Preschool Anxiety Disorders in Primary Care

初级保健中的学前焦虑症

• 批准号: 7143373
• 负责人: ADRIAN C ANGOLD
• 金额: $ 73.76万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-07-01 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7143373
• 关键词: African American; anxiety; anxiety disorders; attention; behavioral /social science research tag; caregivers; caucasian American; child psychology; clinical research; comorbidity; developmental psychology; diagnosis quality /standard; disease /disorder classification; human subject; interview; mental disorder diagnosis; mental health epidemiology; parent offspring interaction; pediatrics; preschool child (1-5); primary care physician; statistics /biometry; teacher

DESCRIPTION (provided by applicant): Recent advances in the technology of structured psychiatric evaluation have proved that reliable psychiatric diagnoses can be made in preschool age (2-5 years) children using the DSM-IV diagnostic criteria. In a relatively small earlier study of psychopathology in general, we found that the prevalence of anxiety disorders in unselected pediatric clinic attendees was 9%. We now propose to conduct the first specific study of DSM-IV anxiety disorders in a preschool pediatric population. We plan to examine the validity of such disorders in terms of their relationships with (1) disability (psychosocial impairment), (2) associations with previously validated scale measures of psychopathology, (3) teacher/caregiver reports of problems, (4) temperamental extremes, (5) measures of attention and inhibitory control, and (6) parental history of psychopathology. We will also determine whether the DSM-IV nosology provides an adequate description of the patterns of association among anxiety symptoms in this age group. We plan to screen an initial sample of 4,900 unselected attendees at several Duke University Medical Center affiliated non-specialty pediatric clinics, using a parent-report anxiety disorders screening measure we have developed. We will then conduct parent-reported interviews about the child for those scoring in the top 20% on this screen, plus a 7.9% random sample of the rest (for a total of 929 completed interviews). From these interviews we will identify nested groups of 250 anxious disorder cases and 250 non-anxious controls for more intensive study, including teacher/caregiver assessments and intensive laboratory assessment with the parent and child. If, as we expect, these diagnoses turn out to be valid, the study will have enormous implications for pediatric clinical practice, because we know that they are not currently being identified, referred for specialist evaluation, or treated by pediatricians. It will also indicate that "prevention" efforts for anxiety disorders will need to be started much earlier than is usually supposed.

描述（由申请人提供）：结构化精神病学评估技术的最新进展证明，可以使用DSM-IV诊断标准在学龄前（2-5岁）的儿童中可靠的精神诊断。一般来说，在一项相对较小的心理病理学研究中，我们发现未选择的儿科诊所与会者的焦虑症患病率为9％。现在，我们建议对学龄前儿童人群中的DSM-IV焦虑症进行首次具体研究。我们计划研究此类疾病与（1）残疾（心理社会障碍），（2）与先前验证的精神病理学量表测量的关联，（3）师范/看护人的问题，（4）气质极端，（5）注意力和抑制控制的度量以及（6）心理学的态度。我们还将确定DSM-IV疾病学是否提供了该年龄段焦虑症状之间关联模式的充分描述。我们计划使用我们已经开发的父母报告焦虑症筛查措施，在几个杜克大学医学中心附属的杜克大学医学中心附属的几个非专业儿科诊所中筛选4,900名未选择的与会者的初始样本。然后，我们将对这个孩子在此屏幕上排名前20％的孩子进行对父母报告的访谈，以及其余的7.9％随机样本（总共929个完成的访谈）。从这些访谈中，我们将确定250例焦虑症病例和250种非焦虑控制的嵌套组，以进行更深入的研究，包括对父母和孩子的教师/照料者评估和强化实验室评估。如果正如我们所期望的那样，这些诊断结果是有效的，那么该研究将对儿科临床实践产生巨大影响，因为我们知道目前尚未确定它们，转介给专家评估或由儿科医生治疗。这还将表明，对焦虑症的“预防”努力将比通常所预期的要早得多。