Significance of childhood conduct problems to later development of conduct disorder among children with ADHD: A prospective follow-up study
Significance of childhood conduct problems to later development of conduct disorder among children with ADHD: A prospective follow-up study
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DOI：
10.1023/b:jacp.0000037784.80885.1a
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发表时间：
2004-10-01
影响因子：
3.6
通讯作者：
Moulton, JL
中科院分区：
文献类型：
--
作者：
Mannuzza, S;Klein, RG;Moulton, JL
本研究调查了患有注意缺陷多动障碍 (ADHD) 的儿童中低至中度的儿童对立违抗障碍 (ODD) 和品行障碍 (CD) 行为是否会导致青春期临床诊断的 CD 的发展。参与者是 207 名患有注意力缺陷多动症（ADHD）但未诊断为行为障碍的白人男孩（6-12 岁）。获得了家长和老师的评分。临床医生对参与者的平均年龄为 18 岁，对他们的童年状况不知情。还对非多动症组（在青春期招募）进行了研究。 ODD 行为评级不能预测青春期的 CD，而 CD 行为评级则可以。没有任何单一的 ODD 或 CD 行为可以预测青少年的结局。与非 ADHD 对照组相比，父母和老师对所有 CD 行为评分非常低（一点也不，只是一点点）的 ADHD 先证者在青春期患 CD 的风险仍然显着增加。儿童时期的 ODD 和 CD 行为以及成年后的反社会人格障碍（平均年龄，25 岁）之间也发现了相同的关系。我们得出的结论是，即使儿童时期没有共病 ODD 或 CD，儿童 ADHD 也是后来反社会障碍的发展前兆。然而，低水平的 CD 类型问题并非无害，因为它们可以预测无合并 CD 的 ADHD 儿童的后期 CD。
This study investigates whether low to moderate levels of childhood oppositional defiant disorder ( ODD) and conduct disorder ( CD) behaviors contribute to the development of clinically diagnosed CD in adolescence, in children with attention deficit hyperactivity disorder (ADHD). Participants were 207 White boys ( ages 6-12) with ADHD free of conduct disorder diagnoses. Parent and teacher ratings were obtained. Participants were assessed at mean age 18 by clinicians blind to childhood status. A non-ADHD group ( recruited in adolescence) was also studied. ODD behavior ratings did not predict CD in adolescence, whereas CD behavior ratings did. No single ODD or CD behavior predicted adolescent outcome. ADHD probands with very low ratings ( Not at all, Just a little) by parents and teachers on all CD behaviors were still at significantly increased risk for CD in adolescence, compared to non-ADHD controls. The same relationships were found between childhood ODD and CD behaviors, and antisocial personality disorder in adulthood ( mean age, 25). We conclude that childhood ADHD is a developmental precursor of later antisocial disorder, even in the absence of comorbid ODD or CD in childhood. However, low levels of CD-type problems are not innocuous, because they predict later CD among children with ADHD without comorbid CD.