台灣與美國青少年心理健康泛文化比較之研究

A Comparison of Mental Health for Youth in Taiwan and the United States

10.30074/FJMH.201009_23(3).0005

黃禎貞(Jen-Jen Huang)；林世華(Sieh-Hwa Lin)

泛文化研究 ； 心理健康 ； 青少年 ； 台灣 ； cross-cultural comparison ； mental health ； youth ； Taiwan

中華心理衛生學刊

23卷3期（2010 / 09 / 01）

465 - 491

繁體中文

研究目的：種族與文化的差異不但受到心理健康研究的重視且闡述其中，也應用於心理健康照護上。儘管如此，台灣在心理健康泛文化的研究上卻如此短缺，因此本研究主要目的在於比較美國與台灣青少年的心理健康狀況。研究方法：本研究以情緒症狀、問題行為、過動/注意力問題與同儕關係問題等四個心理健康指標，針對台灣教育長期追蹤資料庫與美國國家健康調查資料庫2001年的資料，透過單組設計與線性轉換等化資料並且採用多變項變異數分析進行考驗。總樣本數包括6228名12到17歲青少年，其中台灣有3166人，美國則是3062人。研究結果：本研究發現，台灣與美國青少年的心理健康狀況不同，心理問題型態的表現也不同，台灣青少年的心理問題型態表現在情緒症狀上，而美國青少年的心理問題型態則表現在注意力與同儕關係上。再者，性別與年齡對台灣與美國青少年的心理健康狀況之預測不同，台灣青少年心理健康女生比男生差與年長者比年輕者差，但美國並非如此。研究結論：本研究支持青少年的心理健康狀況與心理問題的表現形式，以及性別與年齡因子對青少年心理健康的預測，會因國家的不同而有差異。未來研究可以進一步探討其差異背後的影響因素，同時也建議台灣相關組織機構能夠針對女性與年長的青少年提供更多心理健康服務，尤其是社會技能與情緒調節能力的提升。

Purpose: Racial, ethnic, and cultural disparities have been documented in mental health studies and in application of mental health care. However, comparisons between Taiwan and the U.S. are lacking. The purpose of this study is to compare the mental health of youth in Taiwan and the U.S. to identify differences in the structure of mental health. Methods: Indicators of mental health in this study included emotional symptoms, conduct problems, hyperactivity, and peer-relation problems. Data were collected in 2001 through 2 research projects: the Taiwan Education Panel Survey (TEPS) and the America National Health Interview Survey (NHIS), and the total sample included 6228 (TEPS=3166, NHIS=3062) adolescents of the age between 12 to 17 years. The TEPS and NHIS data were linked and equated with single-group design and linear transformation, and then analyzed with a MANOVA. Results: Mental health and type of mental problems differed between youth in Taiwan and the United States. Taiwanese youths presented emotional symptoms, but Americans presented with hyperactivity and peer-relation problems. Taiwanese mental health differed by gender (females were worse than males) and age (seniors were worse than juniors), although American results did not. Conclusions: Nationality is an important factor in mental health and interacted with gender and age. The Taiwan results differed from the U.S. sample as well as from results represented in the related Western literature. Further research is needed to explore the reasons behind these differences. Implications of this research for policy in Taiwan include the suggestion that the relevant welfare organizations should provide more mental health services for girls and older youth, especially services promoting social skills for emotion regulation.

