母亲童年期不良经历与学龄前儿童情绪行为问题的关联

余伟强; 李若瑜; 黄永玲; 何海燕; 彭春燕; 王心柱; 万宇辉

doi:10.16835/j.cnki.1000-9817.2022.08.003

母亲童年期不良经历与学龄前儿童情绪行为问题的关联

doi: 10.16835/j.cnki.1000-9817.2022.08.003

1.
安徽医科大学公共卫生学院儿少卫生与妇幼保健学系/出生人口健康教育部重点实验室/人口健康与优生安徽省重点实验室，合肥 230032
2.
安徽省妇女儿童保健中心儿童保健科
3.
芜湖市妇幼保健院儿童保健科
4.
六安市妇幼保健院儿童保健科
5.
阜阳市妇幼保健院儿童保健科

基金项目:

安徽省自然科学基金优青项目 2208085Y23

国家自然科学基金项目 82073576

国家自然科学基金项目 81773453

详细信息

作者简介:
余伟强(1999-)，男，安徽安庆人，在读硕士，主要研究方向为儿童心理行为问题

通讯作者:
万宇辉，E-mail: wyhayd@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G78 B844.1 R179
计量
- 文章访问数: 797
- HTML全文浏览量: 312
- PDF下载量: 97
- 被引次数: 0
出版历程
- 收稿日期: 2022-05-05
- 修回日期: 2022-06-22
- 网络出版日期: 2022-08-24
- 刊出日期: 2022-08-25

Relationship between maternal adverse childhood experiences and preschool children's emotional and behavioral problems

1.
Department of Maternal, Child & Adolescent Health, School of Public Health/MOE Key Laboratory of Population Health across Life Cycle/Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei(230032), China

摘要

摘要: 目的探讨母亲童年期不良经历(adverse childhood experiences, ACEs)与学龄前儿童情绪行为问题(emotional and behavioral problems, EBPs)的关联及性别差异，为促进学龄前儿童身心健康提供参考。方法采用分层整群抽样方法，于2021年6月选取安徽省阜阳、芜湖、六安3个地区城乡幼儿园9 647名学龄前儿童为研究对象，采用世界卫生组织童年期不良经历问卷(ACEs-IQ)及长处和困难问卷(SDQ)分别调查母亲ACEs及学龄前儿童EBPs。结果学龄前儿童困难问题、情绪症状、品行问题、多动障碍、同伴交往问题、亲社会行为检出率分别为17.4%，16.3%，18.3%，22.7%，34.2%，18.5%。多因素Logistic回归分析结果显示，母亲不同类型ACEs均与学龄前儿童EBPs的发生风险升高有关(OR=1.51~2.97，P值均 < 0.01);随着母亲ACEs种类数增加，儿童EBPs发生风险也随之上升(OR=3.13~9.61，P值均 < 0.01)。母亲情感虐待、躯体虐待和社区暴力与学龄前儿童同伴交往问题的关联，男童高于女童(ROR值分别为1.25，1.26，1.41，P值均 < 0.05)。结论母亲ACEs与学龄前儿童EBPs发生风险的升高相关，关注母亲ACEs有益于学龄前儿童EBPs防控。
- 生活变动事件 /
- 母亲 /
- 情绪 /
- 行为 /
- 回归分析 /
- 儿童，学龄前
Abstract: Objective To explore the relationship and gender difference between maternal adverse childhood experiences (ACEs) with emotional and behavioral problems (EBPs) in preschool children, and to provide a reference to promote emotional and behavioral problems among preschool children. Methods Using the method of stratified cluster sampling, 9 647 children from kindergartens in three cities of Anhui Province were selected in June 2021. Maternal adverse childhood experiences were investigated with the WHO Adverse Childhood Experiences International Questionnaire(ACEs-IQ), preschool children's emotional and behavioral problems were investigated with Strengths and Difficulties Questionnaire. Results The detection rate of abnormal emotional behavior was 17.4%, emotional symptoms 16.3%, conduct problems 18.3%, hyperactivity 22.7%, peer problems 34.2%, prosocial behaviors 18.5%. Multivariate Logistic regression analysis showed that maternal adverse childhood experiences were positively associated with the risk of emotional and behavioral problems (OR=1.51-2.97, P < 0.01). Maternal cumulative adverse childhood experiences were also positively associated with the risk of emotional and behavioral problems(OR=3.13-9.61, P < 0.01). The association of maternal emotional abuse, physical abuse and community violence with peer problems were stronger in boys than that of girls (ROR=1.25, 1.26, 1.41, P < 0.05). Conclusion The findings suggest maternal adverse childhood experiences were associated with emotional behavior problems among preschool children. Focusing on the maternal adverse childhood experiences is crucial for the prevention and control of childhood emotional and behavioral problems.
- Life change events /
- Mothers /
- Emotions /
- Behavior /
- Regression analysis /
- Child, preschool
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

