美国全国代表性样本中的终生持续性和青少年有限期品行障碍：患病率、预测因素及后果
Life course persistent and adolescence limited conduct disorder in a nationally representative US sample: prevalence, predictors, and outcomes.
作者信息
Moore Ashlee A, Silberg Judy L, Roberson-Nay Roxann, Mezuk Briana
机构信息
Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, VA, USA.
Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA.
出版信息
Soc Psychiatry Psychiatr Epidemiol. 2017 Apr;52(4):435-443. doi: 10.1007/s00127-017-1337-5. Epub 2017 Feb 8.
PURPOSE
The course of conduct disorder (CD) is heterogeneous. Moffitt proposed the heuristic of life course persistent (LCP) and adolescence limited (AL) to differentiate etiologically distinct forms of antisocial behavior (AB), each with distinct predictors and consequences, although a few studies have assessed this demarcation within the context of CD. The objective of this study was to apply Moffitt's taxonomy in a nationally representative US sample to investigate the prevalence, predictors, and outcomes of LCP and AL CD.
METHODS
Data come from the Collaborative Psychiatric Epidemiology Studies, a set of population-based nationally representative cross-sectional surveys (N = 20,130). Predictors included harsh discipline, maternal and paternal closeness, poverty in childhood, history of learning disability, parental deviance, and nativity. Outcomes included substance use, employment status, education attainment, marital status, income level, and self-rated mental and physical health.
RESULTS
The prevalence of LCP and AL CD was 0.5 and 4.6%, respectively, for females, and 1.9 and 5.1%, respectively, for males. Low childhood SES [Odds Ratio (OR) = 3.49], lack of maternal closeness (OR = 2.50), and history of harsh discipline (OR = 2.17) increased odds of LCP group membership. The LCP group had higher odds of developing substance use disorders (OR = 2.00) relative to AL.
CONCLUSIONS
LCP CD is more strongly influenced by childhood environment and confers increased odds for substance use problems in adulthood relative to AL CD.
目的
品行障碍（CD）的病程具有异质性。莫菲特提出了终生持续性（LCP）和青春期有限性（AL）的启发式分类法，以区分病因上不同形式的反社会行为（AB），每种形式都有不同的预测因素和后果，尽管只有少数研究在CD的背景下评估了这种划分。本研究的目的是在美国具有全国代表性的样本中应用莫菲特的分类法，以调查LCP和AL型CD的患病率、预测因素和结果。
方法
数据来自协作精神病流行病学研究，这是一组基于人群的具有全国代表性的横断面调查（N = 20130）。预测因素包括严厉的管教、与父母的亲密程度、童年贫困、学习障碍史、父母偏差和出生地。结果包括物质使用、就业状况、教育程度、婚姻状况、收入水平以及自我评定的身心健康状况。
结果
女性中LCP和AL型CD的患病率分别为0.5%和4.6%，男性分别为1.9%和5.1%。童年社会经济地位低（优势比[OR]=3.49）、与母亲缺乏亲密关系（OR = 2.50）以及严厉管教史（OR = 2.17）增加了属于LCP组的几率。与AL组相比，LCP组发生物质使用障碍的几率更高（OR = 2.00）。
结论
与AL型CD相比，LCP型CD受童年环境的影响更大，且成年后发生物质使用问题的几率更高。
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