Observational Measurement of Preschool Behavior Problems

描述（由申请方提供）：拟定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，破坏性的行为问题，可以广泛区分从规范行为的学龄前儿童，基于家长访谈。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）生成关键参数，用于在该发育期内定性区分典型和非典型行为，以及（c）提供用于将临床判断和规范发育知识整合到诊断决策中的标准化工具。DB-DOS使用结构化的儿童与家长和考官互动的观察，定性评估三个域假设为基础的对立和行为问题的幼儿：破坏性行为，调制的负面影响，和能力的问题。建议的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名目前参加NIMH资助的芝加哥学龄前项目（50%临床上因破坏性行为问题而转诊，50%人口统计学匹配的儿科对照），以及120名非转诊儿童的补充儿科样本，这些儿童对破坏性行为进行了高筛查。这种富集的样本将使DB-DOS临床算法的开发成为可能，该算法优化了沿着连续的破坏性行为问题（临床病例和亚临床组）识别儿童的灵敏度和特异性。DB-DOS的心理测量学特性和有效性将被检查。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对分类的影响将进行测试。该项目的次要目的是建立DB-DOS的初步临床效用。将评估DB-DOS实时临床编码的可靠性和有效性。验证一个标准化的观察工具区分规范和破坏性行为的学龄前儿童是根本的病因学研究，早期识别和治疗破坏性行为障碍。

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.