Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada.
Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal, Montreal, Canada.
Dev Psychopathol. 2022 Aug;34(3):1115-1124. doi: 10.1017/S0954579420001650. Epub 2020 Dec 18.
In the past decades, there has been an overemphasis of a descriptive/behavioral approach to study conduct disorder. In an equifinal perspective, we aimed to examine the developmental multitrajectory groups of psychological features (irritability, interpersonal callousness, hyperactivity/impulsivity, and depressive-anxiety symptoms) and their associations with conduct problems. In a population-based cohort ( = 1,309 participants followed from 5 months to 17 years old), latent-class growth analysis was performed for each psychological feature to identify a two-trajectory model (from ages 6 to 12 years). Based on parameter estimates of the two-trajectory models for each of the four psychological features, a parallel process growth mixture model identified eight significant developmental patterns that were subsequently compared with typically developing children. Furthermore, we observed that while interpersonal callousness conferred an increased risk for childhood and adolescence conduct problems, its co-occurrence with hyperactivity/impulsivity, irritability, and/or depressive-anxiety symptoms heightened the general risk, but also predicted distinct subtypes of conduct problems (i.e., aggressive and rule-breaking behaviors). Thus, by studying complex developmental combinations of psychological features, we observed qualitatively distinct pathways towards conduct problems. A multitrajectory framework of psychological features should be considered as a significant step towards unveiling the multiple etiological pathways leading to conduct disorder and its substantial clinical heterogeneity.
在过去的几十年中，对行为障碍的研究过分强调了描述性/行为方法。在等终末观点中，我们旨在研究心理特征（易怒，人际冷漠，多动/冲动和抑郁焦虑症状）的发展多轨迹组及其与行为问题的关系。在基于人群的队列中（= 1309 名参与者，从 5 个月到 17 岁），对每个心理特征进行潜在类别增长分析，以确定双轨迹模型（从 6 岁到 12 岁）。基于四个心理特征中每个心理特征的双轨迹模型的参数估计，并行过程增长混合模型确定了八个重要的发展模式，随后将其与正常发育的儿童进行了比较。此外，我们观察到人际冷漠会增加儿童和青少年行为问题的风险，但其与多动/冲动，易怒和/或抑郁焦虑症状同时发生会增加一般风险，但也可以预测行为问题的不同亚型（即，攻击性行为和破坏规则行为）。因此，通过研究心理特征的复杂发展组合，我们观察到了行为问题的不同途径。心理特征的多轨迹框架应被视为揭示导致行为障碍及其大量临床异质性的多种病因途径的重要步骤。
