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MỐI TƯƠNG QUAN GIỮA LO ÂU - TRẦM CẢM VÀ MỨC ĐỘ BỊ BẮT NẠT CỦA HỌC SINH TRUNG HỌC CƠ SỞ

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I HC QUC GIA H NI TRNG I HC GIO DC NGUYN TH THU SNG MI TNG QUAN GIA LO U - TRM CM V MC B BT NT CA HC SINH TRUNG HC C S LUN VN THC S TM Lí HC H NI - 2015 I HC QUC GIA H NI TRNG I HC GIO DC NGUYN TH THU SNG MI TNG QUAN GIA LO U TRM CM V MC B BT NT CA HC SINH TRUNG HC C S LUN VN THC S TM Lí HC CHUYấN NGNH: TM Lí HC LM SNG TR EM V V THNH NIấN Mó s: Thớ im Ngi hng dn khoa hc: PGS.TS NGC KHANH H NI - 2015 LI CM N Tụi xin chõn thnh cm n cỏc Thy Cụ ca trng i Hc Giỏo Dc ó to iu kin v giỳp tụi quỏ trỡnh hc v nghiờn cu ti trng Tụi xin gi li cm n ti PGS TS Ngc Khanh, l giỏo viờn hng dn lun ca tụi, ó dnh nhiu thi gian v tõm huyt hng dn nghiờn cu, ng viờn tinh thn, giỳp tụi hon thnh lun Thc s ny Cui cựng, tụi xin gi n gia ỡnh, bn bố li cm n chõn thnh v sõu sc vỡ ó luụn bờn cnh ng viờn, to mi iu kin tt nht cho tụi sut thi gian tụi nghiờn cu v hon thnh lun Mc dự bn thõn ó c gng nhng chc chn lun khụng trỏnh c nhng thiu sút, tụi rt mong nhn c nhng ý kin úng gúp, b sung ca quý thy cụ v cỏc bn Xin trõn trng cm n! Bn Tre, ngy 10 thỏng 11 nm 2015 Tỏc gi Nguyn Th Thu Sng i DANH MC CC CH VIT TT BLH : Bo lc hc ng BNKT : Bt nt kinh t BNTC : Bt nt th cht BNTD : Bt nt tỡnh dc BNTT : Bt nt tinh thn DSM IV : S tay thng kờ v chn oỏn cỏc ri lon tõm thn rỳt gn ln th IV (DSM IV) HKHXH&NV : i hc khoa hc xó hi v nhõn TB : im trung bỡnh GAD- : Thang o lo õu (Generalized Anxiety Disorder 7-item (GAD-7)) ICD 10 : Phõn loi bnh quc t ln th 10 v cỏc RLTT v hnh vi Mụ t lõm sng v cỏc nguyờn tc ch o chn oỏn, bn dch ting Vit (ICD-10) PHQ- : Thang o trm cm (Patient Health Questionnaire 9) RLLA : Ri lon lo õu SKTT : Sc kho tõm thn SPSS : Phn mm x lý s liu h tr x lý v phõn tớch d liu s cp (Statistical Package for the Social Sciences) THCS : Trung hc c s THPT : Trung hc ph thụng YLDs : Ch s s nm sng b mt khuyt tt (Year lost due to disability-YLDs) ii MC LC LI CM N i DANH MC CC CH VIT TT ii MC LC iii DANH MC BNG v DANH MC BIU vi M U Chng 1: C S L LUN Error! Bookmark not defined 1.1.Vi Nột v lch s nghiờn cu Error! Bookmark not defined 1.1.1 Nhng nghiờn cu v bt nt trờn th gii Error! Bookmark not defined 1.1.2 Nhng nghiờn cu v bt nt Vit Nam Error! Bookmark not defined 1.2 Mt s khỏi nim c bn Error! Bookmark not defined 1.2.1 Khỏi nim b bt nt v ngi b bt ntError! Bookmark not defined 1.2.2 Mt s hỡnh thc bt nt thng gp Error! Bookmark not defined 1.2.3 Hc sinh trung hc c s Error! Bookmark not defined 1.2.4 Bt nt gia hc sinh vi hc sinh trung hc c s Error! Bookmark not defined 1.2.5 Trm cm Error! Bookmark not defined 1.2.6 Lo õu Error! Bookmark not defined Tiu kt chng 1: Error! Bookmark not defined Chng 2: T CHC V PHNG PHP NGHIấN CU Error! Bookmark not defined 2.1 Mt s c im v khỏch th v a bn nghiờn cu Error! Bookmark not defined 2.1.1 Mt s c im v khỏch th nghiờn cu Error! Bookmark not defined 2.1.2 Mt s c im v a bn nghiờn cu Error! Bookmark not defined iii 2.2 Quy trỡnh nghiờn cu Error! Bookmark not defined 2.3 Phng