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Medication adherence among emerging adults: the influence of provider communication and patient personality 初出期成人的药物依从性:提供者沟通和患者个性的影响
IF 0.9 4区 医学 Q3 Medicine Pub Date : 2021-09-29 DOI: 10.1080/02739615.2021.1971986
Sara L. Lampert, Estée C. H. Feldman, Lindsay K. Durkin, W. Davies, R. Greenley
ABSTRACT Identifying factors associated with medication adherence among emerging adults (EA) is critical, given their elevated risk for nonadherence and because health behavior patterns during this developmental period persist into adulthood. Patient-healthcare provider communication and patient personality traits correlate with adherence in adult samples, but the independent and interactive influences of these factors on EA adherence are understudied. This study examined the individual and interactive influences of patient-provider communication and patient personality on EA’s medication adherence and adherence barriers in a sample of 399 EA with and without chronic health conditions. Participants (75% female, 77% White) completed questionnaires assessing study constructs (i.e., EA demographics, provider communication, EA personality) and reported on adherence and adherence barriers for recently prescribed medications (43% reported on a new prescription, 70% of the prescriptions were for long-term medications). Provider communication was associated with higher adherence (BCa CI [.032, .260]) and fewer adherence barriers (BCa CI [−.250, −.035]). Extraversion moderated the association between communication and adherence (BCa CI [−10.44, −2.18]) such that individuals with low and average levels of extraversion benefited more from provider communication. Results expand knowledge of factors related to EA adherence and highlight the value of evaluating more complex models of patient and provider influences on adherence.
摘要:鉴于新兴成年人不依从性的风险较高,并且这一发育期的健康行为模式一直持续到成年,识别与药物依从性相关的因素至关重要。在成人样本中,患者与医疗保健提供者的沟通和患者的个性特征与依从性相关,但这些因素对EA依从性的独立和交互影响尚未得到充分研究。本研究在399名患有和不患有慢性健康状况的EA样本中,检验了患者-提供者沟通和患者个性对EA药物依从性和依从性障碍的个体和交互影响。参与者(75%为女性,77%为白人)完成了评估研究结构(即EA人口统计、提供者沟通、EA个性)的问卷调查,并报告了最近开的药物的依从性和依从性障碍(43%报告了新处方,70%的处方是长期药物)。提供者沟通与更高的依从性(BCa CI[0.032,.260])和更少的依从性障碍(BCa CI[-.250,−.035])有关。外向调节了沟通与依从性之间的关联(BCa CI[-10.44,−2.18]),因此外向程度较低和平均的个体从提供者沟通中受益更多。结果扩展了与电针依从性相关因素的知识,并强调了评估患者和提供者对依从性影响的更复杂模型的价值。
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引用次数: 0
Pandemic-related parental distress: examining associations with family meals and child feeding practices during the COVID-19 pandemic 与大流行相关的父母痛苦:研究与COVID-19大流行期间家庭膳食和儿童喂养方式的关系
IF 0.9 4区 医学 Q3 Medicine Pub Date : 2021-09-29 DOI: 10.1080/02739615.2021.1967754
C. West, Clarissa V Shields, Kara V. Hultstrand, Miranda L. Frank, Amy F. Sato
ABSTRACT The present study examined associations between COVID-19-related negative impact and parental distress and aspects of the home food environment. Parents (N= 189) of children ages 7–17 completed an online survey assessing COVID-19-related impact and distress, household meals, feeding practices, and weight concern. Results suggested an inverse association between impact and distress and structured meals and positive associations with both restrictive feeding practices and weight concern. Food insecurity significantly moderated the association between impact and structured meals and remains a necessary target for intervention. Future research should explore factors that may mitigate the impact of COVID-19-related distress on the home food environment.
