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品行障碍:长期结局与干预效果

Conduct disorder: long-term outcomes and intervention effectiveness.

作者信息

Offord D R, Bennett K J

机构信息

Centre for the Studies of Children at Risk, Chedoke-McMaster Hospitals, Hamilton, Ontario, Canada.

出版信息

J Am Acad Child Adolesc Psychiatry. 1994 Oct;33(8):1069-78. doi: 10.1097/00004583-199410000-00001.

Abstract

OBJECTIVE

To review the literature on conduct disorder in two areas: long-term outcome and the effects of interventions.

METHOD

The sources of the articles for review were computer searches, but the articles were selected for this review to illustrate key findings in the long-term outcome area and to review critically four intervention strategies to prevent or treat conduct disorder, namely, parent- and family-targeted programs, social-cognitive programs, peer and school-based programs, and community programs.

RESULTS

Conduct problems in childhood predict the same increased rates of psychiatric disorder overall in men and women but the patterns are different: for externalizing disorders, the prediction is stronger in men and for internalizing disorders, the prediction is stronger in women. In the intervention domain, the literature provides limited evidence of the effectiveness of either primary or secondary prevention.

CONCLUSIONS

Prospective studies of community samples of children provide the best opportunity to understand more thoroughly the adult outcomes of conduct disorder. Because of the heavy burden of suffering of conduct disorder, and the limited effectiveness of clinical interventions, there is a compelling argument in favor of an increased emphasis on primary prevention efforts.

摘要

目的

回顾关于品行障碍两个方面的文献:长期后果及干预效果。

方法

用于回顾的文章来源为计算机检索,但选取这些文章用于本综述是为了阐述长期后果领域的关键发现,并批判性地回顾四种预防或治疗品行障碍的干预策略,即针对父母和家庭的项目、社会认知项目、同伴和基于学校的项目以及社区项目。

结果

童年期的品行问题总体上预示着男性和女性患精神障碍的几率同样增加,但模式有所不同:对于外化性障碍,在男性中的预示更强,而对于内化性障碍,在女性中的预示更强。在干预领域,文献提供的关于一级预防或二级预防有效性的证据有限。

结论

对社区儿童样本进行的前瞻性研究为更全面地了解品行障碍的成人后果提供了最佳机会。由于品行障碍带来的沉重痛苦负担以及临床干预效果有限,有令人信服的理由支持更加强调一级预防工作。

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