DSM-IV field trials for oppositional defiant disorder and conduct disorder in children and adolescents.
DSM-IV field trials for oppositional defiant disorder and conduct disorder in children and adolescents.
复制标题
DSM-IV 针对儿童和青少年对立违抗性障碍和品行障碍的现场试验。
DOI：
10.1176/ajp.151.8.1163
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发表时间：
1994
期刊：
影响因子：
--
通讯作者：
Newcorn,J
中科院分区：
文献类型：
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作者：
Lahey,BB;Applegate,B;Barkley,RA;Garfinkel,B;McBurnett,K;Kerdyk,L;Greenhill,L;Hynd,GW;Frick,PJ;Newcorn,J
目的：通过对440例4~17岁儿童青少年的临床研究，筛选出有效的诊断阈值，并比较DSM-IV中的对立违抗性障碍和品行障碍诊断标准的心理测量学特性。方法对440名4~17岁的儿童青少年进行结构化诊断性访谈、标准化的临床医生验证诊断和多项损伤测量。结果4种对立违抗性障碍的诊断阈值优化了儿童的识别，提高了与临床医生验证诊断的一致性，重测一致性优于DSM-III-R。在品行障碍的情况下，明确了确定症状的最佳时间窗口。三种品行障碍症状的诊断阈值最大限度地提高了对受损儿童的准确识别，并与临床医生的验证诊断相一致，导致重测一致性略好于DSM-III-R。结论DSM-IV对对立违抗性障碍和品行障碍的定义在内部一致性和重测一致性方面略好于DSM-III-R定义，DSM-IV对对立违抗性障碍的定义效度略好于DSM-III-R定义。
ObjectiveThe purpose of the field trials for oppositional defiant disorder and conduct disorder was to select valid diagnostic thresholds for these disorders and to compare the psychometric properties ofDSM-IV criteria for oppositional defiant disorder and conduct disorder with previous DSM diagnostic formulations.MethodStructured diagnostic interviews, standardized clinician’s validation diagnoses, and multiple measures ofimpairment were obtamed for 440 clinic-referred children and adolescents aged 4-1 7 years.ResultsA diagnostic threshold of four symptoms of oppositional defiant disorder optimized identification of impaired children, improved agreement somewhat with the clinician’s validation diagnosis, and had somewhat better test-retest agreement than DSM-III-R. In the case of conduct disorder, the optimal time window for ascertainment ofsymptoms was clarified. A diagnostic threshold ofthree symptoms ofconduct disorder maximized accurate identification ofimpaired children and agreement with the clinician’s validation diagnosis and resulted in slightly better test-retest agreement than DSM-III-R. Compared with the DSM-III-R definition, the DSM-IV definition ofoppositional defiant disorder was somewhat more prevalent, but the prevalence of conduct disorder was essentially unchanged.ConclusionsDSM-IV definitions ofoppositional defiant disorder and conduct disorder are somewhat better than DSM-III-R definitions in terms of internal consistency and test-retest agreement, and the validity of the DSM-IV definition of oppositional defiant disorder is slightly better than that of DSM-III-R.