Validity of Preschool Disruptive Behavior Disorders

开发有效的方法来评估儿童发育过程中的行为问题，对于病因学和预防研究至关重要。学龄前儿童到心理健康诊所寻求服务，并表现出由于行为问题而导致的功能受损。然而，目前还没有广泛认可的方法来评估学龄前儿童的临床重大问题行为。诊断和统计手册第四版(DSM-IV)是最广泛使用的儿童病因学系统，但大多数验证样本由学龄儿童和青少年组成。此外，是否应该在诊断框架内考虑学龄前儿童的行为和情绪问题，也存在争议。因此，是否应该用诊断框架来考虑学龄前的行为和情绪问题是有问题的。因此，迫切需要进行实证性调查，以检验在DSM-IV框架内是否可以有效地诊断幼儿的行为障碍。拟议的纵向研究将通过测试：1)在包括观察儿童行为的发展框架内，DSM-IV ODD和CD对学龄前儿童的同时效度；2)DSM-V ODD和CD对学龄前儿童的结构效度，考察为学龄前ODD和CD确定的风险因素是否与学龄前ODD和CD有关；以及3)DSM-IV ODD和CD的预测效度，通过检查这些障碍从学龄前到学龄前的稳定性，以及影响稳定性的因素。这些目标将在城市环境中从低收入到中等收入的240名3-5岁儿童中进行测试。一半的参与者将被转诊为有破坏性行为问题的临床医生，另一半将是性别和种族匹配的对照组。如果DSM-IV诊断的ODD和CD对学龄前儿童有效，那么病因学和预防研究必须集中在生命的第一年。

The development of valid methods for assessing child behavior problems across development is critical for etiologic and prevention research.. Preschool children present to mental health clinics for services and demonstrate impaired functioning as a result of behavior problems. Yet currently there is no widely endorsed method for assessing clinically significant problem behaviors in preschool children. The Diagnostic and Statistical Manual-Fourth Edition (DSM-IV) is the most widely used nosologic system for children, but the majority of the validation sample consisted of school-age children and adolescents. Furthermore, there is debate as to whether the preschool behavioral and emotional problems should be considered within a diagnostic framework at all. Thus, there is to whether preschool behavioral and emotional problems should be considered with a diagnostic framework at all. Thus, there is an urgent need for empirical investigation that examines whether behavioral disorders can be validly diagnosed in young children within the DSM-IV framework. The proposed longitudinal study will address these issues by testing: 1) the concurrent validity of DSM-IV ODD and CD for preschool children within a developmental framework including observations of child behavior; 2) the construct validity of DSM-V ODD and CD for preschool children by examining whether risk factors established for school-age ODD and CD are associated with preschool ODD and CD; and 3) the predictive validity of DSM-IV ODD and CD by examining the stability of these disorders from preschool to school- age, and the factors that affect stability. These aims will be tested in a sample of 240 3-5 year old children from low to middle income, urban environments. Half of the participants will be clinically referred for disruptive behavior problems and half will be a comparison group matched on gender and ethnicity. If DSM-IV diagnoses of ODD and CD are valid for preschoolers, then etiologic and prevention research must focus on the first years of life.