ĐÁNH GIÁ ĐỘ HIỆU LƢ̣C CỦA BẢNG KIỂM HÀNH VI TRẺ EM ACHENBACH – PHIÊN BẢN VIỆT NAM (CBCL-V) TRONG SÀNG LỌC RỐI LOẠN TĂNG ĐỘNG GIẢM CHÚ Ý

1
I HC QUI
TRƢỜNG ĐẠI HỌC GIÁO DỤC



HONG TH XUYN




ĐA
́
NH GIA
́
ĐÔ
̣
HIÊ
̣
U LƢ
̣
C CU
̉
A BA
̉
NG KIÊ
̉
M HA
̀
NH VI TRE

̉
EM
ACHENBACH – PHIÊN BA
̉
N VIÊ
̣
T NAM (CBCL-V) TRONG
SNG LỌC RI LOẠN TĂNG ĐNG GIẢM CH 




LUẬN VĂN THẠC SĨ TÂM L HỌC










H NI – 2014

2
I HC QUI
TRƢỜNG ĐẠI HỌC GIÁO DỤC

HONG TH XUYN




ĐA
́
NH GIA
́
ĐÔ
̣
HIÊ
̣
U LƢ
̣
C CU
̉
A BA
̉
NG KIÊ
̉
M HA
̀
NH VI TRE
̉
EM
ACHENBACH – PHIÊN BA
̉
N VIÊ

̣
T NAM (CBCL-V) TRONG
SNG LỌC RI LOẠN TĂNG ĐNG GIẢM CH 


LUẬN VĂN THẠC SĨ TÂM L HỌC

CHUYÊN NGNH: TÂM L HỌC LÂM SNG TRẺ EM V V THNH NIÊN
Mã số: Thí điểm


Ngƣời hƣớng dẫn khoa học: PGS.TS. Đặng Hoàng Minh





H NI – 2014

i
Lơ
̀
i ca
̉
m ơn




  , 













, , .
















 



:




,  qu








c  









tng d 


t
























.
  Đặng Hoàng Minh  ,
























.




 m th  








 








.

28 5 





ii
DANH MỤC VIT TẮT
ADHD:
Ri long gi
ASEBA:
H thc nghim ca Achenbach.
ARS:
i long gi
AUC:
Khu vng cong
CBCL:
Bn ki 

cho cha m 
CBCL-V:
Bn ki    n Vit
Nam
CBCL-V-CY:
Bn ki   em Achenbacn Vit
Nam ti 
CBCL-APS:
Bn ki em Achenbach - ti
v 
CBCL-V-HN
Bn ki    n Vit
Nam ti ng ngoi
CBCL-V-HVHT
Bn ki    n Vit
Nam ti
CBCL-V-PVQT
Bn ki    n Vit
Nam ti qui tc
DESR:
T u chnh cu ht
DISC:
Bng ling vn ch em
DSM-IV:
S tay chi lon (Hi
n hc Hoa Kn ln th 
ICD - 10:
Bi bnh quc t (t chc y t th gii) ln th
10
PV:

 
ROC:
ng tip nhn
SD:
 lch chun

iii
VADPRS :
i long gi
b tr li
VADPRS-
ADHD
i long gi
b tr li  phn tii lon
ng gim ch
VADPRS-CY
i long gi
b tr li  phn ti

VADPRS-
i long gi
b tr li  phn ti
ng.

iv
MỤC LỤC

Trang
Li c
i
Danh mc vit tt
ii
Mc lc
iv
Danh mng
vi
Danh m
vii
MỞ ĐẦU
1
Chƣơng 1: CƠ SỞ L LUẬN
7
1.1. T hiu lc ca bng ki
tr c ri lo ng gi

7
1.1.1. T gii

7
1.1.2. Tc
10
1.2. Mt s 
11
1.2.1. Ri long gi
11
i long gi
17

22
c ca mt trc nghic
23
1.2.5. 
24

28
1.2.7 c ADHD
29
Chƣơng 2: TỔ CHỨC V PHƢƠNG PHÁP NGHIÊN CỨU
37
u
37
2.1.1. V u
37
2.1.2. Chn mu
37
u
39
 u

