Impact of oppositional defiant disorder dimensions on the temporal ordering of conduct problems and depression across childhood and adolescence in girls
Impact of oppositional defiant disorder dimensions on the temporal ordering of conduct problems and depression across childhood and adolescence in girls
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DOI：
10.1111/j.1469-7610.2011.02448.x
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发表时间：
2011-10-01
影响因子：
7.6
通讯作者：
Keenan, Kate
中科院分区：
文献类型：
--
作者：
Hipwell, Alison E.;Stepp, Stephanie;Keenan, Kate
背景资料：关于对立违抗性障碍（ODD）维度在儿童期和青春期女孩行为障碍（CD）和抑郁症的时间演变中的作用知之甚少。方法：每年CD和抑郁症之间的关联进行了检查，每年收集的数据（8至16岁）从匹兹堡女孩研究的1215名参与者的9波。一系列的自回归路径模型进行了测试，其中包括ODD-情绪失调（ODD-ED）和ODD-违抗，作为随时间变化的协变量CD预测抑郁症的严重程度，在接下来的一年，反之亦然。结果如下：行为问题，抑郁症和ODD维度在整个儿童期和青少年期相对稳定，这些变量之间存在中等程度的协方差。路径分析表明，CD往往先于抑郁症在这一发展时期，虽然效果的大小是小的。从抑郁症到CD的预测不太一致。ODD-ED和CD的重叠部分解释了CD与抑郁的前瞻性关系，而这些路径完全由ODD-ED和抑郁的重叠来解释。ODD-Defiance和CD之间的重叠并不能解释CD与抑郁症的前瞻性关系。相反，ODD挑战和抑郁症之间的重叠几乎解释了从CD到抑郁症的所有路径。考虑到ODD维度与CD和抑郁之间的重叠，消除了所有显著的预测路径。结论：CD的症状往往先于抑郁症的女孩在童年和青春期。然而，抑郁症和ODD-ED和ODD-Defiance之间的协方差解释了这些前瞻性关系。在评估有行为问题的女孩患抑郁症的风险时，应评估ODD维度，并将ODD的情绪失调和蔑视方面确定为治疗目标，以预防未来的抑郁症。
Background: Little is known about the role of oppositional defiant disorder (ODD) dimensions on the temporal unfolding of conduct disorder (CD) and depression in girls between childhood and adolescence. Method: The year-to-year associations between CD and depressive symptomatology were examined using nine waves of annually collected data (ages 8 through 16 years) from 1215 participants of the Pittsburgh Girls Study. A series of autoregressive path models were tested that included ODD-Emotion Dysregulation (ODD-ED) and ODD-Defiance, as time-varying covariates on CD predicting depression severity in the following year, and vice versa. Results: Conduct problems, depression, and ODD dimensions were relatively stable throughout childhood and adolescence, and a moderate degree of covariance was observed between these variables. Path analyses showed that CD often preceded depression across this developmental period, although the effect sizes were small. There was less consistent prediction from depression to CD. The overlap between ODD-ED and CD partially explained the prospective relations from CD to depression, whereas these paths were fully explained by the overlap between ODD-ED and depression. The overlap between ODD-Defiance and CD did not account for the prospective relations from CD to depression. In contrast, the overlap between ODD-Defiance and depression accounted for virtually all paths from CD to depression. Accounting for the overlap between ODD dimensions and both CD and depression eliminated all significant predictive paths. Conclusions: Symptoms of CD tend to precede depression in girls during childhood and adolescence. However, covariance between depression and both ODD-ED and ODD-Defiance accounts for these prospective relations. ODD dimensions should be assessed when evaluating risk for comorbid depression in girls with conduct problems, and emotion dysregulation and defiance aspects of ODD should be identified as targets for treatment in order to prevent depression in the future.