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破坏性心境失调障碍(DMDD):基于研究领域标准(RDoC)的视角

Disruptive Mood Dysregulation Disorder (DMDD): An RDoC perspective.

作者信息

Meyers Erica, DeSerisy Mariah, Roy Amy Krain

机构信息

Fordham University, Bronx, NY, United States.

Fordham University, Bronx, NY, United States.

出版信息

J Affect Disord. 2017 Jul;216:117-122. doi: 10.1016/j.jad.2016.08.007. Epub 2016 Aug 13.

Abstract

In recent years, there has been much debate regarding the most appropriate diagnostic classification of children exhibiting emotion dysregulation in the form of irritability and severe temper outbursts. Most recently, this has resulted in the addition of a new diagnosis, Disruptive Mood Dysregulation Disorder (DMDD) in the DSM 5. The impetus for including this new disorder was to reduce the number of diagnoses that these children would typically receive; however, there is concern that it has only complicated matters rather than simplifying them. For example, a recent epidemiologic study shows that DMDD cannot be differentiated from oppositional defiant disorder (ODD) based on symptoms alone. Thus, these children are an ideal population in which to apply RDoC constructs in order to obtain greater clarity in terms of underlying processes and ultimately, inform nosology and appropriate interventions. The aim of this article is to provide a foundation for future research by examining extant theoretical and empirical evidence for the role of four key RDoC constructs in DMDD.

摘要

近年来,对于以易怒和严重发脾气形式表现出情绪调节障碍的儿童,其最合适的诊断分类存在诸多争议。最近,这导致在《精神疾病诊断与统计手册》第5版(DSM 5)中新增了一种诊断,即破坏性情绪失调障碍(DMDD)。纳入这一新疾病的推动力是减少这些儿童通常会获得的诊断数量;然而,有人担心这只会使事情变得更复杂而非更简单。例如,最近一项流行病学研究表明,仅根据症状无法将DMDD与对立违抗障碍(ODD)区分开来。因此,这些儿童是应用研究领域标准分类(RDoC)架构的理想人群,以便在潜在过程方面获得更清晰的认识,并最终为疾病分类学和适当干预提供依据。本文的目的是通过审视关于RDoC的四个关键架构在DMDD中作用的现有理论和实证证据,为未来研究奠定基础。

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