摘要本研究探讨了新冠肺炎相关负面影响与父母痛苦和家庭饮食环境之间的关系。7-17岁儿童的父母(N=189)完成了一项在线调查,评估了与COVID-19相关的影响和痛苦、家庭饮食、喂养方式和体重问题。结果表明,影响和痛苦与结构化膳食之间存在负相关,与限制性喂养和体重问题呈正相关。粮食不安全大大缓和了影响与结构化膳食之间的联系,仍然是干预的必要目标。未来的研究应探索可能减轻新冠肺炎相关痛苦对家庭食品环境影响的因素。
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引用次数: 3
Mental health and psychological adaptation on parents of children with neuromuscular diseases 神经肌肉疾病患儿父母的心理健康与心理适应
IF 0.9 4区 医学 Q3 Medicine Pub Date : 2021-09-01 DOI: 10.1080/02739615.2021.1961581
Javiera Ortega, N. Vázquez, Camila Flores, I. Amayra
ABSTRACT The diagnosis of a pediatric neuromuscular disease has a psychological impact on parents. The study aimed to describe mental health and psychological adaptation in parents of children with neuromuscular diseases. The evaluation of parents (n = 35) through the Psychological Adaptation Scale and Adult Self-Report Questionnaire showed that (a) 82.4% of the participants had an adequate level of psychological adaptation; (b) parents presented high levels of mental health problems, (c) significant correlations were found between the mental health problems and psychological adaptation. This study highlights the need for psychological interventions which aim to promote psychological adaptation to NMD diagnoses and protect parental mental health.
摘要儿童神经肌肉疾病的诊断对父母的心理有影响。该研究旨在描述患有神经肌肉疾病的儿童父母的心理健康和心理适应。通过心理适应量表和成人自我报告问卷对父母(n=35)的评估显示:(a)82.4%的参与者具有足够的心理适应水平;(b) 父母存在较高程度的心理健康问题,(c)心理健康问题与心理适应之间存在显著相关性。这项研究强调了心理干预的必要性,旨在促进心理适应NMD诊断并保护父母的心理健康。
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引用次数: 1
Parents’ Experiences of Investigations and Interventions by Child Healthcare, Child and Adolescent Psychiatry and Child and Youth Habilitation 父母对儿童保健、儿童和青少年精神病学以及儿童和青少年适应能力调查和干预的经验
IF 0.9 4区 医学 Q3 Medicine Pub Date : 2021-08-04 DOI: 10.21203/rs.3.rs-638564/v1
Berit M Gustafsson, Märtha Sund Levander
Background: ESSENCE (early symptomatic syndromes eliciting neurodevelopmental clinical examinations) is a collective term for all conditions involving early-onset behavioural problems and/or cognitive difficulties. These lead to consultation with a variety of specialists, who often have no close collaboration with each other. Parents experience frustration about the lack of cooperation between care providers, and helplessness and despair over the lack of structure or routines within the care system. The aim of this study was to elicit parents’ experiences of support and interventions from child healthcare, child and adolescent psychiatry and child and youth habilitation.Method: An explorative, qualitative design taking an inductive approach. Data were collected through semi-structured focus group interviews, with 13 parents of children with behavioural and/or ESSENCE problems. Firstly, a conventional analysis of the interviews was performed. Then the revealed categories were interpreted using the bioecological model to illustrate the effects on the child’s interaction with the surrounding context, i.e. micro-, meso-, exo- and macrosystems. Results: The analysis revealed four main categories: confidence, information, competence and collaboration, affecting parents’ experiences of the encounter with child healthcare, child and adolescent psychiatry and child and youth habilitation providers. Consistent across all four themes was the importance of time, i.e. the parents’ experiences of how the process of getting help and support was constantly delayed.Conclusion: While waiting for an investigation of ESSENCE problems, parents experience anxiety, worry, frustration, lack of information, lack of confidence and doubts about their parenting ability, which also affects the child. They experience a lack of competence among care staff when their concerns about their child’s development are not taken seriously, and demand a comprehensive approach regarding investigation and treatment. Collaboration within the exosystem between the various professionals involved is perceived to have great potential for improvement.Trial registration: Retrospectively registered clinical Trials 2021, PLUSS identifier, NCT04815889.