42
2.2. T chc nghu
46

v
c hin thu thp s liu
46
2.2.2. Ti u
46
Chƣơng 3: KT QUẢ NGHIÊN CỨU
48

48
-V
48

50
3.-ADHD
51
 tin cy c
53
 hiu lc c
54
 hit ca CBCL-V
54
 hiu lc hi t ca CBCL-V
56
 hiu lc d a CBCL-V
57
 ca CBCL-c ADHD

60
KT LUẬN V KHUYN NGH
64
1. Kt lun
64
2. Khuyn ngh
65
TI LIỆU THAM KHẢO
67
PHỤ LỤC
71





vi
DANH MỤC CÁC BẢNG

Trang
Bng 2.1: T l tu u
38
Bng 2.2: M
39
Bng 3.1: t s bin CBCL-V
48
B v ng gia
VADPRS

50

Ba DISC-ADHD
51
B tin cy ca mt s tiu test CBCL-V
53
B tin c
53
Bng
55
Ba v a CBCL-V viVADPRS
57
Bt qu -V-
59
Bng 3.9:Chi long gi
60
B cc ADHD
62

vii
DANH MỤC CÁC BIỂU ĐỒ

Trang
Bi m CBCL-V-CY gi
49
Bi m VADPRS-ADHD gi
51
Bi -ADHD gi
52
Bi            u 
ng.

55
Bi t qu c
58
Bi ng cong ROC
61

1
MỞ ĐẦU
1. Lý do chọn đề tài
Ri lon tng git trong nhng ri lo em
ng hay gp phi. Tr i long gi i din vi rt
nhiu v trong  

, trong hc tp 
trong cuc sng cng hu tp trung,
hay b d  n kt qu hc tp; cn

nh, d   n mi quan h vi mi xung
quanh ca tr.
Theo DSM  IV TR, t l  3 - 7% 
tr  tuc [18]. T chnh Hoa K
(CDC),  l: 3-10% tr  tui t 6-12 tu gii
i long gi [30].
 c ta, 



 

  l tr i lon








Nguyn Th  v 
ca hc sinh tiu hi long
gi l 1,63% tr i lon ng gim  tin
c sinh  ng tiu hc ti [12]. 
cu ca Nguyn Th Thu Hin (2012) ti  c sinh tiu hc
thuc khuc vc qu - i, t l tr i long gim
 [4]. Nng s v  
cc khn ca tr em Vit Nam-Thc tru t nguy
 l 4% tr em Vi v 

 m [9]. Tnh vi
u tip nhu tr u hi








u tr.
T giu  
c ri long gi  ng s (2010) 

2
ti    c ri long
gi        [24]   ng s (2005)  
u v vic ki hiu l u qu ca CBCL trong vic
nhn bit tr  v ri long gi c [25];
Lampert ng s (2004) u v hiu xut ca CBCL  ph
v  c ri long gi Brazil.
 Vi trc nghic Nguy
 c
ri long giu CBCL 
m c ri long gi
V thc tin, trong nhic ti Khoa nh ca Bnh vin
 nhn tht nhing hp tr 





 t  hong hc, vi ch
ch t qu hc t
  v  lri long gim
  ng tng hp, tr n i chn
i long gi
 lchun chi lo
ng gi u, y rng t a bnh
u, hoc tng hc trang b  v
 c ri long gi ch d
nhng triu ch ch
trng chu nhm ly.


, ti  (






, B, B
, 





 ,  





 







 : 




, 











 




 

3
DSM IV,  d 














 , t, 











ri long gi


















 








  ph cp r a bnh

   ng hc, 














   n Vit
Nam (CBCL  V) 
















.
2. Mục đích nghiên cứu
 nh    u lc cao trong  c ri lo 
ng gi a bu.
3. Đối tƣợng, khách thể nghiên cứu
3.1. Đối tượng nghiên cứu
 hiu lc ca Bng ki tr em Achenbach  n Vit
Nam (CBCL-c tr i long gi
3.2. Khách thể nghiên cứu
102 b  6 tu n 12 tui   ng
ngoi tnh vin.
3.3. Mẫu nghiên cứu
102 b m hoi tr tham gia tr
li phiu.
4. Giả thuyết khoa học
Bng ki em Achenbach  th s dng trong c tr 
ri long gi
5. Nhiệm vụ nghiên cứu
- H th n v   v ri lo
ng gim c,  hiu lc; v Bng ki

