Predictive Validity of Childhood Oppositional Defiant Disorder and Conduct Disorder: Implications for the DSM-V
Predictive Validity of Childhood Oppositional Defiant Disorder and Conduct Disorder: Implications for the DSM-V
复制标题
DOI：
10.1037/a0019708
复制
发表时间：
2010-11-01
影响因子：
4.6
通讯作者：
Lahey, Benjamin B.
中科院分区：
文献类型：
--
作者：
Burke, Jeffrey D.;Waldman, Irwin;Lahey, Benjamin B.
数据来自对儿童和青少年的3项研究，以评估《精神障碍诊断和统计手册》第4版(DSM-IV；美国精神病学协会，1994年)和《国际疾病分类》第10版(ICD-10；世界卫生组织，1992)中定义的儿童对立违抗性障碍(ODD)和品行障碍(CD)的预测有效性。目前的分析有力地支持了这些诊断的预测有效性，因为它们既可以预测未来的精神病理学，也可以预测持久的功能损害。此外，目前的研究结果普遍支持DSM-IV中的等级发展假说，即一些儿童有奇怪的进展到儿童期起病CD，一些患有CD的青少年进展到反社会人格障碍(APD)。尽管如此，他们揭示了Cd并不总是与ODD共存，特别是在青春期。重要的是，目前的发现表明，ICD-10的ODD-10诊断标准，当CD的诊断标准不满足时，将CD症状视为ODD症状，比DSM-IV更严格的ODD-IV定义识别出更多的功能受损儿童。填补DSM-IV中ODD标准中的这一“漏洞”应该是DSM-V的优先事项。此外，目前的研究结果表明，尽管童年时期人际冷酷的心理变态特征独立地预测了未来的apd。这些发现并不能证实冷酷无情是CD儿童的一个子集具有更高的雪崩风险的假设。
Data are presented from 3 studies of children and adolescents to evaluate the predictive validity of childhood oppositional defiant disorder (ODD) and conduct disorder (CD) as defined in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV; American Psychiatric Association, 1994) and the International Classification of Diseases, Version 10 (ICD-10; World Health Organization, 1992). The present analyses strongly support the predictive validity of these diagnoses by showing that they predict both future psychopathology and enduring functional impairment. Furthermore, the present findings generally support the hierarchical developmental hypothesis in DSM-IV that some children with ODD progress to childhood-onset CD, and some youth with CD progress to antisocial personality disorder (APD). Nonetheless, they reveal that CD does not always co-occur with ODD, particularly during adolescence. Importantly, the present findings suggest that ICD-10 diagnostic criteria for ODD, which treat CD symptoms as ODD symptoms when diagnostic criteria for CD are not met, identify more functionally impaired children than the more restrictive DSM-IV definition of ODD. Filling this "hole" in the DSM-IV criteria for ODD should be a priority for the DSM-V. In addition, the present findings suggest that although the psychopathic trait of interpersonal callousness in childhood independently predicts future APD. these findings do not confirm the hypothesis that callousness distinguishes a subset of children with CD with an elevated risk for APD.