phỏp nghiờn cu Error! Bookmark not defined 2.3.1 Phng phỏp nghiờn cu lý lun Error! Bookmark not defined 2.3.2 Phng phỏp nghiờn cu thc tin Error! Bookmark not defined 2.3.3 Phng phỏp x lý thụng tin Error! Bookmark not defined Tiu kt chng 2: Error! Bookmark not defined Chng 3: KT QU NGHIấN CU Error! Bookmark not defined 3.1 Thc trng hnh vi bt nt hc sinh THCS Error! Bookmark not defined 3.1.1 B bt nt v tinh thn Error! Bookmark not defined 3.1.2 B bt nt v kinh t Error! Bookmark not defined 3.1.3 B bt nt v th cht Error! Bookmark not defined 3.1.4 B bt nt v tỡnh dc Error! Bookmark not defined 3.1.5 So sỏnh mc b bt nt theo cỏc nhúm hc sinh khỏc Error! Bookmark not defined 3.1.6 Cỏc yu t khỏc liờn quan ti bt nt Error! Bookmark not defined 3.2 Thc trng lo õu trm cm Error! Bookmark not defined 3.2.1 Mc lo õu Error! Bookmark not defined 3.2.2 Mc trm cm Error! Bookmark not defined 3.3 Mi tng quan gia vic b bt nt v lo õu trm cm Error! Bookmark not defined Tiu kt chng 3: Error! Bookmark not defined KT LUN V KHUYN NGH Error! Bookmark not defined Kt lun Error! Bookmark not defined Khuyn ngh Error! Bookmark not defined TI LIU THAM KHO PH LC Error! Bookmark not defined iv DANH MC CC BNG Trang Bng 2.1 Cỏc nhúm khỏch th theo c im nhõn khu hc 33 Bng 2.2 : S bn thõn ca khỏch th 34 Bng 3.1: Trung bỡnh cỏc loi bt nt 41 Bng 3.2: S lng v t l (%) hc sinh tr li mi phng ỏn tiu thang ú bt nt v tinh thn 42 Bng 3.3: S lng v t l (%) hc sinh tr li mi phng ỏn tiu thang ú bt nt v kinh t 44 Bng 3.4: S lng v t l (%) hc sinh b bt nt v th cht 45 Bng 3.5: S lng v t l (%) hc sinh tr li mi phng ỏn tiu thang o bt nt v tỡnh dc 46 Bng 3.6: Trung bỡnh cỏc hỡnh thc b bt nt theo khi/lp 47 Bng 3.7: Trung bỡnh cỏc hỡnh thc bt nt theo gii tớnh 48 Bng 3.8: Trung bỡnh cỏc hỡnh thc bt nt theo trng 49 Bng 3.9: a im hc sinh b bt nt 51 Bng 3.10: i tng thc hin bt nt 51 Bng 3.11: s lng v t l hc sinh phn ng thy bn bố cựng la b bt nt 52 Bng 3.12: Phõn loi lo õu 53 Bng 3.13: phõn loi trm cm 53 Bng 3.14: So sỏnh lo õu trm cm theo gii tớnh 54 Bng 3.15: So sỏnh lo õu trm cm theo hc lc 55 Bng 3.16: Mi tng quan gia vic b bt nt v lo õu trm cm 55 v Bng 3.17: So sỏnh trung bỡnh cỏc hỡnh thc bt nt vi cỏc hc sinh cú mc lo õu khỏc 56 Bng 3.18: So sỏnh trung bỡnh cỏc hỡnh thc bt nt vi cỏc hc sinh cú mc trm cm khỏc 57 Bng 3.19: D bỏo lo õu theo trung bỡnh bt nt 58 Bng 3.20: D bỏo lo õu theo cỏc bin thớch hc, lp, gii, o c, hc lc, trng 59 Bng 3.21: D bỏo trm cm theo trung bỡnh bt nt 60 Bng 3.22: D bỏo trm cm theo cỏc bin thớch hc, lp, gii, o c, hc lc, trng 60 DANH MC CC BIU Trang Biu 2.1: Biu s lng hc sinh theo tng 31 Biu 2.2: Biu s lng hc sinh theo tng trng 32 Biu 2.3: Biu s lng hc sinh theo gii 32 vi M U Lý chn ti Hin nc ta, chm súc v bo v tr em ngy cng c quan tõm ca Chớnh ph, c bit bo v tr b bo lc v th cht v tinh thn Nu nh nhng nm trc, xó hi v d lun thng quan tõm nhiu hn n vic bo v tr em di gúc ngi ln lm tn thng tr em nh: lm dng tỡnh dc, bo lc tinh thn, ỏnh p, lm dng sc lao ng thỡ thi gian gn õy, truyn thụng v d lun bt u quan tõm n vic tr b chớnh bn cựng la gõy tn thng Bng chng l, trờn cỏc phng tin thụng tin i chỳng, ó