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。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。 下文概述了当前项目的调查结果。所有的注意力都集中在小孩子身上？的人际冲突和痛苦的社会情感认知（反映在叙事，情绪和象征性的发挥）作为预测以后的心理问题，精神症状和社会适应。在一篇文章中，敌对和关怀主题的儿童在5岁和7岁，预测不同的发展轨迹的问题，由9-10岁，--区分非问题儿童，儿童的问题改善，和那些问题仍然或恶化随着时间的推移。破坏性女孩和男孩的轨迹也不同。在第二篇文章中，这些儿童被跟踪到青春期早期，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年到12-14年的预测是显而易见的，只有女孩，其早期的敌对主题预测在青春期的关系和公开的侵略。女孩早期的悲伤和痛苦导致了青春期关系攻击的优势。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，男孩的早期痛苦只能预测后来的焦虑和抑郁。在第三份报告中，仅对女孩，早期的关怀主题预测后来的亲社会行为和社会能力，而早期的敌对，侵略性的主题和逃避责任预测后来回避的应对策略。这些项目中的性别差异表明，破坏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。基于这一点和相关工作的三份手稿正在进行编辑审查。另外两个合作手稿的基础上非NIMH的研究样本由其他研究人员，但利用可比的措施，并提供跨项目比较的机会，也在编辑审查。这是最终报告。

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.