Moffitt Terrie E, Arseneault Louise, Jaffee Sara R, Kim-Cohen Julia, Koenen Karestan C, Odgers Candice L, Slutske Wendy S, Viding Essi
Duke University, USA.
J Child Psychol Psychiatry. 2008 Jan;49(1):3-33. doi: 10.1111/j.1469-7610.2007.01823.x.
This article charts a strategic research course toward an empirical foundation for the diagnosis of conduct disorder in the forthcoming DSM-V. Since the DSM-IV appeared in 1994, an impressive amount of new information about conduct disorder has emerged. As a result of this new knowledge, reasonable rationales have been put forward for adding to the conduct disorder diagnostic protocol: a childhood-limited subtype, family psychiatric history, callous-unemotional traits, female-specific criteria, preschool-specific criteria, early substance use, and biomarkers from genetics, neuroimaging, and physiology research. This article reviews the evidence for these and other potential changes to the conduct disorder diagnosis. We report that although there is a great deal of exciting research into each of the topics, very little of it provides the precise sort of evidence base required to justify any alteration to the DSM-V. We outline specific research questions and study designs needed to build the lacking evidence base for or against proposed changes to DSM-V conduct disorder.
本文规划了一条战略研究路线,旨在为即将发布的《精神疾病诊断与统计手册》第五版(DSM-V)中品行障碍的诊断建立实证基础。自1994年《精神疾病诊断与统计手册》第四版(DSM-IV)问世以来,已出现了大量关于品行障碍的新信息。基于这些新知识,人们提出了合理的理由,建议在品行障碍诊断标准中增加以下内容:儿童期有限型亚型、家族精神病史、冷酷无情特质、女性特定标准、学龄前儿童特定标准、早期物质使用,以及来自遗传学、神经影像学和生理学研究的生物标志物。本文回顾了这些以及品行障碍诊断中其他潜在变化的证据。我们报告称,尽管针对每个主题都有大量令人兴奋的研究,但其中很少能提供为《精神疾病诊断与统计手册》第五版的任何改动提供正当理由所需的确切证据基础。我们概述了为支持或反对《精神疾病诊断与统计手册》第五版品行障碍的提议更改而建立缺失证据基础所需的具体研究问题和研究设计。