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儿童和青少年期的内化和外化障碍:基于 ALSPAC 数据的潜在转变分析。

Internalizing and externalizing disorders in childhood and adolescence: A latent transition analysis using ALSPAC data.

机构信息

Ulster University, Londonderry BT48 7JL, Northern Ireland, UK.

Ulster University, Londonderry BT48 7JL, Northern Ireland, UK.

出版信息

Compr Psychiatry. 2017 May;75:75-84. doi: 10.1016/j.comppsych.2017.03.003. Epub 2017 Mar 12.

Abstract

BACKGROUND

Research examining the association between internalizing and externalizing dimensions of psychopathology has relied heavily on variable-centered analytical techniques. Person-centered methodologies complement the variable-centered approach, and may help explain the medium-to-large correlations that exist between higher order dimensions of psychopathology. What little person-centered research exists has been cross-sectional and utilized adult samples. The present study sought to take a person-centered approach to the modeling of psychiatric comorbidity during a key developmental phase; middle childhood through adolescence.

METHODS

Analysis was conducted on data from the Avon Longitudinal Study of Parents and Children (ALSPAC, N=9282). Latent transition analysis (LTA) was conducted using eight DSM-IV disorders assessed at ages 7.5 and 14years as measured indicators.

RESULTS

At both time points, a four class solution provided the best fit, with classes labeled as (i) normative, (ii) primarily internalizing, (iii) primarily externalizing, and (iv) high-risk/multimorbid. There was considerable individual-level stability across time, with approximately 80% of children remaining in the same class at both time points. Those in the internalizing class at baseline were more likely to transition to a less severe class (i.e., the normative class).

CONCLUSIONS

Person-centered methodologies demonstrate that the association between internalizing and externalizing is accounted for by a sub-population at high risk for experiencing psychiatric comorbidity, and 'cross-class' disorders which link the internalizing and externalizing spectra.

摘要

背景

研究内在和外在心理病理维度之间的关联主要依赖于变量中心的分析技术。以个体为中心的方法补充了变量中心的方法,并且可能有助于解释心理病理学高阶维度之间存在的中等至大的相关性。少量的以个体为中心的研究是横断面的,并且使用的是成人样本。本研究试图在关键的发展阶段(从中年到青春期)采用个体为中心的方法来对精神共病进行建模。

方法

分析基于阿冯纵向父母与子女研究(ALSPAC,N=9282)的数据进行。使用八个在 7.5 岁和 14 岁时评估的 DSM-IV 障碍作为衡量指标进行潜在转变分析(LTA)。

结果

在两个时间点上,四类解决方案提供了最佳拟合,这些类别分别标记为(i)正常,(ii)主要内在化,(iii)主要外在化和(iv)高风险/多病共患。在时间上存在相当大的个体水平稳定性,大约 80%的儿童在两个时间点上都保持在相同的类别。在基线时处于内在化类别的人更有可能转变为不太严重的类别(即,正常类别)。

结论

以个体为中心的方法表明,内在化和外在化之间的关联是由处于高风险状态的亚群体引起的,这种风险状态可能会经历精神共病,以及连接内在化和外在化谱系的“跨类”障碍。

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