Unitat d'Epidemiologia i de Diagnòstic en Psicopatologia del Desenvolupament, Barcelona, Spain.
Departament de Psicologia Clínica i de la Salut. Edifici B, Universitat Autònoma de Barcelona, Bellaterra, 08193, Barcelona, Spain.
Child Psychiatry Hum Dev. 2022 Oct;53(5):908-918. doi: 10.1007/s10578-021-01180-z. Epub 2021 Apr 30.
This study ascertains how the proposed subtypes and specifiers of oppositional defiant disorder (ODD) based on irritability and prosocial emotions co-develop and describes the clinical characteristics of the resultant classes. A sample of 488 community children was followed up from ages 3 to 12 years and assessed with categorical and dimensional measures answered by parents and teachers. Latent class growth analysis for three parallel processes [defiant/headstrong, irritability, and limited prosocial emotions (LPE)] identified a 4-class model with adequate entropy (.912) and posterior probabilities of class membership (≥ .921). Class 1 (n = 38, 7.9%) was made up of children with defiant/headstrong with chronic irritability and LPE. Class 2 (n = 128, 26.3%) was comprised of children with defiant/headstrong with chronic irritability and typical prosocial emotions. Class 3 (n = 101, 20.7%) clustered children with LPE without defiant/headstrong and without irritability. Class 4 (n = 220, 45.1%) included children with the lowest scores in all the processes. The classes were distinguishable and showed different clinical characteristics through development. These findings support the validity of ICD-11 ODD subtypes based on chronic irritability and may help to guide clinicians' decision-making regarding treating oppositionality in children.
本研究旨在确定基于易激惹和亲社会情绪的对立违抗性障碍(ODD)的拟议亚型和特征如何共同发展,并描述由此产生的类别的临床特征。对 488 名来自社区的儿童进行了随访,随访时间从 3 岁到 12 岁,通过家长和教师回答的分类和维度测量进行评估。针对三个平行过程(反抗/任性、易激惹和有限的亲社会情绪)的潜在类别增长分析确定了一个具有足够熵(.912)和类别归属后验概率(≥.921)的 4 类模型。第 1 类(n=38,7.9%)由具有反抗/任性、慢性易激惹和有限亲社会情绪的儿童组成。第 2 类(n=128,26.3%)由具有反抗/任性、慢性易激惹和典型亲社会情绪的儿童组成。第 3 类(n=101,20.7%)聚类为没有反抗/任性和没有易激惹的具有有限亲社会情绪的儿童。第 4 类(n=220,45.1%)包括在所有过程中得分最低的儿童。这些类别是可区分的,并在发展过程中表现出不同的临床特征。这些发现支持了基于慢性易激惹的 ICD-11 ODD 亚型的有效性,可能有助于指导临床医生在治疗儿童对立性方面做出决策。