CHILD DISRUPTIVE/MOOD DISORDERS--DIAGNOSIS AND COURSE

目前的项目是一个三阶段调查的开始， 儿童期分裂性和抑郁性障碍的外部效度。 的 该项目的目的是比较破坏性和破坏性/抑郁 儿童对四个主要类别的因变量：背景 （社会经济地位、父母教养方式、生活环境）; （转诊时的认知、学业和注意力表现）;治疗 反应（对行为管理药物的初始反应）; 和结果（16岁时的精神、认知和行为状态， 21岁）。 在该项目的诊断和治疗反应初期，192 将对7至11岁的男性门诊患者进行研究， 四年期间。 将形成六个诊断亚组： 多动;专性攻击性;多动和攻击性共病; 多动和抑郁共病;攻击和抑郁共病; 和混合型多动/攻击性/抑郁。 基线诊断后 评估，每个孩子将被随机分配接受10周 安慰剂对照药物治疗（哌甲酯）或10 心理治疗周（行为导向的父母组 培训）。 计划的多变量分析将解决不同的有效性问题 和科摩罗。 将研究并比较两个诊断系统： Loney的二维模型和DSM（III，III-R和IV）系统。 一 核心实质性问题是， 诊断模型具有不同的患病率、背景因素或 治疗反应。 一个中心的方法论目标是比较经验 和临床方法，用于组合来自量表，来源， 和设置。 这些活动的最终目标是获得声音 建议统一诊断有破坏性的儿童。

The current project is the beginning of a three-phase investigation of the external validity of childhood disruptive and depressive disorders. The aim of the project is to compare disruptive and disruptive/depressive children on four main classes of dependent variables: Background (socioeconomic status, parenting styles, living circumstances); Individual (cognitive, academic, and attentional performance at referral); Treatment Response (initial responsiveness to medication of behavioral management); and Outcome (psychiatric, cognitive, and behavioral status at 16 and again at 21 years of age). In this initial Diagnostic and Treatment Response phase of the project, 192 male out-patients between 7 and 11 years of age will be studied over a four-year period. Six diagnostic subgroups will be formed: Exclusively Hyperactive; Exclusively Aggressive; Comorbid Hyperactive and Aggressive; Comorbid Hyperactive and Depressive; Comorbid Aggressive and Depressive; and Mixed Hyperactive/Aggressive/Depressive. After a baseline diagnostic assessment, each child will be randomly assigned to receive either 10 weeks of a placebo-controlled pharmacological treatment (methylphenidate) or 10 weeks of a psychological treatment (behaviorally oriented parent group training). Planned multivariate analyses will address questions of divergent validity and comorbidity. Two diagnostic systems will be studied and then compared: Loney's Two-Dimensional model and the DSM (III, III-R, and IV) system. A central substantive question is whether subgroups within and across the two diagnostic models have different prevalence, background factors, or treatment response. A central methodological aim is to compare empirical and clinical methods for combining diagnostic data from scales, sources, and settings. A final goal of these activities is to derive sound proposals for unifying the diagnosis of disruptive children.