儿童青少年品行障碍门诊病案分析

目的了解儿童及青少年品行障碍的发生情况及其相关因素。方法以l990年1月至2001年12月期间就诊的96例品行障碍者(年龄在8～18岁之间)作为病例组，根据当时的病历记载所需资料内容．与对正常健康儿童及青少年的调查内容作对照。结果96例品行障碍者以男性多于女性．且随年龄增长有呈逐年增长的趋势，其中以12～15岁为发病率最高。父母文化程度、教育方式及教育态度对品行障碍的发生有着直接影响。结论儿童及青少年品行障碍的发生虽取决于多种因素，但是与其父母的文化程度、家庭教养方式及教育态度有着密切的关系。     

儿童品行障碍危险因素分析

对１０８例儿童品行障碍患者和２３４例正常儿童进行对照研究。结果表明，单亲家庭，家庭关系紧张，父母亲文化程度低，体力劳动者，父亲性格内向，家庭管教方式不良，学龄前寄养，家庭生活事件，学习成绩关东良伙伴等研究组明显高于对照组，两者之间有显著差异，说明上述因素与品行障碍的形成有密切关系。     

注意缺陷多动障碍与家庭因素

近年来,儿童注意缺陷多动障碍（ADHD）的研究在国内外受到广泛关注.美国儿科协会临床指南指出学龄儿童ADHD的患病率为4％～12％,是一种最常见的儿童心理行为疾病[1].我国选用DSM-Ⅳ的注意缺陷多动障碍诊断标准,近年调查学龄儿童检出率为3.94％～6.3％[2-4],调查数据普遍低于国外的数据,但总体呈上升趋势.儿童ADHD核心症状为注意力不集中、多动与冲动,它的病因目前仍不清楚,一般认为是由遗传和环境因素引起的一种心理行为性疾病.近年经许多回顾研究表明,ADHD儿童的不良行为与家庭环境因素和养育方式等具有一定的相关性,现在对此作一综述.关键词：注意缺陷多动障碍;家庭环境;教养方式;依恋     

强迫症患者的防御方式及其家庭因素研究

目的 探讨强迫症患者的防御方式、家庭环境及其父母教养方式的特点。方法 采用防御方式问卷（DSQ）、家庭环境量表（FES—CV）及父母教养方式评价量表（EMBU）对36例强迫症患者（强迫症组）进行了问卷调查,并与36例正常受试者（对照组）加以比较。结果 ①强迫症组不成熟和中间防御机制因子评分均明显高于对照组,而成熟防御机制因子评分则明显低于对照组（P〈0．05或P〈0．01）;②强迫症组家庭亲密度、情感表达及娱乐性评分均明显低于对照组,而矛盾性及控制性评分则明显高于对照组（P〈0．05或P〈0．01）;③强迫症组父母惩罚及过分拒绝因子评分均明显高于对照组（P〈0．05或P〈0．01）;另外患者父亲的情感温暖因子评分极明显低于对照组（P〈0．01）,而过度保护因子评分则明显高于对照组（P〈0．05）。结论 强迫症患者的防御方式、家庭环境及父母教养方式与正常人相比有其特点,可以针对其特点进行相应的心理干预。     

品行障碍患儿父母养育方式及应付方式的研究

目的:探讨父母养育方式对品行障碍患儿的应付方式的影响。方法:采用父母养育方式评价量表(EMBU)及应付方式问卷(CSQ)对46例品行障碍患儿和46名正常儿童为对照进行评估,并对父母养育方式与应付方式作相关分析。结果:品行障碍组患儿父母的情感温暖因子分明显低于对照组,而其他各项因子分(除父母的偏爱被试及父亲的过分干涉、过度保护外)则均明显高于对照组(P<0.05或P<0.01);品行障碍组解决问题评分明显低于对照组,而自责、求助、幻想、退避因子分则明显高于对照组(P<0.01);品行障碍组解决问题、求助与父母的情感温暖因子呈正相关,而与其他各项因子呈负相关;自责、退避与父母的情感温暖因子呈负相关,而与其他各项因子呈正相关。结论:品行障碍患儿多采用消极的应付方式,与父母的养育方式明显相关。     