1. 中央研究院調查研究專題中心學術調查資料庫（2006）：《台灣教育長期追蹤資料庫－資料使用手冊（2006.07.26修訂式出版）》。2006年8月26日，取自http://srda.sinica.edu.tw/TEPS/index.aspx
2. 國家衛生研究院(2006)：〈國民健康訪問調查〉。2006年8月26日，取自http://nhis.nhri.org.tw/EXEC/16/0179tz3i6e0c01k0e17ak76tv2
3. Achenbach, T. M.,Dumenci, L.,Rescorla, L. A.(2003).Are American children's problems still getting worse? A 23-year comparison.Jounal of Abnormal Child Psychology,31,1-11.
4. Australian Department of Health and Ageing(2003).Mental health national outcomes and casemix collection: Overview of clinician-rated and consumer self-report measures, version 1.50, December 2003.Canberra:Mental Health & Suicide Prevention Branch of Compiled by Quality and Effectiveness Section.
5. Bourdon, K. H.,Goodman, R.,Rae, D. S.,Simpson, G.,Koretz, D. S.(2005).The strengths and difficulties questionnaire: U.S. normative data and psychometric properties.Journal of American Academy Child and Adolescent Psychiatry,44(6),557-564.
6. Bromet, E. J.,Gluzman, S. F.,Paniotto, V. I.,Webb, C. P. M.,Tintle, N. L.,Zakhozha,V.(2005).Epidemiology of psychiatric and alcohol disorders in Ukraine findings from the Ukraine world mental health survey.Social Psychiatry and Psychiatric Epidemiology,40,681-690.
7. Carlyle, K. E.,Steinman, K. J.(2007).Demographic differences in the prevalence, cooccurrence, and correlates of adolescent bullying at school.The Journal of School Health,77(9),623-629.
8. Clair, M. S.(2004).Object relations and self psychology: An introduction.Boston:Thomson.
9. Collishaw, S.,Maughan, B.,Goodman, R.,Pickles, A.(2004).Time trends in adolescent mental health.Journal of Child Psychology and Psychiatry,45(8),1350-1362.
10. Crijnen, A. A. M.,Achenbach, T. M.,Verhulst, F. C.(1997).12 cultures: Total problem, externalizing and internalizing.Journal of the American Academy of Child and Adolescent Psychiatry,36,1269-1277.
11. Fung, H.,Chen, E. C. H.(2001).Across time and beyond skin: Self and transgression in the everyday socialization of shame among Taiwanese preschool children.Social Development,10(3),420-437.
12. Gau, S. S.,Chong, M. Y.,Chen, T. H.,Cheng, A. T.(2005).A 3-year panel study of mental disorders among adolescents in Taiwan.The American Journal of Psychiatry,162(7),1344-1350.
13. Goodman, R.(1997).The strengths and difficulties questionnaire: A research note.Journal of Child Psychology and Psychiatry,38,581-586.
14. Goodman, R.,Meltzer, H.,Bailey, V.(1998).The strengths and difficulties questionnaire: A pilot study on the validity of the self-report version.European Child and Adolescent Psychiatry,7,125-130.
15. Goodman, R.,Slobodskaya, H.,Knyazev, G.(2005).Russian child mental health: A cross-sectional study of prevalence and risk factors.European Child and Adolescent Psychiatry,14(1),28-33.
16. Gore, S.,Aseltine, R. H.(2003).Race and ethnic differences in depressed mood following the transition from high School.Journal of Health and Social Behavior,44(3),370-389.
17. Hacker, K.,Drainoni, M. L.(2001).Mental health and illness in Boston's children and adolescents: One city's experience and its implications for mental health policy makers.Public Health Reports,116(4),317-326.
18. Hesketh, T.,Ding, Q. J.,Jenkins, R.(2002).Suicide ideation in Chinese adolescents.Social Psychiatry and Psychiatric Epidemiology,37(5),230-235.
19. Hofstede, G.(2001).Culture's consequences, comparing values, behaviors, institutions, and organizations across nations.Thousand Oaks:Sage Publications.
20. Kessler, R. C.,Walters, E. E.(1998).Epidemiology of DSM-III-R major depression and minor depression among adolescents and young adults in the national comorbidity survey.Depress Anxiety,7,3-14.
21. Kolen, M. J.,Brennan, R. L.(1995).Springer series in statistics: Test equating methods and practices.New York:Springer.
22. Koskelainen, M.,Sourander, A.,Kaljonen, A.(2000).The strengths and difficulties questionnaire among Finnish school-aged children and adolescents.European Child and Adolescent Psychiatry,9,277-284.
23. Lee, S.,Tsang, A.,Huang, Y. Q.,He, Y. L.,Liu, Z. R.,Zhang, M. Y(2009).The epidemiology of depression in metropolitan China.Psychological Medicine,39,735-747.
