Ezpeleta Lourdes, Granero Roser, de la Osa Núria, Trepat Esther, Domènech Josep M
Unitat d'Epidemiologia i de Diagnòstic en Psicopatologia del Desenvolupament - Grup de Recerca 2014 SGR 312 Generalitat de Catalunya, Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Edifici B., Bellaterra, 08193, Barcelona, Spain.
Unitat d'Epidemiologia i de Diagnòstic en Psicopatologia del Desenvolupament - Grup de Recerca 2014 SGR 312 Generalitat de Catalunya, Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain.
J Abnorm Child Psychol. 2016 Jan;44(1):115-28. doi: 10.1007/s10802-015-9972-3.
This study traces the developmental course of irritability symptoms in oppositional defiant disorder (ODD) from ages 3-5 and examines the psychopathological outcomes of the different trajectories at age 6.
A sample of 622 3-year-old preschoolers (311 were boys), followed up until age 6, was assessed yearly with a semi-structured diagnostic interview with parents and at age 6 with questionnaires answered by parents, teachers and children.
Growth-Mixture-Modeling yielded five trajectories of irritability levels for the whole sample (high-persistent 3.5%, decreasing 3.8%, increasing 2.6%, low-persistent 44.1% and null 46.0%). Among the children who presented with ODD during preschool age, three trajectories of irritability symptoms resulted (high-persistent 31.9%, decreasing 34.9% and increasing 33.2%). Null, low-persistent and decreasing irritability courses in the sample as a whole gave very similar discriminative capacity for children's psychopathological state at age 6, while the increasing and high-persistent categories involved poorer clinical outcomes than the null course. For ODD children, the high-persistent and increasing trajectories of irritability predicted disruptive behavior disorders, comorbidity, high level of functional impairment, internalizing and externalizing problems and low anger control at age 6.
Irritability identifies a subset of ODD children at high risk of poorer longitudinal psychopathological and functional outcomes. It might be clinically relevant to identify this subset of ODD children with a high number of irritability symptoms throughout development with a view to preventing comorbid and future adverse longitudinal outcomes.
本研究追踪了对立违抗性障碍（ODD）中易怒症状在3至5岁期间的发展过程，并考察了不同轨迹在6岁时的精神病理学结果。
对622名3岁学龄前儿童（311名男孩）进行样本研究，随访至6岁，每年通过与家长进行半结构化诊断访谈进行评估，并在6岁时让家长、教师和儿童填写问卷。
生长混合模型得出了整个样本易怒水平的五条轨迹（高持续性3.5%，下降3.8%，上升2.6%，低持续性44.1%，无易怒症状46.0%）。在学龄前出现ODD的儿童中，产生了三条易怒症状轨迹（高持续性31.9%，下降34.9%，上升33.2%）。整个样本中无易怒症状、低持续性和下降性易怒过程对6岁儿童的精神病理状态具有非常相似的判别能力，而上升性和高持续性类别与无易怒症状过程相比，临床结果较差。对于ODD儿童，易怒的高持续性和上升轨迹预测了6岁时的破坏性行为障碍、共病、高功能损害水平、内化和外化问题以及低愤怒控制能力。
易怒症状可识别出一部分有较差纵向精神病理学和功能结果高风险的ODD儿童。在整个发育过程中识别出这一有大量易怒症状的ODD儿童子集可能具有临床相关性，以期预防共病和未来不良的纵向结果。
