Preschool Irritability: Longitudinal Associations With Psychiatric Disorders at Age 6 and Parental Psychopathology
Preschool Irritability: Longitudinal Associations With Psychiatric Disorders at Age 6 and Parental Psychopathology
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DOI：
10.1016/j.jaac.2013.09.007
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发表时间：
2013-12-01
影响因子：
13.3
通讯作者：
Klein, Daniel N.
中科院分区：
文献类型：
--
作者：
Dougherty, Lea R.;Smith, Victoria C.;Klein, Daniel N.
目的：青少年慢性易激惹越来越受到科学和临床的关注。然而，人们对幼儿期慢性烦躁的预测有效性和临床意义知之甚少。这项前瞻性的纵向研究探讨了在一个大的社区样本的学龄前儿童慢性易怒与精神疾病和父母的精神病理学的关联。方法：462名学龄前儿童在3岁和6岁时进行了评估。在基线（3年）和随访（6年）时，使用诊断性访谈（学龄前儿童精神病学评估）对儿童精神病理学进行评估。学龄前儿童精神病学评估的项目被用来创建慢性易怒的维度测量。在基线时通过诊断性访谈评估父母的精神病理学。结果如下：慢性易激惹同时与广泛的精神疾病和功能障碍，在3岁和6岁。在控制基线疾病后，3年时的易怒可预测6年时的抑郁、对立违抗性障碍和功能障碍。易怒也与父母的抑郁和焦虑有关。结论：研究结果强调了易怒在早期出现的心理健康问题中的核心作用。他们是一致的纵向研究表明，在大龄青年慢性易怒预测以后的抑郁和焦虑，并支持早期检测和干预措施的重要性，针对学龄前易怒。
Objective: There is increasing scientific and clinical attention to chronic irritability in youth. However, little is known about the predictive validity and clinical significance of chronic irritability during early childhood. This prospective, longitudinal study examined associations of chronic irritability with psychiatric disorders and parental psychopathology in a large community sample of preschoolers. Method: Four hundred sixty-two preschool-age children were assessed at 3 and 6 years of age. Child psychopathology was assessed at baseline (3 years) and follow-up (6 years) using a diagnostic interview, the Preschool Age Psychiatric Assessment, with parents. Items from the Preschool Age Psychiatric Assessment were used to create a dimensional measurement of chronic irritability. Parental psychopathology was assessed with a diagnostic interview at baseline. Results: Chronic irritability was concurrently associated with a wide range of psychiatric disorders and functional impairment at 3 and 6 years of age. Irritability at 3 years predicted depression, oppositional defiant disorder, and functional impairment at 6 years after controlling for baseline disorders. Irritability also was associated with parental depression and anxiety. Conclusions: Findings underscore the central role of irritability in early-emerging mental health problems. They are consistent with longitudinal studies in older youth indicating that chronic irritability predicts later depression and anxiety and support the importance of early detection and interventions targeting preschool irritability.