Validity of Preschool Disruptive Behavior Disorders

发展有效的方法来评估儿童行为问题在整个发展是至关重要的病因和预防研究。学龄前儿童到心理健康诊所寻求服务，并表现出由于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著问题行为。诊断与统计手册第四版（DSM-IV）是最广泛使用的儿童病分学系统，但大多数验证样本由学龄儿童和青少年组成。此外，关于学龄前儿童的行为和情绪问题是否应该在诊断框架内考虑，存在争议。因此，是否应该用诊断框架来考虑学龄前儿童的行为和情绪问题是一个问题。因此，迫切需要进行实证调查，以检查在DSM-IV框架内是否可以有效地诊断幼儿的行为障碍。提出的纵向研究将通过测试来解决这些问题：1)在包括儿童行为观察在内的发展框架内，DSM-IV ODD和CD对学龄前儿童的并发效度；2)通过检验学龄ODD和CD的危险因素是否与学龄前ODD和CD相关来检验DSM-V学龄前儿童ODD和CD的构建效度；3)通过对学龄前至学龄期ODD和CD的稳定性及影响稳定性的因素进行分析，验证DSM-IV ODD和CD的预测效度。这些目标将在来自低收入到中等收入城市环境的240名3-5岁儿童样本中进行测试。一半的参与者将被临床转诊为破坏性行为问题，另一半将作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.