Development Of Disruptive Behavior Disorders

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。随着时间的推移，它们趋于稳定，对治疗有抵抗力，并与青春期和成年期的精神疾病有关。早期发作的攻击行为是终生持续的反社会行为的前兆。然而，对于导致不同发育结果的体质和环境因素及其相互作用，我们所知甚少。在随后的三个时间点对82名4-5岁的儿童进行了研究，这些儿童具有低、中、高风险的后期破坏性行为障碍（基于外化问题的初始水平）；6-7岁，8-10岁，12-13岁。社会，情感，认知和儿童功能的生理领域，结合社会化经验进行检查。目标是确定导致幼儿行为问题的连续性和随时间变化的关键因素。由于反社会、破坏性行为往往与焦虑和抑郁共病，这些内化问题的发展轨迹也被调查。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连续性和改善。

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.