ODD/Depression in young children: Developmental aspects

幼儿中的 ODD/抑郁症：发展方面

• 批准号: 7037480
• 负责人: JOHN V LAVIGNE
• 金额: $ 53.77万
• 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/7037480
• 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）：这是一份针对RFA开发的申请的重新提交，该申请涉及儿童和青少年中抑郁症与破坏性行为障碍（对立违抗性障碍; ODD）的共病研究，这种疾病被认为对治疗特别耐药，是青少年药物滥用的前兆。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。重新提交的评论者的建议扩展了模型，纳入了一个新的变量（注意力问题），改进了某些措施，纳入了教师的观察，并重新引入了原始应用程序的某些元素，以检查具有临床显著水平的ODD和抑郁症儿童的亚组。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，但抑郁症状并不常见。在儿童和青少年的整个年龄范围内的抑郁症和ODD的研究中，几个家庭，母亲和儿童的特征，沿着母子互动模式已被确定为风险因素/相关因素，大多数特征似乎是ODD和抑郁症的风险因素。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，更少研究ODD/抑郁共病的发展。这项拟议的研究将检查一个模型，包括家庭（冲突，压力源），母亲（抑郁症），儿童（气质，学校的学术能力，社会技能问题，注意力问题），和international（母子互动，气质）的变量，已收到实证支持的发展ODD和抑郁症的前兆在一个大的（N=1615）组的儿童年龄4-5在研究开始。参与者将从公立学校和初级保健儿科实践中招募，并在3个年度数据收集浪潮中进行跟踪。首先使用结构方程建模技术，整体模型拟合和特定变量在ODD、抑郁症及其合并症发展中的作用，将对父母和教师评定的结局进行检查;其他分析将检查临床亚组。