Transcript Child Behavior Checklist 兒童行為量表

Study on well-being of children
and their caregivers of the
incarcerated
在囚人士子女成長發展研究
Dr. Eric Chui 崔永康博士
Department of Social Work and Social Administration
The University of Hong Kong
香港大學社會工作及社會行政學系
Introduction – Child Development

Imprisonment of a parent brings about negative
consequences (Partners of Prisoners & Families Support
Group, 2007)
- Emotional level: learning to deal with new thoughts and
feelings such as shame, isolation, confusion and grief
- Behavioral change: aggression, difficulty concentrating,
anxious, withdrawn and clingy towards the remaining
parent or caregiver

Protective factors: social support from non-family
members, positive parent-child relationship, religiosity, a
positive sense of self (Nesmith and Ruhland, 2008)
Introduction - Caregiver well-being

Stigma and disclosure: Children and caregivers might suffer from
stigma attached to the imprisonment of a parent; the family may
therefore protect the child by requiring secrecy in certain settings
(Hagen and Myers, 2003)

Economic deprivation: the removal of a parent might lead to the loss
of an important “breadwinner” and the remaining parent might have
less time and less money to invest in the children (Laing and
McCarthy, 2002)

High level of parenting stress have been associated with parental
depression, less effective parenting behaviour, and poor child
outcomes (Loper, Carlson, Levitt, & Scheffel, 2009)
Background and Aim
背景


A joint investigation with the “Blue Bus – Trip for
Growth” project, the Society of Rehabilitation
and Crime Prevention, Hong Kong(香港善導會藍
巴士--成長之旅合作進行研究)
Aims of the study: to examine competences and
behaviour patterns of offender’s child(兒童行為)
and the relation with caregiver’s psychological
well-being (照顧者的身心健康)
Method
研究方法
80 caregivers (照顧者) were asked to complete a
questionnaire :
(1) General Health Questionnaire (GHQ) (健康狀況
量表)
(2) Social Support scale (社會支援量表)
(3) Stress level scale (生活壓力量表)
(4) Beck Depression Inventory (貝克憂鬱量表 )
(5) Discrimination scale (面對的社會歧視量表)
(6) Child Behaviour Checklist (CBCL)(兒童行為量表)
Caregiver's
Beck Depression Inventory
Caregiver’s
well-being
100%
90%
貝克憂鬱量表
80%
70%
60%
50%
* Source: Mittelman, M. S.,
Brodaty, H., Wallen, A. S., &
Burns, A. (2008). A threecountry randomized controlled
trial of a psychosocial
intervention for caregivers
combined with pharmacological
treatment for patients with
Alzheimer disease: effects on
caregiver depression. The
American Journal of Geriatric
Psychiatry, 16, 893-904.
40%
30%
20%
10%
0%
Blue Bus
service user
No/ Minimal
Mild
Moderate
Severe
35
Caregiver
across 3
countries*
81.8
10
14.3
17.5
3.9
18.8
0
Target groups
Caregiver’s well-being &
mediation study with child’s
behavior
照顧者的身心健康與兒童行為問題
Correlations between caregiver’s well-being &
CBCL *照顧者的身心健康與兒童行為量表
Social support
Perceived
discrimi
nation
(面對的社會
歧視 )
Stress
Depression
General
health
(生活壓力)
(抑鬱)
(健康狀況 )
-
-
-
.43
-.31
-
-
.35
.49
-.31
Withdrawn (退縮行為)
-
-
-
.35
-.28
Somatic complaints (抱怨身體
症狀)
-
-
-
.41
-.30
Anxious-depressed (憂鬱/焦慮)
-
-
-
.41
-.21
-.29
-
.28
.41
-.50
-
.28
-
.31
-
Social (社交問題)
-
-
-
.32
-.29
Thought (問題思想)
-.34
.35
-
.49
-.22
Attention (注意力問題)
-
-
-
.37
-.28
(社會支援 )
Problem Scale (問題量表)
Internalizing (內化問題 )
Externalizing (外化問題 )
Delinquent (犯罪行為)
*p<.05
Mediating Effect of Caregiver’s Depression
between Caregiver’s Stress and Child’s problems
仲介效應分析 :看護者的生活壓力 、抑鬱和兒童行為問題


