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临床区分生命历程持续型和青春期限定型品行问题:起病年龄真的足够吗?

Clinically differentiating life-course-persistent and adolescence-limited conduct problems: Is age-of-onset really enough?

作者信息

Halliburton Amanda E, Ridenour Ty A, White Bradley A, Deater-Deckard Kirby

机构信息

Department of Psychology, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA, USA.

Research Triangle Institute, International, Research Triangle Park, NC, USA.

出版信息

J Appl Dev Psychol. 2017 Sep;52:34-45. doi: 10.1016/j.appdev.2017.06.005. Epub 2017 Jun 26.

Abstract

One important subtyping of behavior problems is Moffitt's (1993) "life-course-persistent" (LCP) and "adolescent limited" (AL) categories of antisocial behavior, which she differentiated in terms of high impulsivity, poor academic performance, and aggression. These problems may be exacerbated by the cumulative effects of chronic stress. Copious evidence has documented validity and developmental differences between these subtypes, whereas far fewer data exist regarding their clinical utility, in spite of the Diagnostic and Statistical Manual's nomenclature including corresponding subtypes based on age-of-onset of behavioral symptoms. The present study evaluated how well age-of-onset based subtyping identifies distinct developmental patterns of antisocial behavior corresponding to Moffitt's subtypes in terms of risk factors and gender between LCP and AL in a prospective sample of chronically stressed youth. A computerized assessment tool (ALEXSA) was used to obtain data from 1,147 youth aged 8-16. Implications for clinical assessment and intervention strategy, particularly with stressed youth, are discussed.

摘要

行为问题的一个重要亚型分类是莫菲特(1993年)提出的反社会行为的“终生持续型”(LCP)和“青少年局限型”(AL)类别,她根据高冲动性、学业成绩差和攻击性对这两类进行了区分。慢性压力的累积效应可能会加剧这些问题。大量证据证明了这些亚型之间的有效性和发展差异,尽管《诊断与统计手册》的命名法包括了基于行为症状发病年龄的相应亚型,但关于它们临床效用的数据却少得多。本研究评估了基于发病年龄的亚型分类在慢性应激青年的前瞻性样本中,就风险因素和LCP与AL之间的性别差异而言,在识别与莫菲特亚型相对应的反社会行为不同发展模式方面的效果如何。使用一种计算机化评估工具(ALEXSA)从1147名8至16岁的青少年中获取数据。文中还讨论了对临床评估和干预策略的启示,尤其是对处于压力下的青少年的启示。

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