Developmental Characterization of Preschool Disruptive Behavior

学龄前破坏性行为的发展特征

• 批准号: 7766922
• 负责人: LAUREN S WAKSCHLAG
• 金额: $ 67.89万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-02-10 至 2014-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7766922
• 关键词: 5 year old; Adolescent; African American; Age; Aggressive behavior; Anger; Arts; Attention deficit hyperactivity disorder; Behavior; Behavioral; Calibration; Characteristics; Child; Child Behavior; Childhood; Classification; Clinic; Clinical; Competence; Conduct Disorder; Consensus; Cues; DSM-IV; Development; Dimensions; Discrimination; Disruptive Behavior Disorder; Early identification; Effectiveness of Interventions; Ethnic Origin; Etiology; Failure; Family; Foundations; Four-dimensional; Fright; General Population; Goals; Heterogeneity; Hylobates Genus; Impairment; Individual Differences; Intervention; Investigation; Laboratories; Latino; Life; Link; Longevity; Mental disorders; Methods; Modeling; Neurocognitive; Not Hispanic or Latino; Nursery Schools; Oppositional Defiant Disorder; Parents; Pattern; Plant Roots; Poverty; Preschool Child; Prevention; Process; Psychopathology; Recruitment Activity; Reporting; Research; Risk Marker; Sampling; Sensitivity and Specificity; Severities; Symptoms; Testing; Time; Validation; Variant; base; behavior disorder diagnosis; boys; clinically significant; design; disease classification; disorder risk; early childhood; follow-up; functional disability; girls; improved; informant; non-compliance; public health relevance; response; sex; theories

DESCRIPTION (provided by applicant): Disruptive behavior disorders (DBDs), including Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD), are among the best, empirically documented forms of early childhood psychopathology. Recent studies have demonstrated that DBDs are identifiable in early childhood, while also highlighting the limitations of current DBD nosology for identifying preschool disruptive behavior in a developmentally sensitive and specific manner. Limitations include: (1) overlap of many ODD symptoms with normative misbehaviors; (2) developmental inappropriateness of the majority of CD symptoms; and, (3) failure to capture substantial clinical heterogeneity across the broad group of children with DBDs. The proposed study is designed to help establish more precise parameters for identifying and classifying disruptive behavior in preschool children and to distinguish it from normal variation by using a rigorous developmentally-sensitive, multidimensional approach. Specifically, we propose to assess preschool disruptive behavior within the following multidimensional framework: a central Shared Disruptive Behavior Severity Dimension and four specific behavioral dimensions representing distinct facets of disruptive behavior: (1) Temper Loss; (2) Noncompliance; (3) Aggression and, (4) Lack of Concern for Others. Two general population samples from pediatric clinics will be recruited: (1) a Calibration Sample (N=1,500) and, (2) an independent Replication Sample (N=2,200). These pediatric samples will be stratified by child age, sex, ethnicity and poverty status. A Validation Sub-Sample (N=350), enriched for disruptive behavior, will be drawn from the Replication Sample, with intensive laboratory assessment at baseline and a 6-month follow-up. Specific aims of the proposed study are to: (I) Document the distributional characteristics of temper loss, noncompliance, aggression and lack of concern for others in a normative preschool sample. (II) Empirically test the developmentally-sensitive, multidimensional approach to preschool disruptive behavior by (a) calibrating the multidimensional model using bi-factor Item Response Theory (IRT), including comparison of the fit of the 4-dimension model to alternative models; (b) testing the fit of the model across demographic sub-groups and children with- and without co- occurring psychopathology; (c) replication in an independent sample and; (d) deriving disruptive behavior sub- types based on cross-dimension patterns. (III) Demonstrate the construct, criterion, convergent, divergent and incremental validity of the developmentally-sensitive, multidimensional approach. In particular, establish its (a) association to key child and family markers of DBD risk; (b) capacity to discriminate preschoolers with impairment over time and; (c) incremental utility for prediction beyond DSM-IV DBD diagnoses and; (IV) Demonstrate the validity of the four specific dimensions by testing for hypothesized differentiated associations to directly assessed features of child disruptive behavior and neurocognitive functioning. Precise characterization of the phenomenology of preschool disruptive behavior is vital for identifying distinct etiological substrates, predicting meaningful variation in course and, enhancing intervention effectiveness. PUBLIC HEALTH RELEVANCE: While there is growing consensus that disruptive behavior disorders (DBDs) are present in preschool children, there is also increasing recognition that the current DBD nosology is misspecified for early childhood. Establishing a developmentally-sensitive approach to characterizing preschool disruptive behavior will improve early identification and provide a foundation for studies that identify distinct causal processes and targeted prevention efforts.

描述（由申请人提供）：破坏性行为障碍（DBD），包括对立违抗性障碍（ODD）和行为障碍（CD），是儿童早期精神病理学中最好的，经验记录的形式。最近的研究表明，DBD在幼儿期是可识别的，同时也强调了当前DBD疾病分类学在以发育敏感和特定的方式识别学前破坏性行为方面的局限性。局限性包括：（1）许多ODD症状与规范性不良行为重叠;（2）大多数CD症状的发育不适当;（3）未能在广泛的DBD儿童组中捕获实质性临床异质性。这项研究旨在帮助建立更精确的参数，用于识别和分类学龄前儿童的破坏性行为，并通过使用严格的发育敏感的多维方法将其与正常变化区分开来。具体而言，我们建议在以下多维框架内评估学前破坏性行为：一个中央共享破坏性行为严重性维度和四个代表破坏性行为不同方面的具体行为维度：（1）脾气失控;（2）不服从;（3）攻击性和（4）缺乏对他人的关注。将从儿科诊所招募两份一般人群样本：（1）校准样本（N= 1，500）和（2）独立复制样本（N= 2，200）。这些儿科样本将按儿童年龄、性别、种族和贫困状况分层。将从复制样本中抽取富含破坏性行为的验证子样本（N=350），并在基线和6个月随访时进行强化实验室评估。本研究的具体目的是：（1）记录规范的学龄前样本中脾气失控、不顺从、攻击和缺乏对他人的关心的分布特征。(II)通过以下方法对学龄前破坏性行为的发展敏感的多维方法进行经验性测试：（a）使用双因素项目反应理论（IRT）校准多维模型，包括比较4维模型与替代模型的拟合;（B）测试模型在人口统计学亚组和有和没有共同发生的精神病理学的儿童中的拟合;（c）在独立样本中复制;以及（d）基于跨维度模式导出破坏性行为子类型。(III)展示发展敏感的多维方法的结构，标准，收敛，发散和增量有效性。特别是，建立其（a）与DBD风险的关键儿童和家庭标志物的关联;（B）随着时间的推移区分学龄前儿童的能力;（c）超出DSM-IV DBD诊断的预测增量效用;（IV）通过测试假设的差异化关联来直接评估儿童破坏性行为和神经认知功能的特征，证明四个特定维度的有效性。学前破坏性行为的现象学的精确表征是至关重要的，以确定不同的病因基板，预测有意义的变化过程中，提高干预的有效性。公共卫生相关性：虽然越来越多的人认为破坏性行为障碍（DBD）存在于学龄前儿童中，但也越来越多的人认识到，目前的DBD疾病分类学在幼儿期被错误地指定。建立一个发展敏感的方法来表征学前破坏性行为将改善早期识别，并为确定不同的因果过程和有针对性的预防工作的研究提供基础。