Althoff Robert R, Kuny-Slock Ana V, Verhulst Frank C, Hudziak James J, van der Ende Jan
Departments of Psychiatry and Pediatrics, College of Medicine, University of Vermont, Burlington, VT, USA; Department of Psychology, University of Vermont, Burlington, VT, USA; Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands.
J Child Psychol Psychiatry. 2014 Oct;55(10):1162-71. doi: 10.1111/jcpp.12233. Epub 2014 Mar 26.
Oppositional defiant disorder (ODD) has components of both irritability and defiance. It remains unclear whether children with variation in these domains have different adult outcomes. This study examined the concurrent and predictive validity of classes of oppositional defiant behavior.
Latent class analysis was performed on the oppositional defiant problems scale of the Child Behavior Checklist in two samples, one in the US (the Achenbach Normative Sample, N = 2029) and one in the Netherlands (the Zuid-Holland Study, N = 2076). A third sample of American children (The Vermont Family Study, N = 399) was examined to determine concurrent validity with DSM diagnoses. Predictive validity over 14 years was assessed using the Zuid-Holland Study.
Four classes of oppositional defiant problems were consistent in the two latent class analyses: No Symptoms, All Symptoms, Irritable, and Defiant. Individuals in the No Symptoms Class were rarely diagnosed concurrently with ODD or any future disorder. Individuals in the All Symptoms Class had an increased frequency of concurrent childhood diagnosis of ODD and of violence in adulthood. Subjects in the Irritable Class had low concurrent diagnosis of ODD, but increased odds of adult mood disorders. Individuals in the Defiant Class had low concurrent diagnosis of ODD, but had increased odds of violence as adults.
Only children in the All Symptoms class were likely to have a concurrent diagnosis of ODD. Although not diagnosed with ODD, children in the Irritable Class were more likely to have adult mood disorders and children in the Defiant Class were more likely to engage in violent behavior.
对立违抗障碍（ODD）具有易怒和违抗两种成分。这些领域存在差异的儿童是否会有不同的成人结局仍不清楚。本研究检验了对立违抗行为类别在同时效度和预测效度方面的情况。
对两份样本（一份来自美国的阿肯巴克常模样本，N = 2029；另一份来自荷兰的南荷兰研究，N = 2076）的儿童行为清单对立违抗问题量表进行潜在类别分析。对第三份美国儿童样本（佛蒙特家庭研究，N = 399）进行检验，以确定与DSM诊断的同时效度。使用南荷兰研究评估14年期间的预测效度。
在两项潜在类别分析中，四类对立违抗问题是一致的：无症状、所有症状、易怒和违抗。无症状类别的个体很少被同时诊断为ODD或任何未来的疾病。所有症状类别的个体儿童期同时被诊断为ODD以及成年期暴力行为的频率增加。易怒类别的受试者ODD的同时诊断率较低，但成年期情绪障碍的几率增加。违抗类别的个体ODD的同时诊断率较低，但成年后暴力行为的几率增加。
只有所有症状类别的儿童可能同时被诊断为ODD。虽然未被诊断为ODD，但易怒类别的儿童更有可能出现成年期情绪障碍，而违抗类别的儿童更有可能实施暴力行为。
