Developmental Characterization of Preschool Disruptive Behavior

学龄前破坏性行为的发展特征

• 批准号: 8477478
• 负责人: LAUREN S WAKSCHLAG
• 金额: $ 16.86万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-02-10 至 2014-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8477478
• 关键词: 5 year old; Adolescent; African American; Age; Aggressive behavior; Anger; Attention deficit hyperactivity disorder; Behavior; Behavioral; Calibration; Characteristics; Child; Child Behavior; Childhood; Classification; Clinic; Clinical; Competence; Conduct Disorder; Consensus; Cues; DSM-IV; Development; Dimensions; Discrimination; Disruptive Behavior Disorder; Early identification; Early treatment; Effectiveness of Interventions; Ethnic Origin; Etiology; Failure; Family; Foundations; Four-dimensional; Fright; General Population; Goals; Health; Heterogeneity; Hylobates Genus; Impairment; Individual Differences; Intervention; Investigation; Laboratories; Latino; Life; Link; Longevity; Mental disorders; Methods; Modeling; Neurocognitive; Not Hispanic or Latino; Nursery Schools; Oppositional Defiant Disorder; Parents; Pattern; Plant Roots; Poverty; Preschool Child; Prevention; Process; Psychopathology; Recruitment Activity; Reporting; Research; Risk Marker; Sampling; Sensitivity and Specificity; Severities; Symptoms; Testing; Time; Validation; Variant; base; behavior disorder diagnosis; boys; clinically significant; design; disease classification; disorder risk; early childhood; follow-up; functional disability; girls; improved; informant; non-compliance; response; sex; theories; 5 year old; Adolescent; African American; Age; Aggressive behavior; Anger; Attention deficit hyperactivity disorder; Behavior; Behavioral; Calibration; Characteristics; Child; Child Behavior; Childhood; Classification; Clinic; Clinical; Competence; Conduct Disorder; Consensus; Cues; DSM-IV; Development; Dimensions; Discrimination; Disruptive Behavior Disorder; Early identification; Early treatment; Effectiveness of Interventions; Ethnic Origin; Etiology; Failure; Family; Foundations; Four-dimensional; Fright; General Population; Goals; Health; Heterogeneity; Hylobates Genus; Impairment; Individual Differences; Intervention; Investigation; Laboratories; Latino; Life; Link; Longevity; Mental disorders; Methods; Modeling; Neurocognitive; Not Hispanic or Latino; Nursery Schools; Oppositional Defiant Disorder; Parents; Pattern; Plant Roots; Poverty; Preschool Child; Prevention; Process; Psychopathology; Recruitment Activity; Reporting; Research; Risk Marker; Sampling; Sensitivity and Specificity; Severities; Symptoms; Testing; Time; Validation; Variant; base; behavior disorder diagnosis; boys; clinically significant; design; disease classification; disorder risk; early childhood; follow-up; functional disability; girls; improved; informant; non-compliance; response; sex; theories