cú nhiu bi bỏo cp n vic hc sinh bt nt nhau, ú cú nhng trng hp ó gõy hu qu nghiờm trng v ht sc thng tõm Nhng nghiờn cu gn õy cng cho thy s phc v mi nguy hi ca nhng hnh vi bt nt tui hc trũ Khong 22,6% tr mu giỏo b bt nt t mc trung bỡnh n nng, khong 10% tr t n 12 c bn cựng lp xem l nn nhõn thng xuyờn ca bt nt [40] Bt nt trng hc thng c coi l nghiờm trng v mt cỏ nhõn, xó hi v giỏo dc Bt nt khụng ch gõy hu qu xu cho nn nhõn thi im b bt nt [41] [85][86][87][94][107], m cũn gõy hu qu v mt phỏt trin cm xỳc sau ny ca tr [76][87] Tr b bt nt cú th cú hnh vi sa sỳt, hn ch cỏc c hi giao lu v kt bn dn ti gim k nng xó hi Bt nt cng gõy nh hng xu c i vi ngi cú hnh vi bt nt Hc sinh chuyờn i bt nt hc sinh khỏc thng phỏt trin thnh thỳ vui vic th hin sc mnh v uy th i vi nn nhõn v khụng th phỏt trin s ng cm vi ngi khỏc C nh vy, nhng tr ú cú th s dn hỡnh thnh nhng hnh vi phm phỏp v ti ỏc [98] Ngoi nhng hu qu v mt xó hi nh b cụ lp, b loi nhúm bn, v hu qu hc nh hc gim sỳt, ớt tham gia hot ng trng lp [98] Bt nt cú th gõy nhiu hu qu nghiờm trng v mt cm xỳc v nhn thc nn nhõn, nh cụ n, lo õu, trm cm, thu mỡnh, kộm t tin Cỏc nghiờn cu v bt nt cú nh hng n sc kho tõm thn cho thy: Trong cỏc mu chn hc sinh trung hc ó kim tra ti Istabul, Th Nh K, t l b bt nt cao v liờn quan n biu hin ca trm cm S tip tc tri nghim bo lc v cng thng cỏc mi quan h xó hi s dn n cỏc biu hin tõm thn [99] Thanh thiu niờn nam l nn nhõn ca bt nn cựng la tri nghim mc stress v lo lng cao Cỏc em cho rng mụi trng trng hc ca cỏc em khụng an ton v s cú bo lc hc ng [92] Nhng nm gn õy, bt nt hc ng c nghiờn cu rt nhiu trờn th gii, nhiờn, ti Vit Nam cỏc nghiờn cu ch dng li vic nghiờn cu v thc trng, cỏc nguyờn nhõn, cng nh a mt vi gii phỏp phũng nga bo lc hc ng nh trng, gia ỡnh v xó hi Gn õy, ó cú nghiờn cu ti cp b Vin Tõm lý hc v bo lc hc ng, nguyờn nhõn v hu qu, nhiờn nghiờn cu trờn mu chn hc sinh ph thụng Bc v Trung Vy tỡnh trng bo lc hc ng hc sinh trung hc c s Nam v mi tng quan n sc kho tõm thn, c th l lo õu v trm cm nh th no rt cn c lm sỏng t Nghiờn cu ti: Mi tng quan gia lo õu trm cm v b bt nt ca hc sinh trung hc c s khụng nhng cú ý ngha v mt lý lun m cũn cú ý ngha v mt thc tin, s giỳp tr li cõu hi trờn Mc tiờu nghiờn cu Nghiờn cu ny nhm tỡm hiu v mi tng quan gia mc b bt nt v biu hin ca lo õu trm cm hc sinh trung hc c s Nhim v nghiờn cu 3.1 H thng hoỏ mt s lớ lun cú liờn quan n ti Lo õu, trm cm, bt nt, hc sinh trung hc c s, bt nt gia hc sinh vi hc sinh trung hc c s TI LIU THAM KHO Ti liu Ting Vit Vừ Vn Bn (2002), Thc hnh v iu tr tõm lý, NXB y hc H Ni Nguyn Thanh Cao (2012), Thc trng trm cm v mt s yu t nguy c n trm cm ngi trng thnh ti phng Sụng Cu, th xó Bc Kn nm 2011 v xut mt s gii phỏp, lun ỏn chuyờn khoa cp II Trn Vn Cụng, Bahr Weiss, David Cole (2009) B bt nt bi bn cựng la v mi liờn h vi nhn thc bn thõn, trm cm hc sinh ph thụng, Tp tõm lý hc s 11(128), 11-2009, S c bit nhõn thnh lp Trng i hc Giỏo dc Trn Vn Cụng, Bahr Weiss, David Cole, Phỏt trin v thớch nghi thang o bt nt v b bt nt cho tr em Vit Nam (cha xut bn) V Dng (2013), T in Tõm Lý hc, NXB T in bỏch 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