表 1 母亲童年期不良经历与学龄前儿童情绪行为问题关联的Logistic回归分析[n=9 647，OR值(OR值95%CI)]

Table 1. Logistic regression analysis on the relationship between maternal adverse childhood experiences and preschool children's emotional and behavioral problems[n=9 647, OR(OR 95%CI)]

自变量	情绪症状	品行问题	多动障碍	同伴交往问题	亲社会行为	困难问题
情感虐待	2.17(1.92~2.46)^**	2.35(2.09~2.65)^**	1.70(1.51~1.90)^**	1.55(1.39~1.72)^**	1.26(1.11~1.43)^**	2.47(2.19~2.79)^**
躯体虐待	1.77(1.57~1.99)^**	2.24(2.00~2.52)^**	1.90(1.70~2.11)^**	1.39(1.26~1.54)^**	1.37(1.21~1.54)^**	2.32(2.06~2.60)^**
性虐待	2.82(2.23~3.58)^**	2.71(2.15~3.41)^**	1.56(1.22~1.98)^**	1.84(1.47~2.29)^**	1.62(1.26~2.09)^**	2.97(2.35~3.75)^**
情感忽视	2.59(2.12~3.15)^**	2.04(1.72~2.43)^**	2.11(1.81~2.47)^**	1.42(1.26~1.61)^**	1.33(1.14~1.55)^**	2.87(2.36~3.48)^**
躯体忽视	1.67(1.49~1.88)^**	1.45(1.30~1.62)^**	1.49(1.34~1.65)^**	1.37(1.25~1.50)^**	1.14(1.01~1.27)^*	1.78(1.59~1.99)^**
同伴欺凌	2.40(2.10~2.75)^**	2.28(2.00~2.60)^**	1.83(1.61~2.07)^**	1.66(1.48~1.87)^**	1.27(1.11~1.47)^**	2.61(2.29~2.98)^**
社区暴力	1.96(1.72~2.25)^**	1.77(1.55~2.02)^**	1.60(1.40~1.81)^**	1.38(1.23~1.55)^**	1.13(0.97~1.29)	2.05(1.80~2.34)^**
家庭功能不全	1.47(1.32~1.64)^**	1.54(1.39~1.71)^**	1.38(1.25~1.52)^**	1.16(1.06~1.26)^**	1.13(1.02~1.25)^*	1.51(1.36~1.68)^**
ACEs种类数
1~2	3.09(2.28~4.18)^**	2.18(1.70~2.80)^**	2.07(1.67~2.57)^**	1.26(1.08~1.47)^**	1.37(1.12~1.67)^**	3.13(2.32~4.23)^**
3~4	4.52(3.32~6.16)^**	3.42(2.65~4.43)^**	3.14(2.51~3.92)^**	1.52(1.28~1.79)^**	1.55(1.26~1.91)^**	5.42(4.00~7.36)^**
5~8	8.07(5.88~11.08)^**	5.96(4.56~7.79)^**	4.15(3.27~5.26)^**	2.32(1.93~2.79)^**	1.77(1.41~2.23)^**	9.61(7.02~13.16)^**
注： P < 0.05，*P < 0.01;ACEs为母亲童年期不良经历。

下载: 导出CSV

表 2 母亲童年期不良经历暴露与学龄前男童情绪行为问题关联的Logistic回归分析[n=4 983, OR值(OR值95%CI)]

Table 2. Logistic regression analysis on the relationship between maternal adverse childhood experiences and preschool boy's emotional and behavioral problems[n=4 983, OR(OR 95%CI)]