背景:ESSENCE(引起神经发育临床检查的早期症状综合征)是一个集合术语,指所有涉及早发性行为问题和/或认知困难的情况。这导致了与各种专家的协商,而这些专家之间往往没有密切的合作。父母对护理提供者之间缺乏合作感到沮丧,对护理系统内缺乏结构或常规感到无助和绝望。这项研究的目的是从儿童保健、儿童和青少年精神病学以及儿童和青少年适应训练中获取父母的支持和干预经验。方法:采用归纳法进行探索性定性设计。数据是通过半结构化的焦点小组访谈收集的,访谈对象是13名有行为和/或基本问题的儿童的父母。首先,对访谈进行了常规分析。然后,使用生物生态学模型对所揭示的类别进行解释,以说明对儿童与周围环境(即微观、中观、外部和宏观系统)互动的影响。结果:分析揭示了四个主要类别:信心、信息、能力和协作,影响父母与儿童保健、儿童和青少年精神病学以及儿童和青少年适应服务提供者的接触体验。在所有四个主题中,时间的重要性是一致的,即父母在获得帮助和支持的过程中如何不断延迟的经历。结论:在等待ESSENCE问题的调查期间,父母会感到焦虑、担忧、沮丧、缺乏信息、缺乏信心和对自己的育儿能力的怀疑,这也会影响孩子。当他们对孩子发展的担忧没有得到认真对待时,他们会遇到护理人员缺乏能力的问题,并要求在调查和治疗方面采取全面的方法。外部系统内参与的各种专业人员之间的合作被认为具有巨大的改进潜力。试验注册:2021年回顾性注册临床试验,PLUSS标识符,NCT04815889。
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引用次数: 1
Cooperative learning in parental education groups – child healthcare nurses’ views on their work as leaders and on the groups 家长教育小组中的合作学习——儿童保健护士对其领导工作和小组的看法
IF 0.9 4区 医学 Q3 Medicine Pub Date : 2021-07-26 DOI: 10.1080/02739615.2021.1949319
K. Forslund Frykedal, Michael Rosander, M. Barimani, Anita Belin
ABSTRACT New parents are offered parental education groups as a way to support their transition to parenthood. Interactive approaches in these groups are of importance, but studies have reported a lack of activities that support interaction. Cooperative learning is a structured method when working with groups and based on five elements essential to maximizing the cooperative potential of groups. The aim was to investigate the leadership skills of child healthcare nurses as leaders for parental education groups, their ideas about creating conditions for well-functioning groups, and what is required to achieve this. The results were analyzed and discussed using social interdependence theory as a framework and especially the five elements of cooperative learning. Further, the study used a qualitative descriptive design, and eight qualitative interviews were analyzed deductively using thematic analysis. The results showed that in their narratives the nurses display vocational knowledge and describe conditions important for their groups from a cooperative learning perspective. Nevertheless, the results indicate that the nurses had difficulty explicitly instructing parents to use their personal experiences and social skills to get groups to function effectively. Knowledge developed in the workplaces from the experience of leading groups is mostly implicit, and formal knowledge and awareness of leadership is necessary for development of the role.
摘要:为新父母提供家长教育小组,以支持他们转变为父母。这些群体中的互动方法很重要,但研究报告称缺乏支持互动的活动。合作学习是一种与团队合作的结构化方法,基于最大限度地发挥团队合作潜力所必需的五个要素。目的是调查儿童保健护士作为家长教育团体领导者的领导技能,他们关于为运作良好的团体创造条件的想法,以及实现这一目标所需的条件。以社会相互依存理论为框架,特别是合作学习的五个要素,对结果进行了分析和讨论。此外,本研究采用了定性描述性设计,并使用主题分析对8次定性访谈进行了演绎分析。结果表明,在他们的叙述中,护士们展示了职业知识,并从合作学习的角度描述了对其群体重要的条件。然而,研究结果表明,护士很难明确指示父母利用他们的个人经历和社交技能来让团队有效运作。在工作场所从领导团队的经验中发展出来的知识大多是隐性的,正式的领导知识和意识对于角色的发展是必要的。
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引用次数: 1
Parental feeding knowledge, practices and Chinese children and adolescents’ weight status 父母喂养知识、做法与中国儿童青少年体重状况的关系
IF 0.9 4区 医学 Q3 Medicine Pub Date : 2021-07-05 DOI: 10.1080/02739615.2021.1919112
Li Zhang, Yao Zhang, Liya Qiu, Guangxing Yang, Haiyan Jiang, Mengyi Zheng, Jie-song Wang
ABSTRACT Childhood obesity is related to impaired health and to some diseases in adulthood. Overweight children and adolescents have also been shown to experience social and psychological problems such as stigmatization and poor self-esteem. Thus, it is imperative to investigate the determinants of children and adolescents’ weight outcomes. Through analyzing the 2004, 2006, 2009 and 2011 waves of survey data released by China Health and Nutrition Survey (CHNS), this paper studied how parental feeding knowledge and practices have impacted the weight status of Chinese children and adolescents aged 6 to 17. The paper focused on exploring how such impacts varied by parental gender and rural-urban residence. Logistic regression was used to conduct the analyses. The results showed that parental feeding knowledge and practices varied by gender and by rural-urban residence. Specifically, food preferences, energy intake (such as carbohydrate, protein and fat intake) and numbers of meals sharing with children showed different patterns among mothers and fathers. Maternal intervention on children and adolescents’ eating and physical activities, parental energy intakes and meal sharing also showed rural and urban differences. The results further highlighted that the ways in which parental feeding knowledge and practices influenced children and adolescents’ weight status also differed by parental gender and residence. Mothers were “gatekeepers” of children and adolescents’ food choices and selection; their feeding practices played a more decisive role when influencing Chinese youth’s weight status.
