Development of disruptive behavior disorders from early childhood to adolescence

破坏性行为障碍的特征是反社会、攻击性行为。外化问题是儿童心理健康问题中最常见的诊断问题。随着时间的推移，它们往往是稳定的，对治疗耐药，并与青春期和成年期的精神障碍有关。早发性攻击是生命过程中持续的反社会行为的先兆。然而，人们对促成不同发展结果的宪法和环境因素及其相互作用知之甚少。对82名低、中或高风险的4-5岁儿童在随后的三个时间点：6-7岁、8-10岁和12-13岁进行了研究，这些儿童后来患有破坏性行为障碍(基于外化问题的初始水平)。结合社会化经验，研究儿童功能的社会、情感、认知和生理领域。目标是找出导致幼儿行为问题随时间延续和变化的关键因素。这里研究的学龄前儿童的问题随着时间的推移表现出显著的稳定性，表明他们的慢性、普遍的性质。以前关于这个样本的报告描述了适应性的儿童养育做法和儿童特征，这些因素导致一些儿童的行为问题最初有所减少。还确定了儿童和父母的风险因素，这些因素有助于维持其他儿童的问题。目前的项目侧重于跟踪这些儿童进入青春期早期。早期和并发的问题都被发现可以预测青春期对社会压力的负面影响和生理反应。早期发现的问题的稳定性一直持续到青春期。接受精神诊断的参与者人数显著增加，通常存在共病(例如，患有内在性(焦虑、抑郁)和外在性(对立、反社会)问题的青少年)。因为与男孩相比，女孩的破坏性行为问题更有可能伴随着焦虑和抑郁，这可能会导致后来在精神病理学形式上的性别差异。我们已经确定了应对的早期性别差异，这可能会使女孩面临更大的内在化问题风险。

Disruptive behavior disorders are characterized by antisocial, aggressive behaviors. Externalizing problems are the most commonly diagnosed mental health problems of childhood. They tend to be stable over time, resistant to treatment, and linked to psychiatric disorders in adolescence and adulthood. Early onset aggression is a precursor of life-course persistent antisocial behavior. Little is known, however, about constitutional and environmental factors, and their interactions, that contribute to different developmental outcomes. Eighty-two 4-5 year-old children at low, moderate or high risk for later disruptive behavior disorders (based on initial levels of externalizing problems), have been studied at three subsequent time points; 6-7, 8-10, and 12-13 years. Social, emotional, cognitive, and physiological areas of child functioning are examined, in conjunction with socialization experiences. The goal is to identify key factors that contribute to continuity and change over time in young children's behavioral problems. The problems of preschool children studied here have shown marked stability over time, indicating their chronic, pervasive nature. Previous reports on this sample described adaptive child-rearing practices and child characteristics that contributed to initial decreases in behavior problems for some of the children. Child and parent risk factors also were identified that contributed to the maintenance of problems for other children. Current projects focus on followup of these children into early adolescence. Both early and concurrent problems have been found to predict negative affect and physiological reactivity to social stress in adolescence. The stability of problems identified at earlier time points continues into adolescence. There is a marked increase in the number of participants who receive psychiatric diagnoses, with comorbidity often present (e.g. adolescents who have internalizing (anxiety, depression) as well as externalizing (oppositional, antisocial) problems. Because disruptive behavior problems are more likely to be comorbid with anxiety and depression in girls than boys, this may lead to later sex differences in forms of psychopathology. We have identified early sex differences in coping that may place girls at greater risk for internalizing problems.