Loeber R, Green S M, Keenan K, Lahey B B
Western Psychiatric Institute and Clinic, School of Medicine, University of Pittsburgh, USA.
J Am Acad Child Adolesc Psychiatry. 1995 Apr;34(4):499-509.
This article addresses the following questions: What are the best demographic and psychiatric predictors of the onset of conduct disorder (CD)? Does physical fighting play a role in the transition from oppositional defiant disorder (ODD) to CD? And what are the predictors of an earlier compared with a later onset of CD?
Data are presented on the follow-up of a clinic-referred sample of 177 preadolescent boys who were studied for a period of 6 years. Psychiatric assessments were based on information from the boys, their parent, and their teacher.
Of all CD symptoms, physical fighting best predicted the onset of CD in bivariate analyses. Logistic regression showed that low socioeconomic status of the parent, ODD, and parental substance abuse best predicted the onset of CD. In addition, attention-deficit hyperactivity disorder (ADHD) predicted an early onset of CD.
Parental substance abuse, low socioeconomic status, and oppositional behavior are key factors in boys' progression to CD. Physical fighting, although not a symptom of ODD, should be targeted in preventive interventions along with ODD symptoms. ADHD is implicated in the early onset of CD, but not in later-onset CD.
本文探讨以下问题：品行障碍（CD）发病的最佳人口统计学和精神病学预测因素是什么？肢体打斗在对立违抗障碍（ODD）向CD的转变中起作用吗？与CD较晚发病相比，较早发病的预测因素是什么？
呈现了对177名青春期前男孩的临床转诊样本进行6年随访的数据。精神病学评估基于来自男孩本人、其父母和老师的信息。
在双变量分析中，在所有CD症状中，肢体打斗最能预测CD的发病。逻辑回归显示，父母社会经济地位低、ODD和父母药物滥用最能预测CD的发病。此外，注意力缺陷多动障碍（ADHD）预示着CD的早发。
父母药物滥用、社会经济地位低和对立行为是男孩发展为CD的关键因素。肢体打斗虽然不是ODD的症状，但在预防性干预中应与ODD症状一起作为目标。ADHD与CD的早发有关，但与CD的晚发无关。