儿童肥胖与健康受损和成年后的某些疾病有关。超重的儿童和青少年还会经历社会和心理问题,如被污名化和缺乏自尊。因此,有必要调查儿童和青少年体重结果的决定因素。本文通过分析中国健康与营养调查(CHNS) 2004年、2006年、2009年和2011年的调查数据,研究父母喂养知识和行为对中国6 ~ 17岁儿童和青少年体重状况的影响。本文重点探讨了这种影响在父母性别和城乡居住地之间的差异。采用Logistic回归进行分析。结果表明,父母喂养知识和做法因性别和城乡居住而异。具体来说,食物偏好、能量摄入(如碳水化合物、蛋白质和脂肪的摄入)和与孩子共餐的次数在母亲和父亲之间表现出不同的模式。母亲对儿童和青少年饮食和体育活动、父母能量摄入和用餐分享的干预也显示出城乡差异。结果进一步强调,父母喂养知识和行为对儿童和青少年体重状况的影响方式也因父母性别和居住地而异。母亲是儿童和青少年食物选择和选择的“看门人”;他们的喂养方式在影响中国青少年体重状况方面起着更决定性的作用。
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引用次数: 2
Disrupted mealtime interactions are associated with stress and internalizing symptoms in caregivers of school-age children 进餐时间中断的互动与学龄儿童照料者的压力和内化症状有关
IF 0.9 4区 医学 Q3 Medicine Pub Date : 2021-06-15 DOI: 10.1080/02739615.2021.1928499
Paulina S. Lim, Kathryn A. Balistreri, A. Silverman, W. Davies
ABSTRACT Caregivers of children with feeding problems (FP) experience more stress and mental health concerns. This study examines the relationship between disruptive mealtime interactions and symptoms of FP with caregiver stress and mental health concerns. A community sample of 198 caregivers of school-age children completed an online survey about child mealtime problems, caregiver perceptions of the severity of their child’s FP, disrupted mealtime interactions severity, caregiver stress, and caregiver depression and anxiety (i.e., internalizing symptoms). Two-thirds of caregivers reported at least 1 mealtime problem. Child picky eating was commonly reported and occurred before and after age 6. Increase in disrupted mealtime interactions and mealtime problem severity was associated with higher ratings of caregiver stress and increased internalizing symptoms. Feeding is an interactive activity between caregivers and children. Caregiver’s perception of FP is important as negative attributions about child feeding behaviors lead to increased risks of caregiver mental health problems. Integrative care providers and psychologists are encouraged to evaluate caregivers’ feeding concerns in addition to traditional objective measures of child nutrition (e.g., growth charts), as the interactions between caregiver stress, internalizing symptoms, and child FP result in poor outcomes.
