Carbonneau Rene, Boivin Michel, Brendgen Mara, Nagin Daniel, Tremblay Richard E
Department of Pediatrics, Faculty of Medicine, University of Montreal, 3050 Edouard-Montpetit, suite 225, Montréal, QC, H3T 1J7, Canada.
Sainte-Justine Hospital Research Center, Montreal, QC, Canada.
J Abnorm Child Psychol. 2016 May;44(4):677-90. doi: 10.1007/s10802-015-0072-1.
Comorbidity is frequent among disruptive behaviors (DB) and leads to mental health problems during adolescence and adulthood. However, the early developmental origins of this comorbidity have so far received little attention. This study investigated the developmental comorbidity of three DB categories during early childhood: hyperactivity-impulsivity, non-compliance, and physical aggression. Joint developmental trajectories of DB were identified based on annual mother interviews from age 1½ to 5 years, in a population-representative birth-cohort (N = 2045). A significant proportion of children (13 % to 21 %, depending on the type of DB) consistently displayed high levels of hyperactivity-impulsivity, non-compliance, or physical aggression from age 1½ to 5 years. Developmental comorbidity was frequent, especially for boys: 10 % of boys and 3.7 % of girls were on a stable trajectory with high levels of symptoms for the three categories of DB. Significant associations were observed between preschool joint-trajectories of DB and indicators of DB and school adjustment assessed by teachers in first grade. Preschoolers who maintained high levels of hyperactivity-impulsivity, non-compliance, and physical aggression, displayed the highest number of DB symptoms in first grade for all categories according to their teacher. They were also among the most disadvantaged of their class for school adjustment indicators. Thus, DB manifestations and developmental comorbidity of DB are highly prevalent in infancy. Early childhood appears to be a critical period to prevent persistent and comorbid DB that leads to impairment at the very beginning of school attendance and to long-term serious health and social adjustment problems.
共病在破坏性行为（DB）中很常见，并会在青少年期和成年期引发心理健康问题。然而，这种共病的早期发育根源至今很少受到关注。本研究调查了幼儿期三种破坏性行为类别的发育共病情况：多动冲动、不顺从和身体攻击。基于对1.5岁至5岁儿童每年进行的母亲访谈，在一个具有人口代表性的出生队列（N = 2045）中确定了破坏性行为的联合发育轨迹。相当比例的儿童（13%至21%，取决于破坏性行为的类型）在1.5岁至5岁期间持续表现出高水平的多动冲动、不顺从或身体攻击。发育共病很常见，尤其是男孩：10%的男孩和3.7%的女孩处于三种破坏性行为类别症状水平都很高的稳定轨迹。观察到学前破坏性行为联合轨迹与一年级教师评估的破坏性行为指标和学校适应指标之间存在显著关联。根据教师的评估，在学前阶段保持高水平多动冲动、不顺从和身体攻击的儿童，在一年级时所有类别中的破坏性行为症状数量最多。在学校适应指标方面，他们也是班级中最弱势的群体之一。因此，破坏性行为的表现和发育共病在幼儿期非常普遍。幼儿期似乎是预防导致入学伊始就出现功能损害以及长期严重健康和社会适应问题的持续性和共病性破坏性行为的关键时期。