自变量	情绪症状	品行问题	多动障碍	同伴交往问题	亲社会行为	困难问题
情感虐待	2.27(1.90~2.71)^**	2.55(2.17~3.00)^**	1.75(1.50~2.04)^**	1.72(1.48~1.99)^**	1.30(1.10~1.54)^**	2.74(2.33~3.22)^**
躯体虐待	1.87(1.57~2.22)^**	2.46(2.10~2.87)^**	1.95(1.68~2.25)^**	1.55(1.35~1.78)^**	1.50(1.28~1.75)^**	2.50(2.14~2.92)^**
性虐待	3.19(2.31~4.41)^**	2.65(1.94~3.64)^**	1.52(1.10~2.09)^**	1.88(1.39~2.54)^**	1.52(1.09~2.12)^*	2.82(2.05~3.87)^**
情感忽视	2.39(1.81~3.14)^**	2.00(1.59~2.51)^**	1.94(1.59~2.36)^**	1.39(1.18~1.64)^**	1.30(1.07~1.58)^**	2.75(2.14~3.54)^**
躯体忽视	1.77(1.49~2.08)^**	1.52(1.31~1.77)^**	1.62(1.41~1.86)^**	1.43(1.26~1.62)^**	1.11(0.96~1.29)	1.84(1.58~2.14)^**
同伴欺凌	2.41(1.99~2.91)^**	2.35(1.97~2.80)^**	1.89(1.59~2.23)^**	1.74(1.48~2.04)^**	1.31(1.09~1.58)^**	2.78(2.33~3.31)^**
社区暴力	1.97(1.62~2.39)^**	1.64(1.42~1.97)^**	1.64(1.38~1.94)^**	1.62(1.38~1.90)^**	1.23(1.02~1.48)^*	2.07(1.73~2.48)^**
家庭功能不全	1.51(1.28~1.76)^**	1.63(1.42~1.89)^**	1.40(1.23~1.59)^**	1.20(1.07~1.35)^**	1.16(1.01~1.33)^*	1.58(1.37~1.83)^**
ACEs种类数
1~2	2.60(1.72~3.93)^**	2.25(1.60~3.16)^**	1.85(1.41~2.42)^**	1.18(0.96~1.45)	1.25(0.97~1.61)	2.77(1.89~4.05)^**
3~4	3.90(2.55~5.94)^**	3.65(2.57~5.19)^**	2.93(2.21~3.88)^**	1.46(1.17~1.83)^**	1.50(1.14~1.96)^**	4.99(3.38~7.36)^**
5~8	7.02(4.55~10.83)^**	6.56(4.56~9.45)^**	3.93(2.90~5.32)^**	2.45(1.91~3.14)^**	1.78(1.32~2.38)^**	9.21(6.17~13.77)^**
注： P < 0.05，*P < 0.01;ACEs为母亲童年期不良经历。

下载: 导出CSV

表 3 母亲童年期不良经历暴露与学龄前女童情绪行为问题关联的Logistic回归分析[n=4 664, OR值(OR值95%CI)]

Table 3. Logistic regression analysis on the relationship between maternal adverse childhood experiences and preschool girl's emotional and behavioral problems[n=4 664, OR(OR 95%CI)]

自变量	情绪症状	品行问题	多动障碍	同伴交往问题	亲社会行为	困难问题
情感虐待	2.09(1.76~2.48)^**	2.16(1.82~2.57)^**	1.63(1.37~1.94)^**	1.38(1.18~1.61)^**	1.21(1.00~1.47)	2.19(1.83~2.62)^**
躯体虐待	1.68(1.42~1.99)^**	2.03(1.72~2.41)^**	1.83(1.55~2.16)^**	1.23(1.06~1.43)^**	1.20(1.00~1.45)	2.12(1.78~2.52)^**
性虐待	2.48(1.76~3.49)^**	2.78(1.97~3.90)^**	1.62(1.12~2.34)^*	1.78(1.28~2.48)^**	1.76(1.20~2.26)^**	3.14(2.22~4.44)^**
情感忽视	2.80(2.11~3.71)^**	2.12(1.63~2.76)^**	2.45(1.89~3.18)^**	1.47(1.22~1.77)^**	1.37(1.08~1.75)^**	3.03(2.23~4.12)^**
躯体忽视	1.60(1.36~1.88)^**	1.38(1.17~1.63)^**	1.33(1.14~1.56)^**	1.31(1.14~1.50)^**	1.17(0.98~1.39)	1.70(1.44~2.01)^**
同伴欺凌	2.43(2.01~2.93)^**	2.20(1.82~2.67)^**	1.76(1.45~2.13)^**	1.56(1.31~1.86)^**	1.23(0.99~1.53)	2.45(2.01~2.98)^**
社区暴力	1.97(1.63~2.38)^**	1.87(1.54~2.26)^**	1.55(1.27~1.88)^**	1.15(0.96~1.36)	0.98(0.78~1.23)	2.05(1.68~2.50)^**
家庭功能不全	1.44(1.24~1.68)^**	1.44(1.23~1.67)^**	1.35(1.16~1.57)^**	1.11(0.98~1.26)	1.11(0.94~1.29)	1.43(1.22~1.68)^**
ACEs种类数
1~2	3.67(2.36~5.71)^**	2.11(1.46~3.05)^**	2.49(1.74~3.56)^**	1.37(1.08~1.73)^**	1.56(1.13~2.14)^**	3.74(2.30~6.08)^**
3~4	5.28(3.36~8.31)^**	3.20(2.19~4.68)^**	3.55(2.45~5.14)^**	1.61(1.25~2.07)^**	1.65(1.18~2.32)^**	6.21(3.78~10.20)^**
5~8	9.31(5.85~14.82)^**	5.38(3.63~7.98)^**	4.59(3.11~6.78)^**	2.17(1.65~2.87)^**	1.76(1.21~2.55)^**	10.42(6.27~17.31)^**
注： P < 0.05，*P < 0.01;ACEs为母亲童年期不良经历。