喂养问题儿童(FP)的照顾者面临更多的压力和心理健康问题。本研究探讨了破坏性用餐时间互动和FP症状与照顾者压力和心理健康问题之间的关系。198名学龄儿童照顾者的社区样本完成了一项关于儿童用餐时间问题、照顾者对孩子FP严重程度的看法、用餐时间互动中断的严重程度、照顾者压力、照顾者抑郁和焦虑(即内化症状)的在线调查。三分之二的护理人员报告了至少一个用餐时间问题。儿童挑食通常发生在6岁前后。用餐时间互动中断和用餐时间问题严重程度的增加与照顾者压力评分较高和内化症状增加有关。喂养是照顾者和儿童之间的互动活动。照顾者对FP的认知是重要的,因为对儿童喂养行为的负面归因导致照顾者心理健康问题的风险增加。由于照顾者压力、内化症状和儿童FP之间的相互作用导致不良结果,除了传统的儿童营养客观测量(如生长图表)外,还鼓励综合护理提供者和心理学家评估照顾者的喂养问题。
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引用次数: 3
Statistically derived patterns of smoking typologies among adolescents and their associations with demographic characteristics, interpersonal influences, and sources of cigarettes 统计得出的青少年吸烟类型模式及其与人口统计学特征、人际关系影响和香烟来源的关系
IF 0.9 4区 医学 Q3 Medicine Pub Date : 2021-06-09 DOI: 10.1080/02739615.2021.1937172
Kinsey Pebley, L. Robinson, K. Campbell, K. Berlin
ABSTRACT Cigarette use is one of the leading causes of death in the United States, with most smokers beginning cigarette use in adolescence. Despite not being of legal age to make tobacco purchases, adolescents are quite successful in their acquisition. The current study used latent variable mixture modeling to identify smoking typologies among adolescents and examine associations with various sources of cigarettes (i.e., stealing, obtaining from friends, obtaining from family members, purchasing), social influences (parental objection to smoking, smoking friends), and demographics. Participants were 195 high school students caught with tobacco in school who completed surveys questions about their cigarette use, and cigarette use of family and friends. Results identified three latent classes pertaining to smoking patterns: recent, heavy, frequent smokers (RHFS), low infrequent smokers (LIS), and recent moderate smokers (RMS). Students in the RHFS and RMS groups were more likely to obtain cigarettes by purchasing or borrowing from a friend, and reported more friends who smoke and lower parental objection compared to LIS members. RHFS members also were more likely to obtain cigarettes from family and be of White race compared to the other groups. These findings highlight the need for tailored prevention or intervention programs depending on risk profile.
在美国,吸烟是导致死亡的主要原因之一,大多数吸烟者在青少年时期开始吸烟。尽管青少年没有达到购买烟草的法定年龄,但他们在购买烟草方面相当成功。目前的研究使用潜在变量混合模型来确定青少年的吸烟类型,并检查与各种香烟来源(即偷窃、从朋友那里获得、从家庭成员那里获得、购买)、社会影响(父母反对吸烟、吸烟的朋友)和人口统计学的关系。参与者是195名在校吸烟的高中生,他们完成了关于自己吸烟情况以及家人和朋友吸烟情况的调查问题。结果确定了与吸烟模式相关的三个潜在类别:近期重度频繁吸烟者(RHFS),低不频繁吸烟者(LIS)和近期中度吸烟者(RMS)。rfs组和RMS组的学生更有可能通过购买或从朋友那里借来香烟,与LIS组的学生相比,他们报告说有更多的朋友吸烟,父母的反对也更少。与其他组相比,rfs成员更有可能从家庭和白人那里获得香烟。这些发现强调了根据风险概况制定量身定制的预防或干预方案的必要性。
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引用次数: 0
Pediatric siblings of children with special health care needs: Well-being outcomes and the role of family resilience 有特殊保健需要儿童的儿科兄弟姐妹:福祉结果和家庭复原力的作用
IF 0.9 4区 医学 Q3 Medicine Pub Date : 2021-06-09 DOI: 10.1080/02739615.2021.1933985
E. Rosenthal, Sara R. Franklin Gillette, G. DuPaul
ABSTRACT Using data from the 2018 National Survey for Children’s Health , this study examined relationships between several adaptive psychological and psychosocial factors among siblings of children with special health care needs (CSHCN) compared to siblings of children without SHCN and the role of family resilience within those relationships. We conducted independent samples t-tests to determine if outcomes of interest differed between the siblings of CSHCN (n = 1486) and the siblings of typically-developing children (n = 1429). We then conducted simple linear regressions to examine family resilience as a correlate of all outcomes. Siblings of CSHCN exhibit significantly worse outcomes in academic and social school engagement, flourishing, and family resilience. Family resiliency is significantly associated with relationships involving school engagement, flourishing, and bullying. Siblings of CSHCN are at increased risk for important negative outcomes. Preventive intervention research is warranted, specifically to enhance resilience of families with CSHCN.
