ODD/Depression in young children: Developmental aspects

描述(由申请人提供)：这是一份针对RFA而开发的申请的重新提交，该申请涉及儿童和青少年中抑郁症与颠覆性行为障碍(对立违抗障碍；奇怪)的共病研究，这种疾病被认为特别抵抗治疗，是青少年药物滥用的先兆。对应用程序的第一次批评导致了数据分析程序的修订，以允许扫描电子显微镜分析更仔细地检查整个模型。纳入评审员对这次重新提交的建议，扩展了模型，纳入了一个新的变量(注意力问题)，改进了某些测量方法，纳入了教师观察，并重新引入了原始应用程序的某些元素，以检查具有临床意义的奇怪和抑郁水平的儿童亚群。对立违抗障碍(ODD)是幼儿中最常见的精神问题；符合DSM诊断标准的抑郁症在学龄前儿童中并不常见，但抑郁症状并不常见。在儿童和青少年整个年龄段中关于抑郁和孤独症的研究中，几个家庭、母亲和儿童的特征以及母子互动模式被确定为危险因素/相关因素，其中大多数特征似乎都是孤独症和抑郁症的危险因素。虽然对ODD早期起源的研究已经存在，但相对较少的研究研究了幼儿抑郁症状的发作，更少的研究了ODD/抑郁症共病的发展。这项拟议的研究将检验一个模型，该模型包括家庭(冲突、压力源)、母亲(抑郁)、孩子(气质、学校学习能力、社交技能问题、注意力问题)和相互作用(母子互动、气质)变量，这些变量在研究开始时得到了经验支持，作为4-5岁的一大群儿童(N=1615)发展成奇怪和抑郁的先兆。参与者将从公立学校和初级保健儿科诊所招募，并在每年3次的数据收集浪潮中进行跟踪。主要使用结构方程建模技术，整体模型拟合和特定变量在ODD、抑郁症及其共病的发展中的作用将被检查父母和教师评定的结果；其他分析将检查临床亚组。

DESCRIPTION (provided by applicant): This is a resubmission of a application developed in response to an RFA concerning studies of the comorbidity of depression with a disruptive behavior disorder (oppositional defiant disorder; ODD) in children and adolescents, a condition that is believed to be particularly resistant to treatment and a precursor to adolescent drug abuse. The first critique of the application led to revisions in data analytic procedures to allow for SEM analysis to examine the overall model more carefully. Incorporating recommendations from reviewers for this resubmission expands the model to incorporate a new variable (attention problems), improves certain measures, incorporates teacher observations, and reintroduces certain elements of the original application to examine subgroups of children with clinically significant levels of ODD and depression. Oppositional defiant disorder (ODD) is the most common psychiatric problem among young children; depression meeting DSM diagnostic criteria is uncommon in preschoolers, but depressive symptoms are not. In studies of depression and ODD among the entire age spectrum of childhood and adolescents, several family, maternal, and child characteristics, along with the mother-child interactional patterns have been identified as risk factors/correlates, with most characteristics seeming to be risk factors for both ODD and depression. While studies of the early origins of ODD exist, relatively few have examined onset of depressive symptoms in young children, and even fewer have examined the development of ODD/depression comorbidity. This proposed study will examine a model included family (conflict, stressors), maternal (depression), child (temperament, school academic competence, social skills problems, attentional problems), and interactional (mother-child interaction, temperament) variables that have received empirical support as precursors to the development of ODD and depression in a large (N=1615) group of children age 4-5 at study onset. Participants will be recruited from public schools and primary care pediatric practices and followed across 3 annual waves of data collection. Primarily using structured equation modeling techniques, overall model fit and the role of specific variables in he development of ODD, depression, and their comorbidity will be examined for both parent and teacher-rated outcomes; additional analyses will examine clinical subgroups.