Christchurch Health and Development Study, University of Otago, Christchurch, New Zealand.
J Am Acad Child Adolesc Psychiatry. 2010 Nov;49(11):1125-33. doi: 10.1016/j.jaac.2010.08.005. Epub 2010 Sep 26.
To examine the social, family background, and individual antecedents of conduct disorder (CD) and oppositional defiant disorder (ODD), the extent to which CD and ODD symptoms were predicted by common environmental risk factors, and the extent to which the antecedents of CD and ODD accounted for the comorbidity between the two disorders.
Data were gathered from 926 members of a New Zealand longitudinal birth cohort. The outcome measures were DSM-IV symptom count measures of CD and ODD at age 14 to 16 years. Predictors measured during the period from 0 to 14 years included the following: maternal smoking during pregnancy; exposure to socioeconomic adversity; parental maladaptive behavior; childhood exposure to abuse and interparental violence; gender; cognitive ability; and affiliation with deviant peers in early adolescence. Associations between the predictors and outcome measures were modeled using structural equation modeling.
The analyses showed that each of the predictors was significantly (p < .05) associated with CD and ODD, with the exception of gender and ODD. After model fitting, the profile of risk factors that predicted CD and ODD were largely similar. The analyses revealed that approximately 40% of the comorbidity between disorders could be accounted for by common factors.
The data showed that CD and ODD had largely similar social and environmental antecedents. One implication of this finding is that treatment and prevention approaches that are developed for use with a particular behavior disorder may in fact reduce the incidence of both disorders.
探讨品行障碍(CD)和对立违抗性障碍(ODD)的社会、家庭背景和个体前因,CD 和 ODD 症状受共同环境风险因素预测的程度,以及 CD 和 ODD 的前因对两种障碍共病的解释程度。
数据来自新西兰一项纵向出生队列的 926 名成员。结局指标为 14 至 16 岁时 DSM-IV 品行障碍和对立违抗性障碍的症状计数。在 0 至 14 岁期间测量的预测指标包括:母亲怀孕期间吸烟;社会经济逆境暴露;父母适应不良行为;儿童期遭受虐待和父母间暴力;性别;认知能力;以及青少年早期与偏差同伴的联系。使用结构方程模型对预测指标与结局指标之间的关系进行建模。
分析表明,除性别和 ODD 外,每个预测指标均与 CD 和 ODD 显著相关(p <.05)。在模型拟合后,预测 CD 和 ODD 的风险因素的特征基本相似。分析显示,大约 40%的障碍共病可以用共同因素来解释。
数据表明,CD 和 ODD 具有大致相似的社会和环境前因。这一发现的一个含义是,为特定行为障碍开发的治疗和预防方法实际上可能会降低两种障碍的发生率。