高危險群兒童與青少年情緒行為問題之心理介入成效：後設分析

近三十年來，兒童與青少年的情緒行為問題逐漸受到重視，而高危險群兒童與青少年比起一般的同儕，更容易經驗到情緒行為問題。故本研究之目的為採用後設分析方法來探討國內高危險群兒童與青少年情緒行為問題之心理介入的成效。本研究透過「中華民國期刊論文索引影像系統」、「台灣博碩士論文知識加值系統」及「政府研究資訊系統」等電腦化資料庫，蒐集介在1983年1月至 2014年6 月間的相關研究文獻，最終收錄65篇符合納入標準之單組或多組設計的研究文獻，共包含1345名研究對象。本研究除了計算心理介入對高危險群兒童與青少年的情緒行為問題之效果量之外，同時亦探討可能會影響成效的介入法、個案特徵、介入設定與情境、結果評量以及方法學等變項。結果發現：（1）國內高危險群兒童與青少年情緒行為問題之心理介入具有中高程度的立即效果（ =0.705），接近高度的維持效果（ =0.752）。（2）內隱性問題的介入具有接近高度的立即效果以及高度的維持效果；外化性問題和其他問題之介入，具有中等的立即效果以及中至中高度的維持效果。（3）內隱性問題中，憂鬱問題的介入成效相較最高，其次為焦慮問題，而退縮與身體抱怨問題的介入成效則相對較低。外化性問題中，破壞規則行為問題的介入成效較攻擊行為問題高。其他問題中，注意力問題的介入成效相對最高，其次為社交問題，而思考問題的介入成效相對較低。（4）可能影響介入成效的變項包括心理介入法理論、成效評估來源、評估工具類型以及控制組的型式。本研究為高危險群兒童與青少年情緒行為問題的心理介入成效之研究議題呈現出一個整體性的面貌，並為未來研究以及實務工作提供可參考的方向。

關鍵字

高危險群；身心障礙；兒童與青少年；情緒行為問題；心理介入；後設分析

並列摘要

In the past 30 years, the emotional and behavioral problems in children and adolescents have been gaining a lot of attention. High-risk children and adolescents with are more likely to experience emotional and behavioral problems than their normal peers. The purpose of this study is to adopt meta-analysis methods to investigate the effects of psychological interventions on emotional and behavioral problems for Taiwanese children and adolescents with high risk. Computerized databases, such as “National Digital Library of Theses and Disserations in Taiwan”, “PeriodPath Index toTaiwan Periodical Literature System”, and “Government Research Bulletin” are searched for relevant studies between January 1983 and June 2014. In total, 65 studies with single group or between-groups design are included, and the total subject numbers are 1345. This meta-analysis study computes effect sizes of psychological interventions and examines the relationships between effect sizes and study characteristics including interventions variables, subject variables, setting and context variables, outcome variables, and methodological variables in an attempt to search for possible moderator variables. The findings of this study are: (1) the overall immediate effect ( =0.705) of psychological interventions for high-risk children and adolescents is moderate to high, while the overall sustained effect ( =0.752) is close to high; (2) the immediate effect of internalizing problems is close to high and the sustained effect is high, while the immediate effect of externalizing and other types of problems are moderate and the sustained effect are moderate to high; (3) in terms of internalizing problems, the interventions are more effective for depressive problems than for anxiety problems, whereas the interventions for withdrawn problems and somatic complaints are less effective; in terms of externalizing problems, the interventions for rule-breaking behavioral problems are more effective than for aggressive problems; in terms of the other types of problems, the interventions for attention problems are more effective than for social problems, whereas the interventions for thought problems are the least effective; (4) study characteristics such as type of psychological theories for intervention, type of assessors, type of assessment tools, and type of control groups are the potential moderators. This study presents a complete aspect of the issue on psychological interventions for reducing emotional and behavioral problems in Taiwanese children and adolescents with high risk, and provides guiding reference for future research and practical work.