Validity of Preschool Disruptive Behavior Disorders

发展有效的方法来评估儿童行为问题的发展是至关重要的病因学和预防研究。学龄前儿童到精神卫生诊所寻求服务，并表现出因行为问题而导致的功能受损。然而，目前还没有广泛认可的方法来评估学龄前儿童的临床显着的问题行为。诊断和统计手册第四版（DSM-IV）是最广泛使用的儿童疾病分类系统，但大多数验证样本由学龄儿童和青少年组成。此外，关于是否应该在诊断框架内考虑学龄前行为和情绪问题也存在争议。因此，是否应该用诊断框架来考虑学前行为和情绪问题。因此，有一个迫切需要的实证调查，检查行为障碍是否可以有效地诊断在DSM-IV框架内的幼儿。本研究拟通过以下两方面的纵向研究来解决这些问题：（1）在包括儿童行为观察的发展框架内，DSM-IV ODD和CD对学龄前儿童的同时效度;（2）DSM-V ODD和CD对学龄前儿童的结构效度，考察学龄前ODD和CD的危险因素是否与学龄前ODD和CD相关;（3）DSM-IV ODD和CD的预测效度，考察这些疾病从学龄前到学龄期的稳定性，以及影响稳定性的因素。这些目标将在240名3-5岁儿童的样本中进行测试，这些儿童来自低收入到中等收入的城市环境。一半的参与者将因破坏性行为问题而被临床转诊，另一半将成为性别和种族匹配的对照组。如果DSM-IV对ODD和CD的诊断对学龄前儿童有效，那么病因学和预防研究必须集中在生命的最初几年。

The development of valid methods for assessing child behavior problems across development is critical for etiologic and prevention research.. Preschool children present to mental health clinics for services and demonstrate impaired functioning as a result of behavior problems. Yet currently there is no widely endorsed method for assessing clinically significant problem behaviors in preschool children. The Diagnostic and Statistical Manual-Fourth Edition (DSM-IV) is the most widely used nosologic system for children, but the majority of the validation sample consisted of school-age children and adolescents. Furthermore, there is debate as to whether the preschool behavioral and emotional problems should be considered within a diagnostic framework at all. Thus, there is to whether preschool behavioral and emotional problems should be considered with a diagnostic framework at all. Thus, there is an urgent need for empirical investigation that examines whether behavioral disorders can be validly diagnosed in young children within the DSM-IV framework. The proposed longitudinal study will address these issues by testing: 1) the concurrent validity of DSM-IV ODD and CD for preschool children within a developmental framework including observations of child behavior; 2) the construct validity of DSM-V ODD and CD for preschool children by examining whether risk factors established for school-age ODD and CD are associated with preschool ODD and CD; and 3) the predictive validity of DSM-IV ODD and CD by examining the stability of these disorders from preschool to school- age, and the factors that affect stability. These aims will be tested in a sample of 240 3-5 year old children from low to middle income, urban environments. Half of the participants will be clinically referred for disruptive behavior problems and half will be a comparison group matched on gender and ethnicity. If DSM-IV diagnoses of ODD and CD are valid for preschoolers, then etiologic and prevention research must focus on the first years of life.