4
tr em Achenbach (CBCL),  i lo  ng gi
Vanderbilt (ADHD Vanderbilt) Bng li em 
phn chi long giDISC-IV  ADHD).
-  hiu lc hi t ca Bng ki em Achenbach
- n Vit Nam a Bng ki
tr n Vit Nam (CBCL-V) ph v 

  i lo  ng gi    (ADHD Vanderbilt)
ph ng gitronc tr  v ri lon
ng gi
-    hiu l  t ca Bng ki    em
Achenbach - n Vit Nam a kt qu
m th c t qu 
m th  cng.
-  hiu lc d a Bng ki em Achenbach -
n Vit Nam qua via kt qu t
qu chng vn chbng DISC.
- tr ca Bng ki n Vit
Nam c ri long gi.
6. Giới hạn phạm vi nghiên cứu
6.1. Giới hạn khách thể nghiên cứu
Tr em t n 12 tu (ho
ti Vin sc khn Bch Mai, Bnh vinh vin

6.2. Giới hạn nội dung nghiên cứu
     hiu lc ca
Bng ki em Achenbach - n Vit Nam ph v
v -V-CY) c tr i long gi

5
Ph-V   v  la
chn bn bnh vi  ng ngoi.
6.3. Giới hạn về không gian nghiên cứu
 
 

6.4. Nguồn thông tin

Cha m ho tr li bng hi.
7. Phƣơng pháp nghiên cứu
7.1. Phương pháp lý luận
t s v n, tham kh
 t s n nhu
 m.
7.2. Phương pháp trắc nghiệm
Thc hin ng hi:
- Bng ki em Achenbach n Vit Nam (CBCL-V),
- T   i lon  ng gi    (ADHD
Vanderbilt).
7.3. Phương pha
́
p pho
̉
ng vâ
́
n sâu
 ng Bng ling vn
ch em  phn chi long gi
(DISC-IV  ADHD).
7.4. Phương pháp thống kê toán học
   c th        li u tra
nht qu u c 
X  liu bng phn mm SPSS 19.0

6
8. Công cụ nghiên cứu
(1). Bng ki n Vit Nam (CBCL-V)
(2). i long gi (ADHD

Vanderbilt)
(3). ng vn ch em - ph
ri long gi-IV  ADHD).
9. Đóng góp mới của luận văn
u  v   hiu lc ca Bng kim
 em Achenbach  n Vit Nam (CBCL  V)  Vit Nam.
Kh ca Bng ki em Achenbach  
bn Vit Nam c tr i long gi
Cung cm m tin c hiu l c ri
long gi
10. Đạo đức nghiên cứu
- S chp nhn: tr  u phc s
a cha m ho ca tr.
- Quyn bo mt: bo mt  cung cp.
-  liu trung thc.
-  u, s liu c 
n.
11. Cấu trúc luận văn
n m u, kt lun, khuyn nghu tham kho, ph lc,
n
  nhng v 
 
 ch 
y m
u.
t qu ng kt qu
c.

7
CHƢƠNG 1

CƠ SỞ L LUẬN
1.1. Tổng quan nghiên cứu đánh giá độ hiệu lực của bảng kiểm hành vi
trẻ em Achenbach (CBCL) trong sàng lọc rối loạn tăng động giảm chú ý
1.1.1. Tổng quan tình hình nghiên cứu trên thế giới
Trong hai thp k tr li   c s dng r
  M  nhi gii, bi s ng v 
hiu lc  tin cy  nhiu n. nh nh
cu v  hiu lc c v sc khn
t nhiu v  hiu lc c
lc tr i long gi
 Chen  Biederman      n
i long gia th
nhba mu hi qui tuyu (s
tr  tui t 6-18 tui long git s
i long gic kim tra
 
mu ch v 
cu li lon giy
  g l  
nh chi long gi [21].
, ng s u v hiu xut chn
 a CBCL (CBCL- 
lc ri lo ng gi i lon
ng gi Brazil. CBCL-c thc hi em
n nhi chnh da
n DSM-IV i long gi. Hiu xut chn
      ng cong ROC. Kt qu   
AUC=0.79, 95%Cl=0.76- c bi i vi b   

