健康委员会

The Health Committee 健康委员会 Child and adolescent mental health Development, measurement and prevention 儿童及青少年心理健康 发展 衡量与预防发展、衡量与预防 A project initiated by the Royal Swedish Academy of Sciences 瑞典皇家科学院研究项目瑞典皇家科学院研究项目 © 瑞典皇家科学院 Background and purposes 背景与目的 • In 2006 the Royal Swedish Academy of Sciences created a Health Committee with the main aim to establish a more solid scientific basis for discussions and actions concerning child and adolescent mental health Frequent alarming reports about deteriorating • 瑞典皇家科学院于2006年创立了健康委员会，主要目 的是为讨论和解决有关儿童和青少年心理健康问题， 建立更加扎实的科学基础。频繁出现的关于学龄儿童 心理健康恶化的提醒报告，是引起这种关注的原因， 而且印证了此项任务的优先性health. Frequent alarming reports about deteriorating mental health among school children was a cause for concern that justified the priority of the task. • The Health Committee initiated a project which aims to deepen the knowledge of school children's mental 而且印证了此项任务的优先性。 • 健康委员会发起了一个项目，目的是通过在审议会议 上进行系统性的知识讨论，就流行病、方法、原因和 预防等方面，加深对学龄儿童心理健康的知识。 p g health concerning epidemiology, methodology, causes and prevention - through systematic knowledge reviews to be presented at consensus conferences. • The project has two comprehensive goals: • 该项目有两个总体目标： – 对学校期间心理健康问题的原因、适当的干预方法和预 防计划达成共识。 – 在学校中采取实际措施的建议。 The project has two comprehensive goals: – That consensus is achieved on the causes of mental health problems during the school period, on appropriate intervention methods and on plans to prevent it. – That proposals for action are put to practical use in the schools. © 瑞典皇家科学院 State of the Science Conferences: The NIH model 科学会议状况： NIH模式 • Criteria: – Issues of great interest from a public health perspective – A need to systematically collect and • 指标: – 从公共健康角度而言重大感兴趣的问题 – 系统收集和评估现有知识的必需性 – 具体的关键问题 evaluate existing knowledge – Concrete key issues • A systematic procedure, with division of labor among groups with clearly defined roles: – Planning committee: prepares the • 系统化操作程序，具备明确角色的团队分工： – 计划委员会: 筹备会议，系统阐述确切 的问题 – 工作组:对研究资料进行系统的评议Planning committee: prepares the conference, formulates precise questions – Working group: conducts a systematic review of the research literature Experts: make statements 工作组: 对研究资料进行系统的评议 – 专家:发表陈述 – 观众:贡献 意见 文理分科指导河道管理范围浙江建筑工程概算定额教材专家评审意见党员教师互相批评意见 和看法 – 评议小组:评估所有信息，以便做出陈 述，对提出的问题予以答复 – Experts: make statements – Audience: contributes points of view – Panel: evaluates all information to make a statement that answers the questions posed © 瑞典皇家科学院 Child and adolescent mental health – three tracks, different perspectives School, learning and mental health Trends in mental health Prevention of poor mental health among school children Conference 12-14 April, 2010 Conference 26-28 April, 2010 The Swedish Council on Technology Assessment in Health Care, SBU 19 May, 2010 Hearing 26 May, 2010 I f ti d i l t ti © 瑞典皇家科学院 Information and implementation Trends in mental health: procedures 心理健康的趋势：程序 • Systematic review of literature: – Systematic search for Swedish h bli h d i • 资料的系统回顾: – 系统性地搜寻，1945年以后发表 在同行评论刊物上的瑞典科研成research published in peer- reviewed journals and reports and other forms of documents (”grey literature”) published after 1945. 在同行评论刊物上的瑞典科研成 果、报告和其他形式的文献 ("灰 色资料")。 – 评估提供了心理健康趋势信息的 的– Assessments of relevance and quality yielded 17 studies with information about trends in mental health. 17项研究的相关性和质量。 – 这些研究中90%的观察是1990年 之后做的。 – 90 % of the observations in these studies were made after 1990. © 瑞典皇家科学院 Trends in mental health: conclusions 心理健康的趋势：结论 • No information available about trends in mental health among children 0-10 years old. • There has been an increase since the mid 1980s in the frequency of certain types of mental health problems, such as anxiety, sadness and irritation. • 没有关于0-10岁儿童心理健康趋势的信息。 • 自从1980年代中期以来，某些形式心理健康问题的频 率有所增加，例如焦虑、悲哀和愤怒。 – 在青少年女孩中，某些形式的问题频率增加了 两至三倍。 – Among teen-age girls the frequency of certain types of problems has increased two or three times. – For teenage boys the trend is increasing too, but the increase is smaller than for girls. – 对于青少年男孩而言，此趋势也在增加，但增 加的幅度小于女孩。 • 在16-24岁女孩中，看上去自杀的倾向增加了。 • 自从1980年代中期以来，自杀率没有变化。然而在青 年人死亡的原因中 自杀类的份额增加了 因为在其 • There seems to have been an increase in suicide attempts among girls 16-24 years old. • There is no change in suicide rates since the mid 1980s. However, the suicide category has increased its share among causes of death among young 年人死亡的原因中，自杀类的份额增加了，因为在其 他领域的预防日益成功，例如交通和其他事故等。 persons, because prevention has been more succesful in other areas, such as traffic and other accidents. © 瑞典皇家科学院 School, learning and mental health: proceduresprocedures 学校、学习和心理健康：程序 S t ti h f lit t 系统性搜寻资料• Systematic search for literature: – Only peer-reviewed articles in English were included. – Search terms to identify aspects of schooling and aspects of mental health (internalizing and externalizing problems, positive aspects of mental health) • 系统性搜寻资料: – 仅包含英文的同行评论文章。 – 搜索术语以便识别学校教育方面和心理健康方 面 (内化和外化问题，心理健康的积极方面)。 – 调出了1999-2009年期间发表的约10 000个参 考资料of mental health). – Around 10 000 references published 1999 – 2009 were retrieved • Screening and assessments of relevance: – Screening of abstracts left 1033 references. – Full text screening left 471 references. • 关于相关性的筛选和评估: – 摘要筛选留下1033个参考。 – 全文 企业安全文化建设方案企业安全文化建设导则安全文明施工及保证措施创建安全文明校园实施方案创建安全文明工地监理工作情况 筛选留下471个参考。 • 聚焦于研究调查学习成绩对心理健康的影响，以及研 究调查心理健康对学习成绩的影响 (180个参考)。 • 进一步的要求:g• Focus on studies investigating effects of school achievement on mental health, and studies investigating effects of mental health on school achievement (180 references). • Further requirements: – Longitudinal design • 进一步的要求: – 纵向 设计 领导形象设计圆作业设计ao工艺污水处理厂设计附属工程施工组织设计清扫机器人结构设计 – 相关性 – 质量 • 此操作留下了51项关于学习成绩和心理健康之间因果关系的研究，其构成最终评论的基础，并基于此写出 了综合报告资料g g– Relevance – Quality • This left 51 studies dealing with causal relations between school achievement and mental health, which comprised the basis for the final review, as well as the basis of which a narrative literature 了综合报告资料。 © 瑞典皇家科学院 synthesis was conducted. School, learning and mental health: conclusionsconclusions 学校、学习和心理健康：结论 响• Effects of school achievement on mental health: – Early school failures and in particular reading difficulties cause internalizing and externalizing mental health problem. – Investment of time and effort in schoolwork without achieving expected outcomes is related to development of depression • 学习成绩对心理健康的影响: – 早期的学习失败特别是阅读困难，导致内化和外化的 心理健康问题。 – 在功课上花了时间和努力却没有获得预期的结果，这 与抑郁的发展有关联。 – 青春期的学习成绩问题，导致女生的内化心理健康问题of depression. – Academic achievement problems in adolescence cause internalizing mental health problems for females. – Good academic achievement improves self-esteem. • Effects of mental health on school achievement: – Internalizing and externalizing mental health problems have negative effects on academic achievement 题。 – 良好的学习成绩改善自尊。 • 心理健康对学习成绩的影响: – 内化和外化的心理健康问题，在一定程度上通过以年龄和性别为特点的机制，对学习成绩产生负面影响。 – 良好的自尊并不改善学习成绩，但与自尊相关联的变 量 例如控制力 确实影响学习成绩have negative effects on academic achievement through mechanisms that are partly age- and gender- specific. – Good self-esteem does not improve academic achievement, but variables correlated with self-esteem, such as locus of control, do affect achievement. • Influence of peers: 量，例如控制力，确实影响学习成绩。 • 同学的影响: – 与同学和老师的关系，涉及到学习失败对心理健康产 生负面影响，但与同学和老师的关系，也可以避免心 理健康问题的发展。 – 与同学的社会对照影响自我概念，并且此影响根据同 学圈子的构成呈函数变化 – Relations with peers and teachers are involved in establishing the negative effects of school failure on mental health, but relations with peers and teachers can also protect against development of mental health problems. – Social comparisons with peers affect self-concept, and effects vary as a function of the composition of the peer 学圈子的构成呈函数变化。 © 瑞典皇家科学院 effects vary as a function of the composition of the peer group. Prevention programs: procedures 预防计划：程序 • Systematic review focused on – Programs aiming to prevent poor mental health – Controlled studies • 系统性评论聚焦于 – 计划目的在于避免脆弱的心理健康 – 有控制的研究 心理健康结果测量Controlled studies – Measures of mental health outcomes – At least six months follow up – 心理健康结果测量 – 至少跟踪六个月 • 系统性调查和评估所产生的相关性和质 量： • Systematic searches and evaluations of relevance and quality yielded: – 38 randomized studies about preventing externalizing problems – 关于避免外化问题的38个随机研究 – 关于避免焦虑和抑郁的21个随机研 究 p g g p – 21 randomized studies about preventing anxiety and depression © 瑞典皇家科学院 Prevention programs: conclusions 预防计划：结论 • In Sweden more than 100 different prevention programs are used to prevent mental unhealth, primarily in the form of externalizing behavior problems. None of these has been evaluated in Sweden in d i d di i h i h f ll • 在瑞典，共有100多个各种预防计划在实施， 以便预防主要以外化行为问题呈现的心理不健 康。瑞典的这些计划中，尚无任何以六个月跟 踪的随机研究方式而做过评估的。 • 六个旨在预防脆弱心理健康的标准化和结构化 randomized studies with six months follow up. • Six standardized and structured programs aiming to prevent poor mental health have a limited scientific support according to 个旨在 防 健 的计划，按照国际研究而言，具有有限的科学 支持。效果趋向于相对较小。 • 那些具有外化行为问题的青少年集体相聚的计 划，会引起增加的问题。 • 极为需要这样的随机研究 以便调查在瑞典实international research. Effects tend to be relatively small. • Programs in which adolescents with externalizing behavior problems meet in group can cause increased problems. • 极为需要这样的随机研究，以便调查在瑞典实 施的富有积极影响的计划，并且也确认，其不 含有负面影响。 g p p • There is a great need for randomized studies to investigate positive effects of programs used in Sweden, and also to establish that they do not have negative effects. © 瑞典皇家科学院 Overall conclusions 总结 初级经济法重点总结下载党员个人总结TXt高中句型全总结.doc高中句型全总结.doc理论力学知识点总结pdf 论 • The three reviews have systematized knowledge about trends in mental health among children and adolescents in Sweden, about how school achievement and different • 这三个评论对于瑞典儿童和青少年心理 健康趋势、学习成绩和心理健康原因的 各个方面以及预防计划的效果等，具有 系统性的知识。 下 步骤就是 这些不同方面产生的知school achievement and different aspects of mental health cause each other, and about effects of prevention programs. • In the next step the knowledge • 下一步骤就是，这些不同方面产生的知识将用于创造对心理健康趋势的更佳诠 释，并且创造预防脆弱的心理健康的更 佳方法。 • 这些评论和会议 识别出一系列领域In the next step the knowledge generated in these different areas should be used to create better explanations of the trends in mental health, and to create better methods for ti t l h lth • 这些评论和会议，识别出 系列领域， 其中亟需做更深入研究。 preventing poor mental health. • The reviews and the conferences have identified several areas in which there is great need for further research. © 瑞典皇家科学院