Development Of Disruptive Behavior Disorders From Early

破坏性行为障碍的特征是反社会，攻击性行为。外化问题是儿童时期最常见的心理健康问题。它们往往随着时间的推移而稳定，对治疗有抵抗力，并与青春期和成年期的精神疾病有关。早发性攻击是终生持续性反社会行为的前兆。然而，人们对导致不同发育结果的体质和环境因素及其相互作用知之甚少。82个4 - 5岁的儿童在低，中度或高风险的后期破坏性行为障碍（基于初始水平的外化问题），已在随后的三个时间点进行了研究; 6 - 7，8 - 10，和12 - 13年。儿童功能的社会，情感，认知和生理领域的研究，结合社会化的经验。我们的目标是确定关键因素，有助于随着时间的推移，在幼儿的行为问题的连续性和变化。 儿童和父母的风险和保护因素，有助于在童年中期的问题的连续性与改善已经确定。目前的项目侧重于这些儿童在青春期早期的功能。5个项目的主要调查结果概述如下。(1)注意力缺陷多动障碍的症状在不同的环境、被调查者和衡量标准中表现出一致性。青春期的ADHD症状可以通过认知功能、敌意和低内疚感的早期损害来预测。ADHD亚型的症状与不同的认知和情绪特征相关。(2)到了青春期，在儿童早期具有攻击性的男性和女性之间存在重要的性别差异。女孩比男孩更容易出现抑郁和焦虑的共病症状。共病内化问题的发展可能有助于抑制以后的反社会行为，但产生随后的情绪障碍的风险。(3)非言语情绪线索加工困难的学龄前儿童在青春期有更多的行为问题和更少的自我能力。这些纵向模式对男孩来说比女孩更强。(4)在学龄前有最严重行为问题的男性青少年，在涉及冲突讨论的社会挑战范式期间和之后，皮质醇水平高于受干扰较少的儿童。因此，有攻击性和反社会行为史的儿童的生理反应失调可能会导致适应不良行为和破坏性，特别是在男孩中。（5）早期的社会化过程会导致后来的情绪和行为问题。早期的婚姻冲突预示着青春期的内在和外在问题，即使在考虑了这些早期儿童的症状之后。此外，早期的支持性父母预测青少年的经验和控制愤怒的方式，积极的父母可能会帮助孩子管理他们的敌对冲动。累积起来，这些研究强调需要研究生物和环境过程的相互作用，以了解不同的发展轨迹的男孩和女孩的行为问题。

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. Child and parent risk and protective factors that contribute to continuity versus amelioration of problems during middle childhood have been identified. Current projects focus on the functioning of these children in early adolescence. Main findings of five projects are summarized below.(1) Symptoms of Attention Deficit Hyperactivity Disorder show consistency across contexts, informants and measures. ADHD symptoms in adolescence are predicted by earlier impairments in cognitive functioning, hostility and low guilt. Symptoms of subtypes of ADHD are associated with different cognitive and emotional profiles. (2) By adolescence, there are important gender differences in males and females who were aggressive in early childhood. Girls are more likely than boys to develop comorbid symptoms of depression and anxiety. The development of comorbid internalizing problems may serve to inhibit later antisocial behavior but create risk for subsequent mood disorders. (3) Preschool children who had difficulty processing nonverbal emotion cues have more behavior problems and less self-competence in adolescence. These longitudinal patterns are stronger for boys than girls. (4) Male adolescents with the most severe behavior problems at preschool age have higher cortisol levels than less disturbed children during and following social challenge paradigms that involve discussions of conflict. Dysregulated physiological reactivity in children with histories of aggression and antisocial behavior thus may contribute to maladaptive behaviors and disruptiveness, particularly in boys. (5)Early socialization processes contribute to later emotional and behavioral problems. Early marital conflict predicts both internalizing and externalizing problems in adolescence, even after these symptoms in early childhood have been taken into account. In addition, early supportive parenting predicted adolescent experience and control of anger suggesting ways in which positive parenting may help children manage their hostile impulses. Cumulatively, these studies highlight the need to study the interaction of biological and environmental processes to understand the different developmental trajectories of young boys and girls with conduct problems.