Department of Psychology, University of Sheffield, Sheffield, UK.
J Abnorm Psychol. 2010 Nov;119(4):726-38. doi: 10.1037/a0020798.
The Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV; American Psychiatric Association, 1994) specifies a developmental relationship between oppositional defiant disorder (ODD) and conduct disorder (CD). Evidence for this link is mixed, however, and recent studies suggest that different symptom dimensions in ODD may have different outcomes. The authors examined links between ODD, CD, and their young adult outcomes in the Great Smoky Mountains Study (E. J. Costello et al., 1996), a longitudinal data set with over 8,000 observations of 1,420 individuals (56% male) covering ages 9-21 years. ODD was a significant predictor of later CD in boys but not in girls after control for comorbid CD and subthreshold CD symptomatology. Transitions between ODD and CD were less common than anticipated, however, particularly during adolescence. The authors examined characteristics and outcomes of children with pure ODD, pure CD, and combined CD/ODD. Alongside many similarities in childhood and adolescent correlates, key differences were also identified: CD largely predicted behavioral outcomes, whereas ODD showed stronger prediction to emotional disorders in early adult life. Factor analysis identified irritable and headstrong dimensions in ODD symptoms that showed differential prediction to later behavioral and emotional disorders. Overall, the results underscore the utility of retaining separate ODD and CD diagnoses in DSM-V.
《精神障碍诊断与统计手册》第四版（DSM-IV；美国精神病学协会，1994 年）规定了对立违抗性障碍（ODD）和品行障碍（CD）之间的发展关系。然而，这种联系的证据是混杂的，最近的研究表明，ODD 中的不同症状维度可能有不同的结果。作者在大烟山研究（E. J. Costello 等人，1996 年）中检查了 ODD、CD 及其年轻成人结局之间的联系，这是一个具有超过 8000 次观察和 1420 名个体（56%为男性）的纵向数据集，涵盖了 9-21 岁的年龄。在控制了共病 CD 和亚临床 CD 症状学之后，ODD 是男孩以后发生 CD 的重要预测因素，但不是女孩。然而，ODD 和 CD 之间的转换并不像预期的那么常见，尤其是在青春期。作者检查了单纯 ODD、单纯 CD 和合并 CD/ODD 儿童的特征和结局。除了在儿童和青少年相关因素中有许多相似之处外，还确定了关键差异：CD 主要预测行为结局，而 ODD 在成年早期显示出对情绪障碍更强的预测。因子分析确定了 ODD 症状中的易怒和固执维度，这些维度对以后的行为和情绪障碍有不同的预测。总的来说，这些结果强调了在 DSM-V 中保留单独的 ODD 和 CD 诊断的实用性。
