Contextual variation in young children's observed disruptive behavior on the DB-DOS: implications for early identification.
Contextual variation in young children's observed disruptive behavior on the DB-DOS: implications for early identification.
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DOI：
10.1111/jcpp.12430
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发表时间：
2015-09
期刊：
影响因子：
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通讯作者：
Wakschlag LS
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文献类型：
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作者：
Petitclerc A;Briggs-Gowan MJ;Estabrook R;Burns JL;Anderson EL;McCarthy KJ;Wakschlag LS
儿童破坏性行为的背景变化是有据可查的，但仍然知之甚少。我们首先研究如何在观察到的破坏性行为的变化，在整个intermittent上下文与产妇的上下文变化的报告，在对立违抗行为和功能障碍。第二，我们测试是否儿童抑制控制解释了观察到的破坏性行为的上下文变化的大小。参与者是497名幼儿（平均年龄= 4岁，11个月），来自MAPS的子样本，一个社会人口统计学上多样化的儿科样本，丰富的破坏性行为的风险。在与父母和考官的互动过程中，观察到的愤怒调节和行为调节问题被编码在破坏性行为诊断观察计划（DB-DOS）上。与母亲进行学龄前精神病评估（PAPA）访谈，测量与父母和非父母成年人的对立违抗行为和关系障碍。家庭生活损害量表（FLIS）评估家庭和户外活动的功能障碍，基线调查和FLIS测量儿童保育/学校的开除情况。在DB-DOS父母情境中观察到的破坏性行为与父母的对立违抗行为以及在家和外出时的损伤有关。观察到的破坏性行为与审查员与父母和非父母的成年人的对立违抗行为，与非父母的成年人的关系受损，儿童保育/学校开除。观察到的破坏性行为在父母与考官的背景下的差异与母亲的报告的反对违抗行为与父母与非父母的成年人的差异。从父母到考官的破坏性行为减少较大的儿童有更好的抑制控制和更少的注意力缺陷/多动障碍症状。DB-DOS在社区样本中显示出临床实用性，用于识别映射到报告的对立违抗行为和跨上下文功能的上下文变化。阐明背景变化对早期识别和有针对性的预防的影响是未来研究的重要领域。
Contextual variation in child disruptive behavior is well documented but remains poorly understood. We first examine how variation in observed disruptive behavior across interactional contexts is associated with maternal reports of contextual variation in oppositional-defiant behavior and functional impairment. Second, we test whether child inhibitory control explains the magnitude of contextual variation in observed disruptive behavior. Participants are 497 young children (mean age = 4 years, 11 months) from a subsample of the MAPS, a sociodemographically diverse pediatric sample, enriched for risk of disruptive behavior. Observed anger modulation and behavioral regulation problems were coded on the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS) during interactions with parent and examiner. Oppositional-defiant behavior, and impairment in relationships, with parents and nonparental adults, were measured with the Preschool Age Psychiatric Assessment (PAPA) interview with the mother. Functional impairment in the home and out-and-about was assessed with the Family Life Impairment Scale (FLIS), and expulsion from child care/school was measured with the baseline survey and FLIS. Observed disruptive behavior on the DB-DOS Parent Context was associated with oppositional-defiant behavior with parents, and with impairment at home and out-and-about. Observed disruptive behavior with the Examiner was associated with oppositional-defiant behavior with both parents and nonparental adults, impairment in relationships with nonparental adults, and child care/school expulsion. Differences in observed disruptive behavior in the Parent versus Examiner Contexts was related to the differences in maternal reports of oppositional-defiant behavior with parents versus nonparental adults. Children with larger decreases in disruptive behavior from Parent to Examiner Context had better inhibitory control and fewer attention-deficit/hyperactivity disorder symptoms. The DB-DOS showed clinical utility in a community sample for identifying contextual variation that maps onto reported oppositional-defiant behavior and functioning across contexts. Elucidating the implications of contextual variation for early identification and targeted prevention is an important area for future research.