DESCRIPTION (provided by applicant): Disruptive behavior disorders (DBDs), including Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD), are among the best, empirically documented forms of early childhood psychopathology. Recent studies have demonstrated that DBDs are identifiable in early childhood, while also highlighting the limitations of current DBD nosology for identifying preschool disruptive behavior in a developmentally sensitive and specific manner. Limitations include: (1) overlap of many ODD symptoms with normative misbehaviors; (2) developmental inappropriateness of the majority of CD symptoms; and, (3) failure to capture substantial clinical heterogeneity across the broad group of children with DBDs. The proposed study is designed to help establish more precise parameters for identifying and classifying disruptive behavior in preschool children and to distinguish it from normal variation by using a rigorous developmentally-sensitive, multidimensional approach. Specifically, we propose to assess preschool disruptive behavior within the following multidimensional framework: a central Shared Disruptive Behavior Severity Dimension and four specific behavioral dimensions representing distinct facets of disruptive behavior: (1) Temper Loss; (2) Noncompliance; (3) Aggression and, (4) Lack of Concern for Others. Two general population samples from pediatric clinics will be recruited: (1) a Calibration Sample (N=1,500) and, (2) an independent Replication Sample (N=2,200). These pediatric samples will be stratified by child age, sex, ethnicity and poverty status. A Validation Sub-Sample (N=350), enriched for disruptive behavior, will be drawn from the Replication Sample, with intensive laboratory assessment at baseline and a 6-month follow-up. Specific aims of the proposed study are to: (I) Document the distributional characteristics of temper loss, noncompliance, aggression and lack of concern for others in a normative preschool sample. (II) Empirically test the developmentally-sensitive, multidimensional approach to preschool disruptive behavior by (a) calibrating the multidimensional model using bi-factor Item Response Theory (IRT), including comparison of the fit of the 4-dimension model to alternative models; (b) testing the fit of the model across demographic sub-groups and children with- and without co- occurring psychopathology; (c) replication in an independent sample and; (d) deriving disruptive behavior sub- types based on cross-dimension patterns. (III) Demonstrate the construct, criterion, convergent, divergent and incremental validity of the developmentally-sensitive, multidimensional approach. In particular, establish its (a) association to key child and family markers of DBD risk; (b) capacity to discriminate preschoolers with impairment over time and; (c) incremental utility for prediction beyond DSM-IV DBD diagnoses and; (IV) Demonstrate the validity of the four specific dimensions by testing for hypothesized differentiated associations to directly assessed features of child disruptive behavior and neurocognitive functioning. Precise characterization of the phenomenology of preschool disruptive behavior is vital for identifying distinct etiological substrates, predicting meaningful variation in course and, enhancing intervention effectiveness. PUBLIC HEALTH RELEVANCE: While there is growing consensus that disruptive behavior disorders (DBDs) are present in preschool children, there is also increasing recognition that the current DBD nosology is misspecified for early childhood. Establishing a developmentally-sensitive approach to characterizing preschool disruptive behavior will improve early identification and provide a foundation for studies that identify distinct causal processes and targeted prevention efforts.

描述（由申请人提供）：破坏性行为障碍（DBD），包括对立的反抗障碍（奇数）和行为障碍（CD），是最佳，经验上记录的早期儿童精神病理学的形式之一。最近的研究表明，DBD在童年时期是可识别的，同时也强调了当前DBD疾病学以以发育敏感和特定方式识别学龄前的破坏性行为的局限性。局限性包括：（1）许多奇怪症状与规范性不当行为重叠； （2）大多数CD症状的发育不适当； （3）未能捕获大量DBD儿童的临床异质性。拟议的研究旨在帮助建立更精确的参数，以识别和分类学龄前儿童的破坏性行为，并通过使用严格的发育敏感，多维方法来区分正常变异。具体而言，我们建议在以下多维框架内评估学龄前的破坏性行为：中央共享的破坏性行为严重程度和四个特定的行为维度，代表了颠覆性行为的不同方面：（1）脾气下降； （2）不合规； （3）侵略性和（4）对他人缺乏关注。将招募来自儿科诊所的两个一般人群样本：（1）校准样本（n = 1,500）和（2）独立复制样本（n = 2,200）。这些小儿样本将根据儿童年龄，性别，种族和贫困状况进行分层。验证子样本（n = 350）富含破坏性行为，将从复制样本中得出，并在基线时进行密集的实验室评估和6个月的随访。拟议的研究的具体目的是：（i）记录脾气损失，不合格，侵略和对其他人在规范学龄前样本中缺乏关注的分布特征。 （ii）通过（a）使用双因素项目响应理论（IRT）校准多维模型，包括对4维模型与替代模型的拟合度进行比较，从经验上测试对发展敏感的多维方法来实现学龄前颠覆性行为； （b）测试模型在人口统计学子群体和患有患有精神病理学的儿童之间的拟合； （c）在独立样本中复制； （d）基于跨维模式得出破坏性行为子类型。 （iii）演示了发育敏感的多维方法的构建体，标准，收敛性，发散和增量有效性。特别是，（a）与DBD风险的关键儿童和家庭标记建立（a）； （b）随着时间的流逝而歧视学龄前儿童的能力； （c）超出DSM-IV DBD诊断的预测的增量实用程序； （iv）通过测试假设的分化关联来直接评估儿童破坏性行为和神经认知功能的特征，证明了四个特定维度的有效性。学龄前颠覆性行为现象学的精确表征对于识别不同的病因底物，预测过程中有意义的变化并增强干预效果至关重要。公共卫生相关性：虽然越来越多的共识是，学龄前儿童中存在破坏性行为障碍（DBD），但人们越来越认识到当前的DBD疾病学在幼儿期间被误解了。建立一种对发展敏感的方法来表征学龄前的破坏性行为将改善早期识别，并为确定不同因果过程和有针对性的预防工作的研究提供基础。