Meehan Alan J, Maughan Barbara, Cecil Charlotte A M, Barker Edward D
Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London.
MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London.
J Abnorm Psychol. 2017 Feb;126(2):225-236. doi: 10.1037/abn0000235. Epub 2016 Dec 15.
Growing evidence suggests heterogeneity within interpersonal-callous (IC) youth based on co-occurring anxiety. The developmental validity of this proposed taxonomy remains unclear however, as most previous research is cross-sectional and/or limited to adolescence. We aimed to identify low-anxiety (IC/ANX-) and high-anxiety (IC/ANX+) IC variants, and compare these groups on (a) early risk exposures, (b) psychiatric symptoms from midchildhood to early adolescence, and (c) school-based functioning. Using the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective epidemiological birth cohort, model-based cluster analysis was performed on children with complete age-13 IC and anxiety scores (n = 6,791). Analysis of variance was used to compare resulting clusters on (a) prenatal and postnatal family adversity and maternal psychopathology, and harsh parenting; (b) developmental differences in attention-deficit/hyperactivity disorder (ADHD), conduct disorder (CD), oppositional defiant disorder (ODD), emotional difficulties, and low pro-social behavior at 7, 10, and 13 years; and (c) teacher-reported discipline problems, along with standardized test performance. We identified a 4-cluster solution: "typical," "low," "IC/ANX-", and "IC/ANX+." IC/ANX+ youth showed the highest prenatal and postnatal levels of family adversity and maternal psychopathology, highest levels of ADHD, CD, ODD, and emotional difficulties, greatest discipline problems, and lowest national test scores (all p < .001). IC/ANX+ also showed a distinct pattern of increasing psychopathology from age 7 to 13 years. Adolescent IC subtypes were successfully validated in ALSPAC across multiple raters using prenatal and early postnatal risk, repeated measures of psychopathology, and school-based outcomes. Greater prenatal environmental risk among IC/ANX+ youth suggests an important target for early intervention. (PsycINFO Database Record
越来越多的证据表明，基于共病焦虑，人际冷漠（IC）青少年群体存在异质性。然而，这种拟议分类法的发展效度仍不明确，因为此前大多数研究都是横断面研究和/或仅限于青少年阶段。我们旨在识别低焦虑（IC/ANX-）和高焦虑（IC/ANX+）的IC变体，并在以下方面比较这些群体：（a）早期风险暴露，（b）从中童年到青春期早期的精神症状，以及（c）学校表现。利用雅芳亲子纵向研究（ALSPAC）这一前瞻性流行病学出生队列，对13岁时IC和焦虑评分完整的儿童（n = 6791）进行了基于模型的聚类分析。方差分析用于比较所得聚类在以下方面的差异：（a）产前和产后家庭逆境、母亲精神病理学以及严厉育儿情况；（b）7岁、10岁和13岁时注意力缺陷多动障碍（ADHD）、品行障碍（CD）、对立违抗障碍（ODD）、情绪问题以及亲社会行为水平较低等方面的发育差异；（c）教师报告纪律问题以及标准化测试成绩。我们确定了一个四聚类解决方案：“典型”、“低”、“IC/ANX-”和“IC/ANX+”。IC/ANX+青少年在产前和产后家庭逆境及母亲精神病理学方面的水平最高，ADHD、CD、ODD和情绪问题的水平最高，纪律问题最严重，国家测试成绩最低（所有p <.001）。IC/ANX+在7岁至十三岁期间还呈现出精神病理学逐渐增加的独特模式。在ALSPAC中，通过产前和产后早期风险以及精神病理学重复测量和学校表现等多个评估者成功验证了青少年IC亚型。IC/ANX+青少年中更高的产前环境风险表明这是早期干预的一个重要目标。（PsycINFO数据库记录）