24. Leung, W. L.,Hung, S. F.,Ho, T. P.,Lee, C. C.,Liu, W. S.,Tang, C. P.(2008).Prevalence of DSM-IV disorders in Chinese adolescents and the effects of an impairment criterion: A pilot community study in Hong Kong.European Child & Adolescent Psychiatry,17(7),452-461.
25. Li, J.(2004).The organization of Chinese shame concepts.Cognition and Emotion,18(6),767-797.
26. National Center for Health Statistics U.S.A.(2003).2001 national health interview survey (NHIS) public use data release: NHIS survey description.Hyattsville, MD:National Center for Health Statistics U.S.A..
27. Newman, B. M.,Lohman, B. J.,Newman, P. R.(2007).Peer group membership and a sense of belonging: Their relationship to adolescent behavior problem.Adolescence,42(166),241-263.
28. Petot, D.,Petot, J. M.,Achenbach, T. M.(2008).Behavioral and emotional problems of Algerian children and adolescents as reported by parents.European Child & Adolescent Psychiatry,17(4),200-208.
29. Roberts, R. E.,Alegria, M.,Roberts, C. R.,Chen, I. G.(2005).Mental health problems of adolescents as reported by their caregivers: A comparison of European, African, and Latino Americans.Journal of Behavioral Health Services & Research,32(1),1-13.
30. Rogoff, B.(2003).The cultural nature of human development.New York:Oxford University Press.
31. Romero, J.,Carvajal, S.,Valle, F.,Orduna, M.(2007).Adolescent bicultural stress and its impact on mental well-being among Latinos, Asian Americans, and European Americans.Journal of Community Psychology,35,519-534.
32. Sagatun, Å.,Lien, L.,Søgaard, A. J.,Bjertness, E.,Heyerdahl, S.(2008).Ethnic Norwegian and ethnic minority adolescents in Oslo, Norway: A longitudinal study comparing changes in mental health.Social Psychiatry and Psychiatric Epidemiology,43,87-95.
33. Schmidt, S.,Power, M.(2006).Cross-cultural analyses of determinants of quality of life and mental health: Results from the EUROHIS Study.Social Indicators Research,77(1),95-138.
34. Scott, K. M.,Von Korff, M.,Alonso, J.,Angermeyer, M.,Bromet, E. J.,Bruffaerts, R.(2008).Age patterns in the prevalence of DSM-IV depressive/anxiety disorders with and without physical co-morbidity.Psychological Medicine,38,1659-1669.
35. Shek, D. T. L.(1987).A study of the mental health status of secondary school students in Hong Kong.Chinese Journal of Psychology,29(2),63-81.
36. Stevens, J.(2002).Applied multivariate statistics for social sciences
37. Stoolmiller, M.(1994).Antisocial behavior, delinquent peer association, and unsupervised wandering for boys: Growth and change from childhood to early adolescent.Multivariate Behavioral Research,29(3),263-288.
38. Verhulst, F. C.,Achenbach, T. M.,Van der Ende, J.,Erol, N.,Lambert, M. C.,Leung, P. W. L.(2003).Comparisons of problems reported by youths from seven countries.American Journal of Psychiatry,160,1479-1485.
39. Vostanis, P.(2006).Strengths and difficulties questionnaire: Research and clinical applications.Current Opinion in Psychiatry,19(4),367-372.
40. Weine, A. M.,Phillips, J. S.,Achenbach, T. M.(1995).Behavioral and emotional problem among Chinese and American children: Parent and teacher report for age 6-13.Journal of Abnormal Child Psychology,23,619-639.
41. World Health Organization(1947).Chronicle of the World Health Organization.Geneva:World Health Organization Interim Commission.
42. World Health Organization(2005).Promoting mental health: Concepts, emerging evidence, practice.Geneva:World Health Organization.
43. Zwirs, B. W. C.,Burger, H.,Schulpen, T. W. J.,Wiznitzer, M.,Fedder, H.,Buitelaar, J. K.(2007).Prevalence of psychiatric disorders among children of different ethnic origin.Journal of Abnormal Child Psychology,35,556.
44. 林宗義主編、Kleinman, A.主編(1996)。文化與行為：古今華人的正常與不正常行為。台北:曉園。
45. 胡台麗主編、許木柱主編、葉光輝主編(2002)。情感、情緒與文化。台北:中研院民族所。
46. 張明永、文榮光(1987)。高三女生心理衛生狀態研究：一所普通高中與一所職業高中的比較。中華心理衛生學刊，3(1)，69-73。
47. 張玨(1987)。大專聯考壓力對青少年健康影響－追蹤研究。中華心理學刊，29(2)，93-112。
48. 許烺光、許木柱譯(2002)。徹底個人主義的省思。台北:南天。
49. 曾文星(2006)。文化精神醫學：學理與應用。台北:水牛。
50. 曾文星主編(1996)。華人的心理與治療。台北:桂冠。
51. 楊國樞主編(1995)。中國人的心理。台北:桂冠。
52. 賴樂山(2004)。碩士論文(碩士論文)。中央大學人力資源管理研究所。

1. 郭乃文,許立港,李婕寧(2018)。青少女高身心症狀抱怨、生活適應與執行功能之關聯探討。臨床心理學刊，12(1/2)，1-14。
2. 郭乃文、許立港、張凱茵(2014)。強化執行功能之團體神經心理治療的成效研究—以高身體症狀青少女為例。中華心理衛生學刊，27(1)，73-95。
3. 黃毅志、游宗輝(2016)。臺灣原住民居住地透過教育、職業、收入與社會支持對心理健康之影響。教育心理學報，48(2)，279-301。
4. 楊春香、黃雅鈴、陳雅惠、梁蕙芳(2017)。利用行動裝置協助一位紅斑性狼瘡青少女適應身體心像改變過程。長庚護理，28(3)，509-518。