Hofstra Marijke B, Van der Ende Jan, Verhulst Frank C
Department of Child and Adolescent Psychiatry, University Hopsital Rotterdam-Sophia/Erasmus University, The Netherlands.
Am J Psychiatry. 2002 Mar;159(3):401-7. doi: 10.1176/appi.ajp.159.3.401.
The authors determined the impact of different pathways of psychopathological development on adult outcome in subjects followed from ages 11-18 to ages 21-28.
Problem behaviors of subjects from a general population sample were assessed through the Youth Self-Report and the Young Adult Self-Report given at four time points (1987, 1989, 1991, and 1997). In addition, DSM-IV diagnoses, information pertaining to signs of maladjustment, and measures of social functioning were obtained at the last assessment. On the basis of the self-report ratings, four contrasting developmental pathways of psychopathology were determined: persistent, decreasing, increasing, and consistently normal.
Subjects whose overall level of psychopathology was persistent over time had a higher lifetime prevalence of DSM-IV diagnoses and a poorer general outcome in adulthood than did subjects whose level of psychopathology increased. Subjects whose level of psychopathology returned to normal after high levels of problems in adolescence were only slightly different in terms of outcome from subjects with consistently normal ratings.
作者确定了从11至18岁追踪到21至28岁的受试者中,不同心理病理发展途径对成人结局的影响。
通过在四个时间点(1987年、1989年、1991年和1997年)进行的青少年自评量表和青年成人自评量表,评估了来自普通人群样本的受试者的问题行为。此外,在最后一次评估时获得了DSM-IV诊断、与适应不良迹象相关的信息以及社会功能测量结果。根据自评评分,确定了四种截然不同的心理病理发展途径:持续型、下降型、上升型和始终正常型。
心理病理总体水平随时间持续的受试者,其DSM-IV诊断的终生患病率更高,成年后的总体结局比心理病理水平上升的受试者更差。在青春期出现高水平问题后心理病理水平恢复正常的受试者,其结局与评分始终正常的受试者仅略有不同。
1)在青春期早期表现出高水平问题但到成年期心理病理水平降低的人,似乎与从未达到严重心理病理水平的人一样健康。2)持续进入成年期的偏离途径对许多功能领域有负面影响。这两个发现都是青春期早期进行干预的有力论据。