Danforth Jeffrey S, Connor Daniel F, Doerfler Leonard A
Eastern Connecticut State University, Willimantic, CT, USA
University of CT Medical School, Farmington, CT, USA.
J Atten Disord. 2016 Mar;20(3):214-29. doi: 10.1177/1087054713517546. Epub 2014 Jan 10.
We describe interactions among factors that contribute to the development of conduct problems among children with ADHD.
An integrative developmental psychopathology analysis combines various approaches and posits one model of how diverse risk factors operate together to contribute to the development of conduct problems among children with ADHD.
Substantial genetic risk increases covariation between ADHD and conduct problems. Candidate genes are associated with CNS monoaminergic neurotransmission. Subsequent neurodevelopmental impairment interferes with executive function, with impaired verbal working memory playing an important role. Parent/child bi-directional influences exacerbate the risk for conduct problems when ADHD symptoms increase the likelihood of a coercive parenting style. Parent stress in reaction to child comorbid ADHD and conduct problems, and parent attribution for the child's conduct problem behavior, add to the potential for coercion and reduce constructive parent-child interaction that might otherwise enhance the development of verbal working memory.
In an integrated manner, these variables increase the risk that a child with ADHD will subsequently develop conduct problems.
我们描述了导致多动症儿童出现品行问题的诸多因素之间的相互作用。
一项综合发展性心理病理学分析结合了多种方法，并提出了一个模型，说明各种风险因素如何共同作用，导致多动症儿童出现品行问题。
大量的遗传风险增加了多动症与品行问题之间的共变关系。候选基因与中枢神经系统单胺能神经传递有关。随后的神经发育障碍会干扰执行功能，其中言语工作记忆受损起着重要作用。当多动症症状增加强制型养育方式的可能性时，亲子双向影响会加剧品行问题的风险。家长因孩子同时患有多动症和品行问题而产生的压力，以及家长对孩子品行问题行为的归因，增加了强制行为的可能性，并减少了本可促进言语工作记忆发展的建设性亲子互动。
这些变量以综合的方式增加了多动症儿童随后出现品行问题的风险。
