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，破坏性行为诊断观察时间表（DB-DOS）。最近的研究表明，基于父母访谈，破坏性行为问题可以从学龄前儿童的规范行为中大致区分出来。开发一种用于评估幼儿破坏性行为的标准化临床观察方法是推进对早期出现的破坏性行为障碍的理解的关键下一步，因为它有可能(a)推进表型描述，(b)产生关键参数，以便在这一发育时期对典型和非典型行为进行定性区分。(c)提供一个标准化的工具，将临床判断和规范性发展知识整合到诊断决策中。DB-DOS通过对儿童与父母和考官互动的结构化观察，定性地评估三个领域，假设这些领域是幼儿对立和行为问题的基础：破坏性行为、负面影响的调节和能力问题。本研究的主要目的是建立DB-DOS的信度和效度。主要验证样本将由360名学龄前儿童组成：240名目前正在参加nimh资助的芝加哥学前项目（50%临床转诊为破坏性行为问题，50%人口统计学匹配的儿科对照）和120名非转诊儿童的补充儿科样本，这些儿童在破坏性行为方面筛查较高。这一丰富的样本将使DB-DOS临床算法的发展成为可能，该算法可以优化识别具有连续破坏性行为问题的儿童（包括临床病例和亚临床组）的敏感性和特异性。本研究将检验问卷的心理测量学性质及效度。将测试年龄和性别差异、语言问题、共病性多动症、紧张的家庭环境和观察到的养育方式对分类的影响。该项目的第二个目标是建立DB-DOS的初步临床应用。评估DB-DOS临床实时编码的信度和效度。验证一种区分学龄前儿童规范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、早期识别和治疗研究至关重要。

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.