下载: 导出CSV

参考文献(23)

[1]	孟昭兰. 情绪心理学[M]. 北京: 北京大学出版社, 2005: 314-317. MENG Z L. The psychology of emotion[M]. Beijing: Beijing University Press, 2005: 314-317.
[2]	黄永玲, 张唯敏, 方亮. 安徽省学龄前儿童行为问题现况调查[J]. 中国妇幼保健, 2018, 33(11): 2559-2561. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201811054.htm HUANG Y L, ZHANG W M, FANG L. Investigation on behavior problems of preschool children in Anhui Province[J]. Matern Child Health Care China, 2018, 33(11): 2559-2561. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201811054.htm
[3]	BEARS A M, FULCO C J, AGBEKE D, et al. The joint development of externalizing and internalizing behaviors in black and Hispanic youth and the link to late adolescent substance use[J]. Dev Psychopathol, 2021. DOI: 10.1017/S0954579420001881.
[4]	FELITTI V J, ANDA R F, NORDENBERG D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The adverse childhood experiences(ACE) study[J]. Am J Prev Med, 1998, 14(4): 245-258. doi: 10.1016/S0749-3797(98)00017-8
[5]	PLANT D T, BARKER E D, WATERS C S, et al. Intergenerational transmission of maltreatment and psychopathology: the role of antenatal depression[J]. Psychol Med, 2013, 43(3): 519-528. doi: 10.1017/S0033291712001298
[6]	LETOURNEAU N, DEWEY D, KAPLAN B J, et al. Intergenerational transmission of adverse childhood experiences via maternal depression and anxiety and moderation by child sex[J]. J Dev Orig Health Dis, 2019, 10(1): 88-99. doi: 10.1017/S2040174418000648
[7]	WANG X, YIN G, GUO F, et al. Associations of maternal adverse childhood experiences with behavioral problems in preschool children[J]. J Interpers Viol, 2021. DOI: 10.1177/08862605211050093.
[8]	WHO. Adverse Childhood Experiences International Questionnaire(ACE-IQ)[EB/OL]. (2019-06-13)[2020-11-01]. http.//www.who.int/violence_injury_prevention/violence/activities/adverse_childhood_experience/en/.
[9]	寇建华, 杜亚松, 夏黎明. 儿童长处和困难问卷(父母版)上海常模的信度和效度[J]. 上海精神医学, 2005, 17(1): 25-28. doi: 10.3969/j.issn.1002-0829.2005.01.007 KOU J H, DU Y S, XIA L M. Reliability and validity of "children strengths and difficulties questionnaire" in Shanghai norm[J]. Shanghai Arch Psych, 2005, 17(1): 25-28. doi: 10.3969/j.issn.1002-0829.2005.01.007
[10]	高越, 张云婷, 赵瑾, 等. 上海市入园儿童心理健康状况及影响因素研究[J]. 中国儿童保健杂志, 2021, 29(1): 28-32. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO202101010.htm GAO Y, ZHANG Y T, ZHAO J, et al. Study on meatal health status and its influencing factors in kindergarten children in Shanghai[J]. Chin J Child Health Care, 2021, 29(1): 28-32. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO202101010.htm
[11]	王鹭, 黄彦科, 江文庆, 等. 深圳市南山区学龄前儿童心理卫生问题及其影响因素分析[J]. 中国儿童保健杂志, 2019, 27(5): 527-530. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO201905016.htm WANG L, HUANG Y K, JIANG W Q, et al. Analysis on mental health problems and related risk factors of preschool children in Nanshan District of Shenzhen[J]. Chin J Child Health Care, 2019, 27(5): 527-530. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO201905016.htm
