CHILD DISRUPTIVE/MOOD DISORDERS--DIAGNOSIS AND COURSE

儿童破坏性/情绪障碍——诊断和课程

• 批准号: 2246177
• 负责人: JAN LONEY
• 金额: $ 36.56万
• 依托单位: STATE UNIVERSITY NEW YORK STONY BROOK
• 依托单位国家: 美国
• 财政年份: 1992
• 资助国家: 美国
• 起止时间: 1992-04-01 至 1997-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2246177
• 关键词: academic achievement; aggression; attention deficit disorder; behavior modification; child behavior disorders; depression; family therapy; human subject; longitudinal human study; male; mental disorder chemotherapy; mental disorder diagnosis; methylphenidate; middle childhood (6-11); mood disorders; parent offspring interaction; psychological tests; socioeconomics

The current project is the beginning of a three-phase investigation of the external validity of childhood disruptive and depressive disorders. The aim of the project is to compare disruptive and disruptive/depressive children on four main classes of dependent variables: Background (socioeconomic status, parenting styles, living circumstances); Individual (cognitive, academic, and attentional performance at referral); Treatment Response (initial responsiveness to medication of behavioral management); and Outcome (psychiatric, cognitive, and behavioral status at 16 and again at 21 years of age). In this initial Diagnostic and Treatment Response phase of the project, 192 male out-patients between 7 and 11 years of age will be studied over a four-year period. Six diagnostic subgroups will be formed: Exclusively Hyperactive; Exclusively Aggressive; Comorbid Hyperactive and Aggressive; Comorbid Hyperactive and Depressive; Comorbid Aggressive and Depressive; and Mixed Hyperactive/Aggressive/Depressive. After a baseline diagnostic assessment, each child will be randomly assigned to receive either 10 weeks of a placebo-controlled pharmacological treatment (methylphenidate) or 10 weeks of a psychological treatment (behaviorally oriented parent group training). Planned multivariate analyses will address questions of divergent validity and comorbidity. Two diagnostic systems will be studied and then compared: Loney's Two-Dimensional model and the DSM (III, III-R, and IV) system. A central substantive question is whether subgroups within and across the two diagnostic models have different prevalence, background factors, or treatment response. A central methodological aim is to compare empirical and clinical methods for combining diagnostic data from scales, sources, and settings. A final goal of these activities is to derive sound proposals for unifying the diagnosis of disruptive children.

当前项目是三阶段调查的开始 儿童破坏性和抑郁症的外部效度。 这 该项目的目的是比较破坏性和破坏性/抑郁性 儿童对四类主要因变量的了解： 背景 （社会经济地位、养育方式、生活环境）；个人 （转诊时的认知、学业和注意力表现）；治疗 反应（对行为管理药物的初始反应）； 和结果（16 岁时的精神、认知和行为状态） 21 岁）。 在该项目的初始诊断和治疗响应阶段，192 将对 7 至 11 岁的男性门诊患者进行为期一年的研究 四年期间。 将形成六个诊断亚组： 独家 过度活跃；极具攻击性；合并症 过度活跃和攻击性； 多动症和抑郁症并存；攻击性和抑郁共存； 以及混合型过度活跃/攻击性/抑郁。 基线诊断后 评估，每个孩子将被随机分配接受 10 周 安慰剂对照药物治疗（哌醋甲酯）或 10 数周的心理治疗（以行为为导向的家长小组 训练）。 计划的多变量分析将解决不同有效性的问题 和合并症。 将研究并比较两个诊断系统： Loney 的二维模型和 DSM（III、III-R 和 IV）系统。 一个 核心的实质性问题是两个小组内部和之间的小组是否 诊断模型具有不同的流行率、背景因素或 治疗反应。 方法论的一个中心目标是比较实证 以及结合来自量表、来源、 和设置。 这些活动的最终目标是获得声音 统一对破坏性儿童的诊断的建议。