Oppositional defiant and conduct disorders: issues to be resolved for DSM-IV.

Oppositional defiant and conduct disorders: issues to be resolved for DSM-IV.
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对立挑衅和品行障碍:DSM-IV 需要解决的问题。

DOI:
10.1097/00004583-199205000-00023
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发表时间:
1992
影响因子:
13.3
通讯作者:
Grimm,J
Grimm,J
中科院分区:
医学1区
文献类型:
--
作者:
Lahey,BB;Loeber,R;Quay,HC;Frick,PJ;Grimm,J

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对立违抗障碍(ODD)和品行障碍(CD)在症状和发病年龄之间的统计协变性方面都有相当大的区别。这两种障碍与精神损害和反社会行为家族史的关系相似,但CD的相关性比ODD更强。几乎所有青春期前CD发作的临床转诊青年都保留了在较早年龄出现的奇怪症状。此外,一些患有CD的年轻人在晚年典型地出现了一系列严重的反社会行为,这表明CD进一步发展。这些发现与ODD和CD的概念是一致的,它们是同一疾病的发展阶段、分级组织的严重程度,但两个发现支持在DSM-IV中区分不同的障碍:(1)许多患有ODD的年轻人从不发展CD,(2)在青春期第一次出现的CD似乎与ODD无关。
Oppositional defiant disorder (ODD) and conduct disorder (CD) are reasonably distinct both in terms of statistical covariation among symptoms and ages of onset. The two disorders are related in similar ways to impairment and family history of antisocial behavior, but the association is stronger for CD than ODD. Virtually all clinic-referred youths with prepubertal onset of CD have retained the symptoms of ODD that emerged at earlier ages. Furthermore, a set of serious antisocial behaviors characteristically emerges at later ages in some youths with CD, suggesting further developmental progression within CD. These findings are consistent with a conceptualization of ODD and CD as developmentally staged, hierarchically organized levels of severity of the same disorder, but two findings argue for distinguishing separate disorders inDSM-IV: (1) many youths with ODD never develop CD, and (2) CD that emerges for the first time in adolescence appears to be independent of ODD.
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