Department of Child Psychiatry, 'Eugenio Medea' Scientific Institute, Bosisio Parini, Italy.
Epidemiol Psychiatr Sci. 2013 Mar;22(1):63-73. doi: 10.1017/S2045796012000145. Epub 2012 Apr 11.
Aims. Adolescence is a critical transition phase between childhood and adulthood, when the burden of mental disorder may still be prevented. The aim of this study was to evaluate the continuity and discontinuity of behavioural problems in adolescence while taking into account the multiple co-variation of psychopathological traits and the complex role of recent stressful life events (SLEs). Methods. This is a 5-year follow-up investigation of emotional and behavioural problems assessed by the newly developed Child Behavior Checklist (CBCL) DSM-Oriented Scales (DOSs) in 420 general population subjects aged 15-19 years. Results. The DOSs showed good stability, even when multiple co-variation was taken into account. Longitudinal data showed that homotypic evolution of psychopathology was to be expected in the first place. Equifinality and multifinality were also found. Oppositional Defiant Problems emerged to be polyvalent predictors of both internalizing and externalizing problems. Furthermore, Oppositional Defiant Problems predicted more SLEs, which in turn predicted more Depression, Anxiety and Oppositional Defiant Problems. Mediational analyses confirmed the role of SLEs in partially accounting for the continuity of Oppositional Defiant Problems and for the heterotypic progression towards Affective Problems. Conclusions. These data underscore early adolescence behavioural problems as an important focus for primary and secondary intervention.
目的。青春期是儿童期向成年期的关键过渡阶段,此时精神障碍的负担仍有可能得到预防。本研究的目的是评估青春期行为问题的连续性和非连续性,同时考虑到精神病理特征的多重共变和近期生活应激事件(SLEs)的复杂作用。
方法。这是对 420 名年龄在 15-19 岁的普通人群进行的新开发的儿童行为检查表(CBCL)DSM 定向量表(DOS)评估的情绪和行为问题的 5 年随访研究。
结果。DOS 表现出良好的稳定性,即使考虑到多种共变因素也是如此。纵向数据显示,首先可以预期同型精神病演变。还发现了等效性和多效性。对立违抗性问题是内部问题和外部问题的多价预测因子。此外,对立违抗性问题预测了更多的 SLEs,而 SLEs 又预测了更多的抑郁、焦虑和对立违抗性问题。中介分析证实了 SLEs 在部分解释对立违抗性问题的连续性和向情感问题的异质进展方面的作用。
结论。这些数据强调了青少年早期行为问题是初级和二级干预的重要重点。