The clinical utility of the proposed DSM-5 callous-unemotional subtype of conduct disorder in young girls.
The clinical utility of the proposed DSM-5 callous-unemotional subtype of conduct disorder in young girls.
复制标题
所提出的 DSM-5 冷酷无情感行为障碍亚型在年轻女孩中的临床效用。
DOI：
10.1016/j.jaac.2011.10.005
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发表时间：
2012
影响因子：
13.3
通讯作者：
Loeber,Rolf
中科院分区：
文献类型：
--
作者：
Pardini,Dustin;Stepp,Stephanie;Hipwell,Alison;Stouthamer-Loeber,Magda;Loeber,Rolf
目的：品行障碍（CD）的一种冷酷无情（CU）亚型已被提议作为精神障碍诊断与统计手册（DSM-5）第五版的新增内容。该研究验证了一个假设，即患有CU亚型乳糜泻的年轻女孩与单独患有乳糜泻的女孩相比，随着时间的推移会表现出更严重的反社会行为和更轻的内化问题。其次，在没有CD的情况下，研究了具有CU特征的女孩的发育结果，因为这些女孩可能被拟议的CU亚型方案所忽视。方法对1862名6 ~ 8岁的社区女童进行调查。结果包括内在化和外在化问题，学业成绩，同时评估和6年随访时的整体损伤。结果患有CU亚型乳糜泻的女孩比单独患有乳糜泻的女孩有更高水平的外化障碍症状、欺凌、关系攻击和整体损害。单独患有CD的女孩往往比患有CD的CU亚型的女孩有更多的焦虑问题。与没有CU特征和CD的女孩相比，患有CD的高CU特征的女孩在6年的随访中表现出更高的ODD和注意缺陷/多动障碍（ADHD）症状，学习成绩较低。6年随访期间的组间差异主要是基线结果差异。结论拟议的DSM-5 CD CU亚型识别出比单独患有CD的女孩表现出更低的焦虑问题和更严重的攻击、CD症状、学业问题和整体损害的年轻女孩。
OBJECTIVEA callous-unemotional (CU) subtype of conduct disorder (CD) has been proposed as an addition to the fifth edition of the Diagnostic and Statistic Manual of Mental Disorders (DSM-5). This study tested the hypothesis that young girls with the CU subtype of CD would exhibit more severe antisocial behavior and less severe internalizing problems over time relative to girls with CD alone. Second, the developmental outcomes of girls with CU traits in the absence of CD was examined because these girls would be overlooked by the proposed CU subtyping scheme.METHODTheses issues were examined in a community sample of 1,862 girls 6 to 8 years of age at study onset. Outcomes included internalizing and externalizing problems, academic achievement, and global impairment assessed concurrently and at a 6-year follow-up.RESULTSGirls with the CU subtype of CD had higher levels of externalizing disorder symptoms, bullying, relational aggression, and global impairment than girls with CD alone. Girls with CD alone tended to have more anxiety problems than girls with the CU subtype of CD. Girls with high CU traits without CD exhibited higher ODD and attention-deficit/hyperactivity disorder (ADHD) symptoms and lower academic achievement at the 6-year follow-up relative to girls without CU traits and CD. Group differences at the 6-year follow-up were primarily accounted for by baseline differences on the outcomes.CONCLUSIONSThe proposed DSM-5 CU subtype of CD identifies young girls who exhibit lower anxiety problems and more severe aggression, CD symptoms, academic problems and global impairment across time than girls with CD alone.