Department of Psychology, Stony Brook University.
Department of Psychology, University of Maryland College Park.
J Clin Child Adolesc Psychol. 2020 May-Jun;49(3):353-364. doi: 10.1080/15374416.2018.1504298. Epub 2018 Oct 11.
Psychopathology in school-age children predicts impairment later in development. However, the long-term psychosocial consequences of early childhood psychopathology are less well known. The current study is the first to prospectively examine how a range of diagnoses and symptoms in early childhood predict psychosocial functioning across specific domains during early adolescence 6-9 years later. A community sample (= 595; 44.9% female; 88.7% White, 12.6% Hispanic) was assessed for psychopathology at ages 3 and 6 using the Preschool Age Psychiatric Assessment. Diagnoses and dimensional scores for depressive, anxiety, attention-deficit/hyperactivity (ADHD), and oppositional defiant disorders (ODD) were examined. When children were 12 years old, children and parents completed the UCLA Life Stress Interview for Children, a semistructured interview assessing functioning in multiple domains (academic, behavior, close friends, broader peers, maternal relationship, paternal relationship). Having a diagnosis in early childhood predicted greater impairment in all domains in early adolescence, except paternal relationship. Externalizing disorders predicted impairment in more domains than internalizing disorders. Most of the associations between early childhood psychopathology and poorer functioning in adolescence persisted after taking into account adolescent psychopathology. Moreover, the majority of bivariate associations with depressive, ODD, and ADHD symptoms, but not anxiety symptoms, persisted in a subsample of children who did not meet criteria for a diagnosis in early childhood. Early childhood psychopathology has long-lasting deleterious effects on several domains of psychosocial functioning, often beyond the effects of continuing or recurring adolescent psychopathology. Findings thereby highlight the validity and clinical significance of early psychopathology.
儿童期精神病理学可预测后期发展中的障碍。然而,儿童早期精神病理学的长期社会心理后果却知之甚少。本研究首次前瞻性地考察了儿童早期的一系列诊断和症状如何预测 6-9 年后青少年早期特定领域的社会心理功能。使用学龄前儿童精神评估(Preschool Age Psychiatric Assessment),对一个社区样本(=595;44.9%为女性;88.7%为白人,12.6%为西班牙裔)在 3 岁和 6 岁时进行精神病理学评估。评估了抑郁、焦虑、注意力缺陷/多动障碍(ADHD)和对立违抗性障碍(ODD)的诊断和维度分数。当孩子 12 岁时,孩子和父母完成了加利福尼亚大学洛杉矶分校儿童生活压力访谈(UCLA Life Stress Interview for Children),这是一种半结构化访谈,评估多个领域(学业、行为、亲密朋友、更广泛的同龄人、母子关系、父子关系)的功能。儿童早期有诊断结果预测青少年早期所有领域的功能障碍,除了父子关系。外显行为障碍比内隐行为障碍预测更多领域的功能障碍。在考虑青少年期精神病理学后,儿童早期精神病理学与青春期功能障碍之间的大多数关联仍然存在。此外,与抑郁、ODD 和 ADHD 症状相关的大多数双变量关联,但与焦虑症状无关,在一个未达到儿童早期诊断标准的儿童亚样本中仍然存在。儿童早期精神病理学对社会心理功能的多个领域具有持久的有害影响,往往超出持续或反复出现的青少年精神病理学的影响。这些发现强调了早期精神病理学的有效性和临床意义。