Outcomes of Preschool Mental Health Problems

学前心理健康问题的后果

• 批准号: 7115289
• 负责人: ADRIAN C ANGOLD
• 金额: $ 58.34万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-08-23 至 2010-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7115289
• 关键词: anxiety; anxiety disorders; behavior prediction; behavior test; behavioral /social science research tag; child mental disorders; child psychology; clinical depression; clinical research; comorbidity; depression; disease /disorder proneness /risk; functional ability; human subject; longitudinal human study; mental disorder diagnosis; mental health epidemiology; neuropsychological tests; parent offspring interaction; pathologic process; patient oriented research; preschool child (1-5); prognosis; psychopathology; sign /symptom; social behavior

DESCRIPTION (provided by applicant): The aim of this application, "Outcomes of Preschool Mental Health Problems," is to examine the predictive validity of preschool anxiety and depressive symptoms, syndromes, and disorders that present in the preschool period at follow-up 3 1/2 to 6 1/2 years after the initial psychiatric assessment. We propose to build upon a study of 307 children aged 2 to 5 involved in a successful test-retest study of a psychiatric diagnostic interview for parents of preschoolers (the Preschool Age Psychiatric Assessment- PAPA). In the original study, we screened 1,073 parents of preschool children attending a general pediatric clinic with the parent report Child Behavior Checklist 11/2-5 (CBCL). Parents of children screening at or above the 30th percentile (N=193) and a random selection of the rest (N=114) were administered the PAPA twice separated by a week. The sample was stratified by age (2-5), gender, and race (African-American versus non-African-American). Data can be weighted back to the screening population. Here we propose to add 3 waves of follow-ups to this study, the first a 3 1/2 year follow-up, with 2 subsequent 18 month follow-ups. Across these 3 waves, the children's ages will range from 5 1/2 to 11 1/2 years old. We will use multi-modal, multi-informant assessments of psychiatric symptoms and disorders, as well as measures of developmental status, parent-child interactions, and risk factors known to be associated with psychiatric symptoms in older children.} Predictive validity will be examined through (1) temporal stability of psychiatric symptoms, syndromes, and disorders and (2) prediction of preschool symptoms to later psychiatric symptoms, disorders, and impairment and (3) association of early childhood anxiety and depressive symptoms and disorders with psychosocial impairment, neurocognitive deficits, particularly language problems, and risk factors including adverse life events, problems in the parent-child relationship, parental stress, and parental psychopathology. In the absence of any gold-standard for the identification of preschool psychiatric syndromes we adopt a construct-validation approach based on reasonable expectations for (1) stability over time of (a) syndrome scale scores (e.g., count of depressive symptoms) and (b) categorical syndromes (e.g., major depressive disorder) (homotypic continuity); (2) continuity of syndrome scale score and categorical syndrome problems even when those problems change in form over time (e.g., from depressive to conduct symptoms - heterotypie continuity).

描述（由申请人提供）：本申请“学前心理健康问题的结果”的目的是检查随访中学龄前阶段出现的学前焦虑和抑郁症状、综合症和疾病的预测有效性 3初次精神病学评估后 1/2 至 6 1/2 年。我们建议在一项对 307 名 2 至 5 岁儿童进行的研究的基础上，参与一项针对学龄前儿童家长的精神病学诊断访谈的成功测试再测试研究（学前年龄精神病学评估 - PAPA）。在最初的研究中，我们使用家长报告儿童行为检查表 11/2-5 (CBCL) 对 1,073 名到普通儿科诊所就诊的学龄前儿童家长进行了筛查。筛查处于或高于第 30 个百分位的儿童的父母 (N=193) 和随机选择的其余儿童 (N=114) 均接受 PAPA 两次，间隔一周。样本按年龄 (2-5)、性别和种族（非裔美国人与非非裔美国人）进行分层。数据可以加权回筛查人群。在这里，我们建议为本研究添加 3 波随访，第一波 3 1/2 年随访，随后 2 波 18 个月随访。在这 3 波中，孩子们的年龄范围为 5 1/2 至 11 1/2 岁。我们将使用对精神症状和疾病的多模式、多信息评估，以及对发育状态、亲子互动以及已知与年龄较大儿童精神症状相关的风险因素的测量。}将检查预测有效性通过 (1) 精神症状、综合症和障碍的时间稳定性；(2) 预测学龄前症状到后来的精神症状、障碍和障碍；(3) 儿童早期焦虑和抑郁症状的关联社会心理障碍、神经认知缺陷，特别是语言问题，以及包括不良生活事件、亲子关系问题、父母压力和父母精神病理学在内的危险因素。在缺乏识别学前精神综合症的任何金标准的情况下，我们采用了一种基于合理预期的构建验证方法，该方法基于以下合理预期：(1) (a) 综合症量表评分（例如抑郁症状的计数）随时间的稳定性和（ b) 分类综合征（例如，重度抑郁症）（同型连续性）； (2) 症状量表评分和分类症状问题的连续性，即使这些问题的形式随着时间的推移而改变（例如，从抑郁症状到品行症状 - 异型连续性）。