[12]	黄广文, 吴虹, 杜其云, 等. 湖南省农村3~7岁留守儿童长处和困难问卷调查分析[J]. 中国儿童保健杂志, 2010, 18(1): 26-29. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO201001010.htm HUANG G W, WU H, DU Q Y, et al. Analysis of behavior problems in left-behind children aged 3 to 7 years in countryside of Hunan Province[J]. Chin J Child Health Care, 2010, 18(1): 26-29. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO201001010.htm
[13]	韩阿珠, 张国宝, 苏普玉, 等. 家庭教养方式对学龄前儿童行为和情绪问题的影响[J]. 中国学校卫生, 2018, 39(12): 1773-1778. https://www.cnki.com.cn/Article/CJFDTOTAL-XIWS201812006.htm HAN A Z, ZHANG G B, SU P Y, et al. Relationships between parental rearing styles and emotional and behavioral problems in preschool children[J]. Chin J Sch Health, 2018, 39(12): 1773-1778. https://www.cnki.com.cn/Article/CJFDTOTAL-XIWS201812006.htm
[14]	刘雯雯, 伍晓艳, 陶舒曼, 等. 学龄前儿童健康危害行为与情绪行为问题的关联研究[J]. 中华预防医学杂志, 2020, 54(11): 1255-1260. LIU W W, WU X Y, TAO S M, et al. Emotional and behavioral problems associated with health-risk behaviors in preschool children[J]. Chin J Prev Med, 2020, 54(11): 1255-1260.
[15]	高欣, 梁靖, 王淑芬, 等. 我国八省小学生心理状况及家长对其评价分析[J]. 中华疾病控制杂志, 2013, 17(7): 592-595. https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ201307014.htm GAO X, LIANG J, WANG S F, et al. Analysis on pupils' current mental health situation and their guardians' attitude in eight provinces in China[J]. Chin J Dis Control Prev, 2013, 17(7): 592-595. https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ201307014.htm
[16]	PLANT D T, JONES F W, PARIANTE C M, et al. Association between maternal childhood trauma and offspring childhood psychopathology: mediation analysis from the ALSPAC cohort[J]. Br J Psychiatry, 2017, 211(3): 144-150. doi: 10.1192/bjp.bp.117.198721
[17]	LOUNDS J J, BORKOWSKI J G, WHITMAN T L. The potential for child neglect: the case of adolescent mothers and their children[J]. Child Maltreat, 2006, 11(3): 281-294.
[18]	KUMAR M, AMUGUNE B, MADEGHE B, et al. Mechanisms associated with maternal adverse childhood experiences on offspring's mental health in Nairobi informal settlements: a mediational model testing approach[J]. BMC Psychiatry, 2018, 18(1): 381. doi: 10.1186/s12888-018-1953-y
[19]	WAEHRER G M, MILLER T R, SILVERIO M S C, et al. Disease burden of adverse childhood experiences across 14 states[J]. PLoS One, 2020, 15(1): e0226134. doi: 10.1371/journal.pone.0226134
[20]	KANG N R, KWACK Y S, SONG J K, et al. The impact of maternal adverse childhood experiences on offspring's internalizing and externalizing problems[J]. Psychiatry Invest, 2021, 18(11): 1050-1057.
[21]	MCDONALD S W, MADIGAN S, RACINE N, et al. Maternal adverse childhood experiences, mental health, and child behaviour at age 3: the all our families community cohort study[J]. Prev Med, 2019, 118: 286-294. doi: 10.1016/j.ypmed.2018.11.013
[22]	OSHIO T, UMEDA M. Gender-specific linkages of parents' childhood physical abuse and neglect with children's problem behaviour: evidence from Japan[J]. BMC Public Health, 2016, 16: 403.
[23]	HAUGLAND S H, DOVRAN A, ALBAEK A U, et al. Adverse childhood experiences among 28, 047 Norwegian adults from a general population[J]. Front Public Health, 2021, 9: 711344.