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名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），已被再次研究，在随后的三个时间点; 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。由于反社会，破坏性行为往往与焦虑和抑郁症共病，这些内化问题的发展轨迹也进行了调查。一些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以前的报告。 下面概述三个新项目的调查结果。前两个集中在早期儿童特征和父母环境因素的作用，影响情绪和行为问题的发展。第三部分探讨了生理反应在青少年早期问题和精神症状表达中的作用。(1)父母的观察和自我报告的社会化实践往往准确地反映在儿童的和象征性的游戏。到了小学早期，破坏性的女孩和男孩都认为父母比非攻击性的孩子更容易受到惩罚。反社会的女孩（而不是反社会的男孩）也认为更多的父母拒绝和爱的撤回，表明更关心与家庭成员的关系。这些反社会的女孩也更有可能在青春期早期经历焦虑和情绪症状，这表明社会化经历和精神病结果之间存在重要联系。(2)在学龄前和学龄期，女孩比男孩表达更多的顺从情绪（悲伤和焦虑）（如在家庭游戏互动中观察到的）。父母对女孩的这些情绪比男孩更敏感。因此，除了孩子的贡献，父母的反应方式，将鼓励性别角色一致的情感表达。这些早期观察到的情绪预测了两年后抑郁症的精神症状。这表明早期详细观察儿童在家庭互动和父母的情感社会化过程中表达的情绪对于理解后期精神症状的出现的重要性。(3)自我报告的情绪状态，心率和血压进行了检查之前和之后的青少年从事两个社会挑战，评估操作。内化问题与更大的焦虑和心血管觉醒相关，而外化问题预测更大的敌意，但心血管觉醒较少。这些发现反映了将共病特征和多反应系统纳入对压力的生理反应与情绪和行为问题之间联系的研究的必要性。

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 again 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. Because antisocial, disruptive behaviors often are comorbid with anxiety and depression, the developmental trajectories for these internalizing problems also are investigated. Several child and parent risk and protective factors that contribute to continuity versus amelioration of problems during middle childhood were previously reported. The findings from three new projects are summarized next. The first two focus on the role of early child characteristics and parental environmental factors that influence the development of emotional and behavioral problems. The third examines the role of physiological reactivity in the expression of problems and psychiatric symptoms in early adolescence. (1) Parents' observed and self-reported socialization practices often are accurately reflected in children's and symbolic play. By early grade school, both disruptive girls and boys perceived parents as punitive more often than non-aggressive children. Antisocial girls (but not antisocial boys) also perceived more parental rejection and love withdrawal, indicating greater concerns about relationships with family members. These antisocial girls also were more likely to experience anxiety and mood symptoms by early adolescence, suggesting important links between socialization experiences and psychiatric outcomes.(2) Girls both at preschool and school age, expressed more submissive emotions (sadness and anxiety) than boys (as observed during and emotionally arousing family game interaction. Parents were more responsive to these emotions in girls than boys. Thus, in addition to the child's contribution, parents responsed in a way that would encourage gender-role consistent emotion expressions. These early observed emotions predicted psychiatric symptoms of depression two years later. This indicates the importance of early detailed observations of children's emotions expressed during family interactions and parental socialization of emotion for understanding the emergence of later psychiatric symptoms. (3) Self-reported emotional states, heart rate and blood pressure were examined before and after adolescents engaged in two socially challenging, evaluative manipulations. Internalizing problems were associated with greater anxiety and cardiovascular arousal, whereas externalizing problems predicted greater hostility but less cardiovascular arousal. These findings reflect the need to incorporate comorbid characteristics and multiple response systems into studies of the links between physiological reactivity to stress and emotional and behavioral problems.