ODD/Depression in young children: Developmental aspects

幼儿中的 ODD/抑郁症：发展方面

• 批准号: 6886791
• 负责人: JOHN V LAVIGNE
• 金额: $ 56.57万
• 依托单位: LURIE CHILDREN'S HOSPITAL OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-04-20 至 2009-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6886791
• 关键词: behavioral /social science research tag; child psychology; clinical research; comorbidity; depression; developmental psychology; disease /disorder onset; disease /disorder proneness /risk; family structure /dynamics; human subject; longitudinal human study; mood disorders; mother child interaction; oppositional defiant disorder; preschool child (1-5); questionnaires

DESCRIPTION (provided by applicant): This is a resubmission of a application developed in response to an RFA concerning studies of the comorbidity of depression with a disruptive behavior disorder (oppositional defiant disorder; ODD) in children and adolescents, a condition that is believed to be particularly resistant to treatment and a precursor to adolescent drug abuse. The first critique of the application led to revisions in data analytic procedures to allow for SEM analysis to examine the overall model more carefully. Incorporating recommendations from reviewers for this resubmission expands the model to incorporate a new variable (attention problems), improves certain measures, incorporates teacher observations, and reintroduces certain elements of the original application to examine subgroups of children with clinically significant levels of ODD and depression. Oppositional defiant disorder (ODD) is the most common psychiatric problem among young children; depression meeting DSM diagnostic criteria is uncommon in preschoolers, but depressive symptoms are not. In studies of depression and ODD among the entire age spectrum of childhood and adolescents, several family, maternal, and child characteristics, along with the mother-child interactional patterns have been identified as risk factors/correlates, with most characteristics seeming to be risk factors for both ODD and depression. While studies of the early origins of ODD exist, relatively few have examined onset of depressive symptoms in young children, and even fewer have examined the development of ODD/depression comorbidity. This proposed study will examine a model included family (conflict, stressors), maternal (depression), child (temperament, school academic competence, social skills problems, attentional problems), and interactional (mother-child interaction, temperament) variables that have received empirical support as precursors to the development of ODD and depression in a large (N=1615) group of children age 4-5 at study onset. Participants will be recruited from public schools and primary care pediatric practices and followed across 3 annual waves of data collection. Primarily using structured equation modeling techniques, overall model fit and the role of specific variables in he development of ODD, depression, and their comorbidity will be examined for both parent and teacher-rated outcomes; additional analyses will examine clinical subgroups.

描述（由申请人提供）：这是针对一项 RFA 开发的申请的重新提交，该 RFA 涉及儿童和青少年抑郁症与破坏性行为障碍（对立违抗障碍；ODD）共病的研究，这种疾病被认为对治疗特别有抵抗力，也是青少年药物滥用的先兆。对应用程序的第一次批评导致了数据分析程序的修订，以允许 SEM 分析更仔细地检查整个模型。纳入审稿人对此重新提交的建议扩展了模型，以纳入新变量（注意力问题），改进了某些措施，纳入了教师观察，并重新引入了原始应用程序的某些元素，以检查具有临床显着水平的 ODD 和抑郁症的儿童亚组。对立违抗性障碍 (ODD) 是幼儿中最常见的精神问题；符合 DSM 诊断标准的抑郁症在学龄前儿童中并不常见，但抑郁症状却并不常见。在针对整个儿童和青少年年龄段的抑郁症和对立障碍的研究中，一些家庭、母亲和儿童特征以及母子互动模式已被确定为危险因素/相关因素，其中大多数特征似乎都是对立障碍和抑郁症的危险因素。虽然存在对 ODD 早期起源的研究，但相对较少研究幼儿抑郁症状的发作，甚至更少研究 ODD/抑郁共病的发展。这项拟议的研究将检验一个模型，该模型包括家庭（冲突、压力源）、母亲（抑郁）、儿童（气质、学校学业能力、社交技能问题、注意力问题）和互动（母子互动、气质）变量，这些变量在研究开始时已得到实证支持，作为一大群（N = 1615）4-5岁儿童中出现对立障碍和抑郁症的先兆。参与者将从公立学校和初级保健儿科诊所招募，并在每年 3 波的数据收集中进行跟踪。主要使用结构化方程建模技术，总体模型拟合以及特定变量在 ODD、抑郁症及其合并症发展中的作用将针对家长和教师评价的结果进行检查；其他分析将检查临床亚组。