Observational Measurement of Preschool Behavior Problems

描述(由申请人提供)：拟议的研究将验证一种新的临床观察工具，即破坏性行为诊断观察计划(DB-DOS)。最近的研究表明，根据父母的访谈，学龄前儿童的破坏性行为问题可以广泛地与正常行为区分开来。开发一种评估幼儿破坏性行为的标准化临床观察方法是促进对早期出现的破坏性行为障碍的理解的关键下一步，因为它具有以下潜力：(A)促进表型描述，(B)产生关键参数，以便在这一发育期内对典型和非典型行为进行定性区分，以及(C)为将临床判断和规范性发展知识整合到诊断决策中提供标准化工具。DB-DOS使用对儿童与家长和考官互动的结构化观察，定性地评估了三个假设导致幼儿对立和品行问题的领域：破坏性行为，负面情绪的调节，以及能力问题。本研究的主要目的是建立DB-DOS的信度和效度。初步验证样本将包括360名学龄前儿童：240名目前参与NIMH资助的芝加哥学龄前项目(50%被临床转介为破坏性行为问题，50%为人口统计学匹配的儿科对照)，以及120名高筛查破坏性行为的非转介儿童的补充儿科样本。这一丰富的样本将使DB-DOS临床算法的开发能够优化敏感度和特异度，以识别一系列破坏性行为问题(临床病例和亚临床组)的儿童。将检验DB-DOS的心理测量学特性和效度。将测试年龄和性别差异、语言问题、共病多动症、紧张的家庭环境和观察到的父母教养方式对分类的影响。拟议项目的次要目标是建立DB-DOS的初步临床应用。将评估DB-DOS实时临床编码的可靠性和有效性。验证区分学龄前儿童正常行为和破坏性行为的标准化观察工具对于推进破坏性行为障碍的病因学研究、早期识别和治疗至关重要。

DESCRIPTION (provided by applicant): The proposed study will validate a new clinical observation instrument, the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS). Recent research demonstrates that disruptive behavior problems can be broadly distinguished from normative behavior in preschoolers, based on parent interviews. The development of a standardized clinical observation method for assessing disruptive behavior in young children is a critical next step for advancing understanding of early-emerging disruptive behavior disorders because of its potential to (a) advance phenotypic description, (b) generate critical parameters for making qualitative distinctions between typical and atypical behavior during this developmental period, and (c) provide a standardized tool for integrating clinical judgment and normative developmental knowledge into diagnostic decision-making. The DB-DOS uses structured observations of the child interacting with the parent and examiner to qualitatively assess three domains hypothesized to underlie oppositional and conduct problems in young children: disruptive behavior, modulation of negative affect, and problems in competence. The principal aim of the proposed study is to establish the reliability and validity of the DB-DOS. The primary validation sample will be comprised of 360 preschoolers: 240 currently participating in the NIMH-funded Chicago Preschool Project (50% clinically referred for disruptive behavior problems and 50% demographically matched pediatric controls) and a supplementary pediatric sample of 120 non-referred children who screen high for disruptive behaviors. This enriched sample will enable the development of a DB-DOS clinical algorithm that optimizes sensitivity and specificity for identifying children along a continuum of disruptive behavior problems (both clinical cases and sub-clinical group). The psychometric properties and validity of the DB-DOS will be examined. The effects of age and sex differences, language problems, co-morbid ADHD, stressful family circumstances and observed parenting on classification will be tested. The secondary aim of the proposed project is to establish preliminary clinical utility of the DB-DOS. The reliability and validity of live clinical coding of the DB-DOS will be assessed. Validation of a standardized observational tool distinguishing between normative and disruptive behavior in preschoolers is fundamental to advancing research on the etiology, early identification and treatment of disruptive behavior disorders.