Developmental Characterization of Preschool Disruptive Behavior

学龄前破坏性行为的发展特征

基本信息

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
项目类别：
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

项目摘要

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），包括对立违抗障碍（ODD）和品行障碍（CD），是早期儿童精神病理学中最好的、有经验记录的形式之一。最近的研究表明，DBD 在儿童早期是可以识别的，同时也强调了当前 DBD 分类学在以发展敏感和特定的方式识别学前破坏性行为方面的局限性。局限性包括：（1）许多 ODD 症状与规范的不当行为重叠； (2) 大多数克罗恩病症状发育不适当； (3) 未能捕捉到广泛的 DBD 儿童群体的显着临床异质性。拟议的研究旨在帮助建立更精确的参数来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展敏感的多维方法将其与正常变化区分开来。具体来说，我们建议在以下多维度框架内评估学龄前破坏性行为：一个核心的共享破坏性行为严重性维度和代表破坏性行为不同方面的四个具体行为维度：（1）脾气暴躁； (2) 不遵守规定； (3) 攻击性，(4) 缺乏对他人的关心。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)。这些儿科样本将根据儿童年龄、性别、种族和贫困状况进行分层。将从复制样本中抽取富含破坏性行为的验证子样本 (N=350)，并在基线时进行强化实验室评估并进行 6 个月的随访。本研究的具体目标是：（I）记录规范学前样本中脾气暴躁、不服从、攻击性和缺乏对他人的关心的分布特征。 (II) 通过 (a) 使用双因素项目反应理论 (IRT) 校准多维模型，包括比较 4 维模型与替代模型的拟合度，对学前破坏性行为的发展敏感的多维方法进行实证检验； (b) 测试该模型在不同人口亚群体以及同时患有和不患有精神病理学的儿童中的适用性； (c) 在独立样本中复制； (d) 基于跨维度模式导出破坏性行为子类型。 (III) 展示发展敏感的多维方法的构造、标准、收敛、发散和增量有效性。特别是，建立 (a) 与 DBD 风险的关键儿童和家庭标志的关联； (b) 随着时间的推移，歧视有缺陷的学龄前儿童的能力； (c) DSM-IV DBD 诊断之外的预测增量效用； (IV) 通过测试假设的差异关联来直接评估儿童破坏性行为和神经认知功能的特征，证明四个特定维度的有效性。准确描述学前破坏性行为的现象对于识别不同的病因学基础、预测过程中有意义的变化以及提高干预效果至关重要。公共卫生相关性：虽然人们越来越一致认为学龄前儿童中存在破坏性行为障碍 (DBD)，但人们也越来越认识到当前的 DBD 分类学错误地适用于幼儿期。建立一种对发展敏感的方法来描述学前破坏性行为将改善早期识别，并为识别不同因果过程和有针对性的预防工作的研究奠定基础。