Development Of Disruptive Behavior Disorders From Early

破坏性行为障碍的早期发展

• 批准号: 6507485
• 负责人: Carolyn Zahn-Waxler
• 金额: --
• 依托单位: NATIONAL INSTITUTE OF MENTAL HEALTH
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/6507485
• 关键词: adolescence (12-20); aggression; antisocial personality; attention deficit disorder; child (0-11); child behavior disorders; child psychology; clinical research; conduct disorder; disease /disorder etiology; disease /disorder onset; disease /disorder proneness /risk; gender difference; human subject; interview; mental disorders; pathologic process; social behavior

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.

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。 儿童和父母的风险和保护因素有助于儿童中期问题的延续和改善。目前的项目侧重于这些儿童在青春期早期的功能。五个项目的主要研究结果总结如下：(1)注意缺陷多动障碍的症状在背景、告密者和测量方法上表现出一致性。青春期的ADHD症状可以通过早期的认知功能障碍、敌意和低负罪感来预测。ADHD亚型的症状与不同的认知和情绪特征有关。(2)到了青春期，攻击性儿童早期的男性和女性存在显著的性别差异。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后来的反社会行为，但会为随后的情绪障碍创造风险。(3)非言语情绪线索加工困难的学龄前儿童青春期行为问题较多，自我能力较差。这些纵向模式对男孩来说比女孩更强烈。(4)在涉及冲突讨论的社会挑战范式中，学龄前行为问题最严重的男性青少年的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行为，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。早期婚姻冲突预示着青春期的内在性和外在性问题，即使在考虑了儿童早期的这些症状之后也是如此。此外，早期的支持性父母教育预测了青少年的经历和愤怒的控制，这表明积极的父母教育可能会帮助孩子管理他们的敌意冲动。总体而言，这些研究强调需要研究生物和环境过程的相互作用，以了解有行为问题的男孩和女孩的不同发展轨迹。