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儿童行为检查表情绪失调谱在具有破坏性行为障碍的青少年中的表现:临床相关性和治疗意义。

Child behaviour checklist emotional dysregulation profiles in youth with disruptive behaviour disorders: clinical correlates and treatment implications.

机构信息

IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy.

IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy.

出版信息

Psychiatry Res. 2015 Jan 30;225(1-2):191-196. doi: 10.1016/j.psychres.2014.11.019. Epub 2014 Nov 20.

DOI:10.1016/j.psychres.2014.11.019
PMID:25480545
Abstract

Two Child Behaviour Checklist (CBCL) profiles were correlated to poor self-regulation, Deficient Emotional Self-Regulation (DESR) (elevation between 1 and 2 Standard Deviations (SD) in Anxiety/Depression, Aggression, Attention subscales), and Dysregulation Profile (DP) (elevation of 2 Standard Deviations or more). We explored youths with Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) whether these profiles are associated with specific clinical features. The sample included 57 patients with DESR profile and 41 with DP profile, ages 9 to 15 years, all assigned to a non-pharmacological Multimodal Treatment Program. No differences resulted between groups in demographic features, diagnosis ratio, and comorbidities with Attention Deficit Hyperactivity Disorder (ADHD), Bipolar Disorder (BD), and Anxiety Disorder. The DP group was associated with higher scores in Withdrawn, Social Problem, Thought, Rule Breaking, and Somatic CBCL subscales, and higher scores in Narcissism and Impulsivity (but not Callous-Unemotional (CU)), according to the Antisocial Process Screening Device (APSD). After treatment, patients with DESR improved their personality traits (Narcissistic and Callous-Unemotional, but not Impulsivity), while changes in CBCL scales were modest. Patients with DP improved scales of Attention, Aggression, Anxiety-Depression, Rule Breaking, Withdrawal, Social Problem and Thought, while personality features did not change. These results suggest diagnostic implications of CBCL profiles, and indications for targeted treatment strategies.

摘要

两份儿童行为检查表(CBCL)的特征与自我调节不良、情绪自我调节不足(DESR)(焦虑/抑郁、攻击、注意力分量表中 1 到 2 个标准差的升高)和失调特征(DP)(2 个标准差或更高的升高)相关。我们探讨了患有对立违抗性障碍(ODD)和品行障碍(CD)的青少年,这些特征是否与特定的临床特征有关。该样本包括 57 名 DESR 特征和 41 名 DP 特征的患者,年龄 9 至 15 岁,均被分配到非药物性多模式治疗方案中。在人口统计学特征、诊断比例以及与注意力缺陷多动障碍(ADHD)、双相情感障碍(BD)和焦虑障碍的共病方面,两组之间没有差异。根据反社会过程筛选装置(APSD),DP 组在 withdrawn、social problem、Thought、rule breaking 和 somatic CBCL 分量表中的得分较高,在自恋和冲动(但不是冷酷无情(CU))方面的得分较高。经过治疗,DESR 患者改善了他们的人格特质(自恋和冷酷无情,但不是冲动),而 CBCL 量表的变化不大。DP 患者改善了注意力、攻击性、焦虑-抑郁、违规、回避、社会问题和思维等量表,而人格特征没有变化。这些结果表明 CBCL 特征具有诊断意义,并提示需要针对特定治疗策略。

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