父母教养方式和3岁学龄前儿童品行问题的关系

目的以学龄前3岁儿童为对象,探讨父母教养方式与品行问题的关系。方法对深圳市龙华区新入园儿童进行调查,采用一般情况问卷、父母教养方式(Egna Minnen Betraffande Uppfostran-Parents,EMBU-P)问卷、Conners父母用症状量表中品行问题因子向主要照护人收集儿童一般情况、父母教养方式和儿童品行问题等资料。共发放10972份问卷,回收9289份有效问卷。使用logistic回归分析教养方式与儿童品行问题的关系。结果 349名(3.8%)儿童品行问题因子得分高于临界值。在控制父母年龄、父母教育水平、家庭收入等混杂因素后,儿童品行问题与父母拒绝(OR=1.17,P0.01)、控制/过度保护(OR=1.03,P0.01)和情感温暖(OR=0.98,P0.01)的关联有统计学意义。分层分析结果显示,父母拒绝(OR_父=1.16,P0.01;OR母=1.17,P0.01)、父亲的情感温暖(OR_父=0.96,P0.01)和母亲的控制/过度保护(OR_母=1.04,P0.01)与品行问题存在统计学关联,该关联在不同性别、独生与非独生儿童中基本相同。结论父母教养方式可能是学龄前儿童品行问题的影响因素,在预防和治疗儿童品行问题时应给予关注。     

18例少女品行障碍的临床资料初步分析

近三年到我院就诊的品行障碍者38例,其中男性20例,女性18例。本文兹就后者的临床资料进行初步分析。现报道于后。     

品行障碍暴力攻击行为的生物学影响因素

品行障碍是在儿童青少年时期发生的严重行为障碍,不仅影响儿童青少年的健康成长,而且可能造成社会问题.暴力攻击行为是品行障碍最突出的症状表现之一,其与品行障碍之间的联系以及潜在的生物学机制在近年来随着相关技术条件的发展而逐步受到研究者关注.本文对目前研究较多的生物学因素进行了总结,旨在对儿童青少年品行障碍暴力攻击行为的病因探索以及针对性预防干预研究提供参考信息.     

Lithium and conduct disorder

Lithium administration has been effective in treating severe aggression in children and adolescents with Conduct Disorder. An overview of the pertinent literature is presented. Side effects associated with lithium administration are discussed. Guidelines for lithium administration are given, including dosage regulation, monitoring of serum lithium, as well as of side effects and laboratory measures. When prescribed judiciously, under careful monitoring, lithium can be an important part of the comprehensive treatment program.     

Risk factors for conduct disorder among Navajo Indian men and women

Objectives: To describe the risk factors for conduct disorder before age 15 among Navajo Indians. Methods. The study was based on a survey of a stratified random sample of adult Navajo Indians between the ages of 21 and 65 living on and adjacent to two different areas of the Navajo Reservation. There were 531 male and 203 female respondents. The average age (SD) of the men was 38.7 (10.5) years and of the women 35.5 (9.0) years. Conduct disorder was diagnosed retrospectively using the Diagnostic Interview Schedule first developed for the Epidemiological Catchment Area study. The responses were combined into a continuous scale. Results: Significant risk factors for increased scores on the conduct disorder scale were: histories of physical and sexual abuse in childhood; abusive maternal drinking; a small number of households per camp; younger age; and being male rather than female. Measures of social status and religion in which subjects were raised were not significant. Conclusions: Many of the risk factors that are associated with conduct disorder in other populations are also risk factors in the Navajo population. There is suggestive evidence that some of these risk factors have become more common since World War II, raising the possibility that conduct disorder has become more prevalent, as is thought to be the case nationwide. Accepted: 1 June 1998     

Diagnosis and pharmacotherapy of conduct disorder

Lavin Michael R. and Arthur Rifkin: Diagnosis and Pharmacotherapy of Conduct Disorders. Prog. Neuro- Psychopharmacol. & Biol. Psychiat. 1993, 17(6): 875–885.

1. 1. There are few double-blind, placebo-controlled studies of the drug treatment of conduct disorders in children and adolescents.

2. 2. The diagnosis of conduct disorders involves a persistent pattern of behavior in which the basic rights of others and standards of society are violated.

3. 3. There is frequent comorbidity associated with conduct disorders including attention-deficit hyperactivity disorder, oppositional defiant disorder, mood disorders and substance abuse.

4. 4. Childhood Conduct disorder is associated with a significant risk for adult psychopathology.

5. 5. A variety of treatment approaches may be employed to combat conduct disorders.

6. 6. The use of neuroleptics, lithium carbonate, stimulants and other agents is reviewed.