Zahn-Waxler C, Klimes-Dougan B, Slattery M J
Section on Developmental Psychopathology, Child Psychiatry Branch, National Institute of Mental Health Bethesada, MD 20892, USA.
Dev Psychopathol. 2000 Summer;12(3):443-66.
The focus of this article is on internalizing problems that are experienced by children and adolescents. We provide an historical perspective, selectively examine the current state of knowledge, consider advances and gaps in what is known, and identify new research directions. Diagnosis, epidemiology, theory, and research first are considered separately for anxiety and depressive disorders. These internalizing problems, however, whether clinical or subclinical, share many common features and show high comorbidity rates. We emphasize the importance of systematic analysis of comorbid anxiety and depression, including their comorbidity with externalizing problems. This could lead to more valid classification of subtypes of internalizing problems and further an understanding of the diverse conditions that constitute internalized distress. We highlight the need to study anxiety and depression within a developmental psychopathology framework, as well as to include both categorical and dimensional assessments of these problems in the same research designs. This will be essential for understanding the complex interplay of biological and environmental processes that contribute to the emergence, progression, and amelioration of internalizing problems over time.
本文的重点是儿童和青少年所经历的内化问题。我们提供一个历史视角，有选择地审视当前的知识状况，考量已知内容的进展与差距，并确定新的研究方向。首先分别针对焦虑症和抑郁症探讨诊断、流行病学、理论及研究情况。然而，这些内化问题，无论临床的还是亚临床的，都有许多共同特征且共病率很高。我们强调系统分析共病焦虑和抑郁的重要性，包括它们与外化问题的共病情况。这可能会带来对内化问题亚型更有效的分类，并进一步加深对构成内化困扰的各种状况的理解。我们强调有必要在发展心理病理学框架内研究焦虑和抑郁，同时在同一研究设计中纳入对这些问题的分类评估和维度评估。这对于理解随着时间推移促成内化问题的出现、发展和改善的生物与环境过程的复杂相互作用至关重要。