8

95%Cl=0.82-   y rng hiu xut ch  a CBCL-
i vi vic tr i long git cao [27].
          u trong
cng, s dng CBCL i long gi
(ARS  the ADHD Rating Scale i long gim 
M hiu lc c
c ri long ginh b
n thc hin dn cha DSM  IV. Kt
qu c 46 tr  v ng gi, trong 
tr c chnh b ri long gi
t 90% m ranh gii, cho th hiu lc
d t cao. Nhhy rng vic s
dng kt hp c 
 d c th em b ri
long gich t hc. Np mt
ng dn h m u da
ng cn
t s hn ch c chn  c, c
mu ca ri long gii nh [25].
m 2007, mnhm c 
tr  ri long gia tr  c
thc hin bi ng s. M
   v vic ch  ri lon
ng gi n ca DSM  i lo
ng gi  dn ca ICD 10.  dng p
u bnh phm ca tr ci long gi
(Brazil, N=248 c; N=154)  s dng CBCL   hiu lc ca
u chng v v . Kt qu, m i
m s  t c a CBCL so

9
vi b c (p<0,05); kt qu CBCL 
ng n trong c hai nt qu cho thy rng vic
s di ch v  v  ca
 tin c hiu lc ri long
gi [29].
,  c ri lo
ng gi M gc Phi do Flowers  thc hin.
 dng thang  c tr em M
gi long gi. Ma   
th cung cp mn gu qu   M gc
i long gi Phn li lon
ng gi hiu lc b mt du chun cha
DSM-IV. Nhng n lc thc hi u
qu ci ri long gi th trong
n th c tc. ADHD  tin cu lc cao trong
c ADHD  tr i M gc Phi [24].
, Biederman ng s u v vic s dng CBCL
  t u chnh cu h
c vi ri long giTuy cn ch u tra v
 cnh biu hia ri lo
c ki  tit ch i
long gin tui v a tr. 
la chn 177 tr i long gi i lon
ng gia tui t 6-18 tui, (54% tr c
bng phng vn chng ca ch
  
CBLC-m >=180 < 210 trong tu ch
m cm)  u. 
   p = 0.01), mt t l a ri lon

10
c chi (z = 3.01, p = 0. i - 
41, p = 0.02) so vng ADHD. 
cho thy rng mt h -  n
tiu ch tr i long gi
thy r nh tr  ADHD [20].
 thy r gii quyt mt
phn nhu cu c c hi c ri long gi
 c  c
lc ADHD.
1.1.2. Tổng quan tình hình nghiên cứu trong nước
Nguy(2003) u  trc nghim
Conner nh trc nghi hu hi n tr 
ri long gi [7]vic x t qu ca Conner
i phc t ng r bin trong cng.
 u n hin
ng ri nhing gi hc sinh trung h
kt lun: h s t ch ging gi
 hn hng gic nghim Conner [3].
 
 -
-
-V


, hay 
  



11
1.2. Một số khái niệm công cụ
1.2.1. Rối loạn tăng động giảm chú ý
1.2.1.1. [32], [16]
ADHD , einrich
Hofman  . Trong
"The story of Fidgety Philip
   

 
 [32]. 
 
.
Neorge 
gia     
 - 


        
 [29].

  


              -


- Minimal Brain Dysfunction

12

 

 
 DSM-, 
 
Theo DSM  


 [18].
T
 


 [16].
1.2.1.2.   [16]
 
 

 .




  

 [16].

13

g  


 

                



 [16].
 giai
             

ti, k  ,
 ung quanh

               
 


  v
     [16].







14

1.2.1.3.  [32]
, 
 tranh

 do
 [13], [32].
  
. 


 

 [34]. 



 
 -  [29]

  
    
 






15


[12], [32].
 



             
 
[29].
  [29]:


. [12], [32].
 o:




1.2.1.4.  ADHD
-

8], [32].
+  [32]:
- -


- 


16
+  [32]:

- 


- 
    -       


- -7%.
Phân biệt với các bệnh:  c;
              

Tiên lượng [32]:
-            



- ADH -
              
 

1.2.1.5.  [29]
- 


- 
