PREDICTIVE-VALIDITY OF CATEGORICALLY AND DIMENSIONALLY SCORED MEASURES OF DISRUPTIVE CHILDHOOD BEHAVIORS
PREDICTIVE-VALIDITY OF CATEGORICALLY AND DIMENSIONALLY SCORED MEASURES OF DISRUPTIVE CHILDHOOD BEHAVIORS
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DOI：
10.1097/00004583-199504000-00015
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发表时间：
1995-04-01
影响因子：
13.3
通讯作者：
HORWOOD, J
中科院分区：
文献类型：
--
作者：
FERGUSSON, DM;HORWOOD, J
目的：检验分类法和维度法对儿童破坏性行为变异的预测效度。方法：出生队列包括935名新西兰儿童在15岁时进行评估的措施的基础上DSM-III-R诊断标准对立违抗性障碍，行为障碍，注意力缺陷多动障碍。这些症状测量以两种方式评分：（1）使用DSM-III-R诊断标准作为病例或非病例;（2）作为维度变量，其中障碍的严重程度从无到严重不等。在16岁时，该队列重新评估了一系列措施，包括物质使用行为，青少年犯罪和辍学。结果如下：该分析比较了15岁时分类和维度评分指标作为16岁时观察到的结局预测因子的有效性。这种比较表明，症状严重程度和结局风险之间存在连续且通常呈线性的剂量反应函数，并且维度评分变量比基于诊断分类的测量值更能预测结局。结论：这些发现支持了这样一种观点，即破坏性行为问题具有维度属性，其中干扰的严重程度从无到严重不等。虽然DSM-III-R诊断标准可能具有相当大的价值和实用性，作为诊断年轻人行为障碍的一种手段，值得临床关注，常规使用这些标准作为描述行为变异性的一种手段，可能会导致测量系统产生的变量，具有低于最佳的预测有效性。
Objective: To examine the predictive validity of categorical and dimensional methods of representing variation in disruptive childhood behaviors. Method: A birth cohort comprising 935 New Zealand children was assessed at age 15 years on measures based on DSM-III-R diagnostic criteria for oppositional defiant disorder, conduct disorder, and attention-deficit hyperactivity disorder. These symptom measures were scored in two ways: (1) as cases or noncases using DSM-III-R diagnostic criteria and (2) as dimensional variables in which the severity of disturbance ranged from none to severe. At age 16 years the cohort was reassessed on a series of measures including substance use behaviors, juvenile offending, and school dropout. Results: The analysis compared the efficacy of the categorically and dimensionally scored measures at age 15 years as predictors of outcomes observed at age 16 years. This comparison showed evidence of continuous and generally linear dose-response functions between symptom severity and outcome risks and that dimensionally scored variables were considerably better predictors of outcome than measures based on a diagnostic classification. Conclusions: These findings support the view that disruptive behavior problems have dimensional properties in which the severity of disturbance ranges from none to severe. While DSM-III-R diagnostic criteria may have considerable value and utility as a means of diagnosing in young people behavior disturbances that merit clinical attention, the routine use of these criteria as a means of describing behavioral variability may result in a system of measurement that produces variables that have less than optimal predictive validity.