Development Of Disruptive Behavior Disorders

破坏性行为障碍的发展

• 批准号: 6980434
• 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/6980434
• 关键词: adolescence (12-20); aggression; antisocial personality; behavioral /social science research tag; child (0-11); child behavior disorders; child psychology; cognition; conduct disorder; conflict; disease /disorder etiology; disease /disorder onset; disease /disorder proneness /risk; early experience; family structure /dynamics; gender difference; human subject; interview; patient oriented research; psychopathology; social behavior; socializations

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 current projects are summarized next. All focus on young children?s social-affective cognitions about interpersonal conflict and distress (reflected in narratives, emotions, and symbolic play) as predictors of later psychological problems, psychiatric symptoms, and social adjustment. In one article, both hostile and caring themes of children at ages 5 and 7 years, predicted different developmental trajectories of problems by 9-10 years of age, ---distinguishing among non-problem children, children whose problems improved, and those whose problems remained or worsened over time. Trajectories also differed for disruptive girls and boys. In a second article the children were followed into early adolescence, in order to identify precursors of different types of antisocial behavior (overt, physical aggression vs. relational aggression) and psychiatric symptoms. Prediction from 7 years to 12-14 years was evident only for girls, whose early hostile themes predicted both relational and overt aggression in adolescence. Early sadness and distress in girls led to a preponderance of relational aggression in adolescence. Also for girls, a general lack of emotional expressiveness foretold more psychiatric symptoms of all kinds. In contrast, early distress in boys only predicted later anxiety and depression. In a third report, for girls only, early caring themes predicted later prosocial behaviors and social competence, while early hostile, aggressive themes and avoidance of responsibility predicted later avoidant coping strategies. The gender differences across these projects point to different underlying processes implicated in the developmental course of disruptive boys and girls, even when they have been initially equated for levels of problem behaviors. Three manuscripts based on this and related work are under editorial review. Two additional collaborative manuscripts based on non-NIMH research samples by other investigators, but which utilize comparable measures and provide opportunities for cross-project comparisons, are also under editorial review. This is a final report.

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。在随后的三个时间点，即6-7岁、8-10岁和12-13岁，对82名低、中或高风险的4-5岁儿童(基于外化问题的初始水平)进行了再次研究。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。由于反社会、破坏性行为往往与焦虑和抑郁并存，因此也对这些内在化问题的发展轨迹进行了调查。一些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而不是改善，此前已有报道。 下面对当前项目的发现进行总结。都集中在幼儿身上？S对人际冲突和痛苦的社会情感认知(反映在叙事、情感和象征性游戏中)是未来心理问题、精神症状和社会适应的预测因子。在一篇文章中，5岁和7岁儿童的敌对和关怀主题预测了9-10岁问题的不同发展轨迹-区分无问题儿童、问题改善的儿童和问题随着时间推移仍然或恶化的儿童。具有颠覆性的女孩和男孩的轨迹也不同。在第二篇文章中，对这些儿童进行了青春期早期的跟踪调查，以确定不同类型的反社会行为(公开的身体攻击与关系攻击)和精神症状的前兆。从7岁到12-14岁的预测只对女孩很明显，她们早期的敌对主题预示着青春期的关系性和公开攻击性。女孩早期的悲伤和苦恼导致青春期的关系攻击性占优势。同样，对于女孩来说，普遍缺乏情感表达预示着更多的各种精神症状。相比之下，男孩早期的痛苦只预示着后来的焦虑和抑郁。在第三份报告中，仅对女孩而言，早期的关爱主题预示着后来的亲社会行为和社交能力，而早期的敌对、攻击性和逃避责任的主题预示着后来的回避性应对策略。这些项目的性别差异表明，颠覆性男孩和女孩的发展过程中涉及不同的潜在过程，即使他们最初被等同于问题行为的水平。以此为基础的三份手稿和相关工作正在编辑审查中。另外两份合作手稿也在编辑审查中，这些手稿基于其他研究人员的非NIMH研究样本，但利用了可比的衡量标准，并提供了进行跨项目比较的机会。这是一份最终报告。