared with control group,significant higher ratio of abnormal behaviors was found in children with obesity(P<0.05).FES-CV showed that the degree of expressiveness((3.16±1.93),(4.65±1.02)),intellectual-cultural orientation((5.31±1.28),(6.10±1.83))and active-recreational((2.78±1.36),(4.84±1.72))were lower than control group,and the degree of family conflict((4.11±1.45),(3.32±1.27))and control((6.42±1.37),(5.09±1.65))were higher in children with obesity(P<0.05).Moreover,EMBU showed that emotional warmth score was significantly lower in obese group than that in control group(P<0.01),and the scores of parent's rejection,father's severity,parent's over-interference,and mother's over-protection were significantly higher than the scores in control group(P<0.05).In obese group,the correlation analyses showed a negative association between social withdrawal in children's behavioral problems and family expressiveness(r=-0.62,P<0.01),and a positive association between aggressivity and family conflict(r=0.39,P<0.05).There was a positive correlation between internalizing behavioral problems and mother's over-protection and over-interference(r=0.60,P<0.01).Low self-awareness was positive associated with parent's rejection and father's severity(r=0.46,0.51,0.44 respectively,P<0.05).Conclusion A significant higher risk of abnormal psychological behaviors and low self-concept can be found in children with obesity,which can closely related to family factors.