本研究利用2018年全国儿童健康调查的数据,研究了有特殊卫生保健需求儿童(CSHCN)的兄弟姐妹与无特殊卫生保健需求儿童的兄弟姐妹之间几种适应性心理和社会心理因素之间的关系,以及家庭弹性在这些关系中的作用。我们进行了独立样本t检验,以确定CSHCN患儿的兄弟姐妹(n = 1486)和正常发育儿童的兄弟姐妹(n = 1429)的结局是否不同。然后,我们进行了简单的线性回归,以检验家庭弹性作为所有结果的相关性。CSHCN的兄弟姐妹在学业和社会学校参与、成长和家庭弹性方面表现出明显较差的结果。家庭弹性与学校参与、成长和欺凌等关系密切相关。CSHCN的兄弟姐妹发生重要负面结果的风险增加。预防干预研究是有必要的,特别是为了提高CSHCN家庭的复原力。
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引用次数: 2
Theory of mind failure and emotion dysregulation as contributors to peer bullying among adolescents with attention-deficit/hyperactivity disorder 注意缺陷/多动障碍青少年同伴欺凌的心理失败和情绪失调理论
IF 0.9 4区 医学 Q3 Medicine Pub Date : 2021-06-08 DOI: 10.1080/02739615.2021.1926250
H. Yilmaz Kafali, Binay Kayan Ocakoğlu, Adem Işık, Ümran Gül Ayvalık Baydur, Gizem Müjdecioğlu Demir, Müge Şahin Erener, Ö. Üneri
ABSTRACT This study investigated whether poor performance in the Reading the Mind in the Eyes Test (RMET) and emotion dysregulation (ED) contributes to involvement in bullying among adolescents with attention-deficit/hyperactivity disorder (ADHD). Altogether, 105 adolescents with ADHD aged 10–18 years (mean: 13.9±1.8 years, 77% boys) were recruited. RMET was applied to evaluate the ToM abilities. Participants completed the Difficulties in Emotion Regulation Scale (DERS) and the Olweus Bully/Victim Questionnaire to measure ED and evaluate involvement in bullying, respectively. Among the subjects, 24.8% were victims, 23.8% were perpetrators. The perpetrators and victims exhibited significantly lower RMET scores and higher DERS awareness scores than non-victims/non-perpetrators. The perpetrators also exhibited significantly higher DERS impulse scores and DERS total scores than non-victims/non-perpetrators. Binary logistic regression analysis revealed that a 1-point decrease in the RMET score increased the odds of bullying victimization by 53% and bullying perpetration by 21.6%, while a 1-point increase in DERS impulse scores increased the risk of bullying perpetration by 14.9%. This study is the first to show an association between poor ToM ability and involvement in bullying as victims/perpetrators among children with ADHD. Both victims and perpetrators had problems with emotional awareness, while only perpetrators had difficulties controlling their impulses.
摘要:本研究旨在探讨注意力缺陷多动障碍(ADHD)青少年在眼读心术测试(RMET)和情绪调节障碍(ED)中的不良表现是否会导致欺凌行为。共纳入105名10-18岁ADHD青少年(平均:13.9±1.8岁,77%为男孩)。采用RMET法评价学生的ToM能力。被试分别填写了情绪调节困难量表(DERS)和Olweus欺凌/受害者问卷来测量ED和评估欺凌参与。被害者占24.8%,加害者占23.8%。加害者和受害者的RMET得分显著低于非受害者/非加害者,而DERS意识得分显著高于非受害者/非加害者。加害者也表现出显著高于非受害者/非加害者的DERS冲动得分和DERS总分。二元logistic回归分析显示,RMET得分每降低1分,霸凌受害的几率增加53%,霸凌实施的几率增加21.6%,而DERS冲动得分每增加1分,霸凌实施的风险增加14.9%。这项研究首次表明,在患有多动症的儿童中,较差的ToM能力与作为受害者/施暴者参与欺凌之间存在关联。受害者和加害者都有情感意识方面的问题,而只有加害者难以控制自己的冲动。
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引用次数: 2
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Childrens Health Care
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