Clinic for Child and Adolescent Psychiatry and Psychotherapy,University Medical Center Göttingen,Germany.
Robert Koch Institute,Department of Epidemiology and Health Monitoring,Berlin,Germany.
Psychol Med. 2018 Feb;48(3):404-415. doi: 10.1017/S0033291717001714. Epub 2017 Jun 22.
Severe mood dysregulation is common in childhood and can be highly impairing. The Dysregulation Profile (DP) can be considered as a broader phenotype of emotional dysregulation, including affect, cognition and behaviour. Since mood dysregulation may persist, but differently in boys and girls, the gender associated course needs to be considered longitudinally to gain a better insight in order to support the children more adequately. This study is focusing on gender associated subgroup trajectories of the Strengths and Difficulties Questionnaire-Dysregulation Profile (SDQ-DP) in middle childhood (9-13 years of age) and includes the potential impact of clinical and psychosocial characteristics.
The data set was available from the BELLA study on mental health and well-being in children and adolescents, which is the mental health module of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). A representative epidemiological sample of 564 children living in Germany was examined at three assessment points over 2 years (data collection 2003-2006). The SDQ-DP of children aged 9-13 years was evaluated using Latent Class Growth Analysis (LCGA).
For both genders three trajectories with low (girls 67.0% and boys 59.5%), moderate (girls 28.0% and boys 31.7%) and high SDQ-DP (girls 5.0% and boys 8.8%) scores were detected. The courses of low and moderate subgroups were stable, while in the high SDQ-DP subgroup boys showed a decreasing and girls an increasing trend in symptom severity on a descriptive level. The results of the multinomial logistic regression analyses revealed a significant influence of mainly externalising but also internalising problems both increasing the risk of moderate and high SDQ-DP in both genders. Good quality of life was a protective factor for the SDQ-DP course in all subgroups.
In addition to the known clinical and scientific value of the SDQ-DP, three distinguishable trajectories of SDQ-DP in boys and girls could be found. High externalising problems at the beginning of the trajectory were associated with an undesirable course of SDQ-DP. These findings might be helpful for better psychoeducation, counselling and monitoring in clinical cases and public health.
严重的情绪失调在儿童中很常见，并且可能会造成严重的损害。失调特征（DP）可以被视为情绪失调的更广泛表型，包括情感、认知和行为。由于情绪失调可能持续存在，但在男孩和女孩中表现不同，因此需要从纵向角度考虑与性别相关的病程，以便更深入地了解情况，从而更充分地支持儿童。本研究重点关注儿童中期（9-13 岁）的性别相关 DP 轨迹，并包括临床和心理社会特征的潜在影响。
数据来自儿童和青少年心理健康和幸福感的 BELLA 研究，该研究是德国儿童和青少年健康访谈和检查调查（KiGGS）的心理健康模块。对 564 名居住在德国的代表性流行病学儿童样本进行了 2 年 3 次评估（数据收集时间为 2003-2006 年）。使用潜在类别增长分析（LCGA）评估 9-13 岁儿童的 DP 得分。
对于男孩和女孩，都发现了低（女孩 67.0%，男孩 59.5%）、中（女孩 28.0%，男孩 31.7%）和高 DP 得分（女孩 5.0%，男孩 8.8%）轨迹。低和中分组的课程是稳定的，而在高 DP 分组中，男孩的症状严重程度在描述性水平上呈下降趋势，女孩呈上升趋势。多变量逻辑回归分析的结果表明，主要是外化问题，也包括内化问题，都增加了男孩和女孩中 DP 中值和高值的风险。良好的生活质量是所有亚组 DP 轨迹的保护因素。
除了 DP 的已知临床和科学价值外，还发现了男孩和女孩 DP 轨迹的三个可区分轨迹。轨迹开始时存在较高的外化问题与 DP 轨迹的不良预后相关。这些发现可能有助于在临床病例和公共卫生中进行更好的心理教育、咨询和监测。