The stress perceived by the caregiver was associated positively with
the severity of the problem presented by the child, including
emotional disturbance and disruptive behaviors, as measured by
CBCL
The psychological wellbeing of the caregiver, measured in terms of
levels of depression, would mediate the above relationship
照顧者的生活壓力對自兒童的外化及內化問題均有直接效果
(direct effect)，而抑鬱作為一個中介變項(mediation
variable)則解讀了兩者間的關聯。
研究成果表明，在囚/更生人士孩子的照顧者在生活中面臨很
大的壓力，並有明顯抑鬱徵兆。這些精神及情緒問題更直
接影響他們照顧的孩子，誘發孩子的行為和情緒問題。
Child Behavior Checklist
兒童行為量表
Child Behavior Checklist
兒童行為量表
*The Child Behavior Checklist (CBCL) assesses social competencies and behavioral problems of children as reported by parents. Social
competencies are measured by the 20-item Competence Scales, which consist of three sub-scales (i.e. activities, social, and school).
The Problem Scales consist of 120 items on behavior or emotional problems during the past 6 months, and assess internalizing
problems (i.e., withdrawn, anxious/ depressive behaviors, & somatic complaints) and externalizing problems (i.e., delinquent &
aggressive behaviors), as well as social, thought, & attention problems (Leung et al., 2006).
Child Behavior Checklist
兒童行為量表
*Cases defined by borderline cutoff, which include scores falling within the borderline clinical and abnormal ranges
(Achenbach, 1991)
** Source: Chang, S., Ng, C., & Wong, S. (2002). Behavioral problems in children and parenting stress associated with
primary nocturnal enuresis in Hong Kong. Acta Paediatrica, 91, 475-479.
Child Behavior Checklist
兒童行為量表

Compared with general population:

Fewer Blue Bus service users are categorized as
problematic cases in Competence Scale and
more cases in Problem Scale
在服務使用者的組別中，有較多的兒童出現行為和情
緒問題，包括外化及內化問題，卻有較少的能力問
題個案。
Child Behavior Checklist &
disclosure of parent’s
incarceration
孩子的行為問題與是否知悉父母
被捕入獄
Condition of Disclosure
孩子的行為問題與是否知悉父被捕入獄
Age first learnt about parent’s incarceration
•3-14 years old
•Mean age = 7.26, SD = 2.9
If the child know the parent’s incarceration (知悉父被捕入獄)
Frequency
Percent
No
29
36.3
Yes
51
63.8
From where did the child learn the incarceration
Frequency
Percent
Incarcerated parent
11
22.0
Caregiver
31
62.0
9
16.0
Other
* Other includes learning from other relatives, overhearing the issue from family’s conversations, social
worker, and the child discovers the issue by himself.
Difference of Disclose or not
孩子的行為問題與是否知悉父母被捕入獄
Mean（平均分）
F
Sig
Not Disclose
(N=13)
Disclose
(N=46)
40.4
46.3
-1.73
.09
Anxious/ Depressed (憂鬱/焦慮)
61.0
56.2
1.95
.06
Social (社交問題)
59.7
54.7
2.23
.00
Attention (注意力問題)
62.0
54.9
3.08
.04
Aggressive (攻擊行為)
58.4
54.4
2.04
.05
Competencies Scale (能力量表)
Problem Scale (問題量表)
Difference of Disclose or not
孩子的行為問題與是否知悉父母被捕入獄


Disclose/ not has a relation with child’s wellbeing
Children who do not know the incarceration
score poorer on the competence scale and 3 of
the problem sub-scales, i.e. being less
competent and having more behavioral problems
在不知道的組別中，有較多的兒童出現注意力問題、攻
擊性行為及社交問題。