Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Storrs, CT 06269, USA.
Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Storrs, CT 06269, USA.
Child Adolesc Psychiatr Clin N Am. 2021 Jul;30(3):637-647. doi: 10.1016/j.chc.2021.04.012.
Oppositional defiant disorder includes distinct but inseparable dimensions of chronic irritability and oppositional behavior. The dimensions have been identified in early childhood to adulthood, and show discriminant associations with internalizing and externalizing psychopathology. The introduction of disruptive mood dysregulation disorders and the requirements that it take precedence over oppositional defiant disorder diagnostically are not supported by evidence and introduce confusion about the structure and linkages of irritability and oppositional behavior, and obscure the importance of the behavioral dimension in explaining and predicting poor outcomes. A dimensional framework with irritability, oppositionality, callous-unemotional traits, and aggression may more fully describe antisocial outcomes.
对立违抗障碍包括慢性易怒和对立行为两个截然不同但又不可分割的维度。这两个维度在儿童早期到成年期都有表现，并与内化和外化精神病理学有明显的关联。破坏性情绪失调障碍的引入以及要求其在诊断上优先于对立违抗障碍的做法并没有得到证据的支持，反而导致了人们对易怒和对立行为的结构和联系的混淆，并掩盖了行为维度在解释和预测不良后果方面的重要性。一个具有易怒、对立、冷酷无情特征和攻击性的维度框架可能更全面地描述反社会行为的结果。
