Department of Psychiatry and Behavioral Neurosciences, McMaster University, and the Offord Centre for Child Studies, Hamilton, Ontario, Canada.
J Am Acad Child Adolesc Psychiatry. 2010 Feb;49(2):152-61. doi: 10.1097/00004583-201002000-00009.
Symptoms of oppositional defiant disorder (ODD) and depression show high rates of co-occurrence, both cross-sectionally and longitudinally. This study examines the extent to which variation in oppositional symptoms predict, variation in depressive symptoms over time, accounting for co-occurring depressive symptoms and measurement error.
The sample for analyses includes a cohort of 6- and 7-year-old (N = 903) children from the National Longitudinal Study of Youth who were assessed biannually at ages 6 to 7 (T1), 8 to 9 (T2), and 10 to 11 (T3) years of age. Childhood oppositional behaviors and depressive symptoms were measured using maternal reports on the Behavior Problem Index. Structural equation modeling was used to test whether oppositional behavior predicted subsequent depressive symptoms in boys and girls across childhood.
For boys, oppositional behaviors predicted increases in subsequent depressive symptoms across both time points, even after accounting for previous and co-occurring levels of depression symptoms. For girls, depressive symptoms at T2 and T3 were predictive of lower levels of oppositional symptoms at T3.
Oppositional behavior may be a risk factor for depression in boys, but in girls its co-occurrence at each time point obscures any such relationship. Developmental relationships between oppositional and depressive symptoms in children are complex and differ by sex.
对立违抗障碍（ODD）和抑郁症的症状均存在较高的共病发生率，无论是在横断面还是纵向研究中。本研究旨在考察对立症状的变化在多大程度上可以预测随时间变化的抑郁症状，同时考虑到共病抑郁症状和测量误差的影响。
分析的样本包括来自全国青少年纵向研究的 6 岁和 7 岁儿童队列（N=903），这些儿童在 6 至 7 岁（T1）、8 至 9 岁（T2）和 10 至 11 岁（T3）时进行了两次评估。儿童期对立行为和抑郁症状使用母亲对行为问题指数的报告进行测量。结构方程模型用于测试男孩和女孩在整个童年时期，对立行为是否可以预测随后的抑郁症状。
对于男孩，即使考虑到先前和共病的抑郁症状水平，对立行为也可以预测随后的抑郁症状在两个时间点上的增加。对于女孩，T2 和 T3 的抑郁症状可以预测 T3 时对立症状水平的降低。
对立行为可能是男孩抑郁的一个风险因素，但在女孩中，其在每个时间点的共病掩盖了任何这样的关系。儿童对立和抑郁症状之间的发展关系是复杂的，并且因性别而异。
