Department of Psychology, University of Notre Dame, Notre Dame, USA.
Institute of Neuroscience and Physiology, Centre for Ethics Law and Mental Health, Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden.
Eur Child Adolesc Psychiatry. 2019 Jul;28(7):899-911. doi: 10.1007/s00787-018-1250-9. Epub 2018 Nov 10.
Severe childhood aggressive behaviors are known to predict negative outcomes later in life; however, little is known about the effect of when in childhood aggression problems are diagnosed. While an earlier first diagnosis of problematic aggressive behavior might be associated with increased severity and, thus, worse outcomes, it is also possible that an earlier diagnosis affords an earlier start of treatment programs or indicates that greater attention is being paid to behavioral problems, thus resulting in attenuation of the severity of childhood aggression's impact on distal outcomes. The current study analyzed data from the population-based Swedish Data Registries, which include data on all children formally diagnosed by the Swedish medical system with a wide range of aggression problems between ages 8 and 18 (N = 5816) during the years 1987-2013, along with a matched control. Time-to-event analyses investigated whether the age at time of diagnosis affects later life outcomes while controlling for relevant confounders. Results show that for both boys and girls, those with a later diagnosis had lower average incomes (regression coefficient b = - 0.055, p < 0.005) and a higher probability of having a criminal record (odds ratio 1.126, p < 0.005) than children with earlier diagnoses. The effect on suicide attempts was not significant after correcting for multiple testing (odds ratio 1.264, p = 0.016). Grade score was not significantly affected. The results warrant further research concerning the potential advantage of earlier diagnoses, especially concerning generalizability beyond the Swedish population.
严重的儿童攻击行为已知会预测以后生活中的负面结果；然而，对于攻击问题在儿童期何时被诊断出的影响却知之甚少。虽然早期首次诊断出有问题的攻击行为可能与更严重的问题相关，从而导致更糟糕的结果，但也有可能更早的诊断为更早开始治疗计划或表明对行为问题的关注度更高，从而减轻儿童攻击行为对远端结果的影响的严重程度。本研究分析了基于人群的瑞典数据登记处的数据，这些数据包括在 1987 年至 2013 年期间，瑞典医疗系统正式诊断出的 8 至 18 岁之间患有广泛攻击问题的所有儿童（N=5816）的资料，以及与之匹配的对照组。事件时间分析调查了诊断时的年龄是否会影响以后的生活结果，同时控制了相关混杂因素。结果表明，对于男孩和女孩来说，那些诊断较晚的人的平均收入较低（回归系数 b=-0.055，p<0.005），而且有犯罪记录的可能性更高（优势比 1.126，p<0.005），比那些诊断较早的儿童。在经过多次测试校正后，自杀未遂的影响并不显著（优势比 1.264，p=0.016）。成绩分数没有受到显著影响。这些结果需要进一步研究早期诊断的潜在优势，特别是在瑞典人群之外的推广性。
