Western Psychiatric Institute and Clinic at the University of Pittsburgh, Pittsburgh, PA 15213, USA.
J Am Acad Child Adolesc Psychiatry. 2010 May;49(5):484-92. doi: 10.1097/00004583-201005000-00009.
To examine whether oppositional defiant disorder (ODD) rather than conduct disorder (CD) may explain the comorbidity between behavioral disorders and depression; to test whether distinct affective and behavioral dimensions can be discerned within the symptoms of ODD; and to determine whether an affective dimension of ODD symptoms is specifically predictive of later depression.
The dimensions of ODD and their prediction to later CD and depression were examined in a community sample of 2,451 girls between the ages of 5 and 8 years, followed up annually over a 5-year period, using parent, child, and teacher questionnaire ratings of the severity of symptoms of psychopathology.
Dimensions of negative affect, oppositional behavior, and antagonistic behavior were found within ODD symptoms. Negative affect predicted later depression. Oppositional and antagonistic behavior predicted CD overall, and for Caucasian girls, negative affect also predicted later CD. CD was not predictive of later depression, controlling for comorbid conditions.
ODD plays a key role in the early development of psychopathology. It is central in the comorbidity between internalizing and externalizing psychopathology, which may be caused by a dimension of negative affective symptoms within ODD. How this dimension relates to later CD appears to vary by race.
探讨对立违抗性障碍(ODD)而非品行障碍(CD)是否可以解释行为障碍与抑郁之间的共病关系;检验 ODD 症状内是否存在不同的情感和行为维度;并确定 ODD 症状的情感维度是否可以预测日后的抑郁。
对年龄在 5 至 8 岁的 2451 名女童进行了为期 5 年的年度随访,采用家长、儿童和教师对儿童精神病理学症状严重程度的问卷评定,研究了 ODD 的维度及其对以后 CD 和抑郁的预测作用。
在 ODD 症状内发现了负性情绪、对立行为和敌对行为的维度。负性情绪预测了以后的抑郁。对立和敌对行为总体上预测了 CD,对于白种女孩,负性情绪也预测了以后的 CD。控制了共病情况后,CD 对以后的抑郁没有预测作用。
ODD 在精神病理学的早期发展中起着关键作用。它是内在和外在精神病理学共病的核心,这种共病可能是由于 ODD 中的负性情感症状维度引起的。这一维度与以后的 CD 的关系似乎因种族而异。