Towbin K E, Dykens E M, Pearson G S, Cohen D J
Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut 06510.
J Am Acad Child Adolesc Psychiatry. 1993 Jul;32(4):775-82. doi: 10.1097/00004583-199307000-00011.
This is the first attempt to define and validate criteria for an early onset, chronic syndrome of disturbances in affect modulation, social relatedness, and thinking. This study formulates and tests five hypotheses that follow from conceptualizing this syndrome as a developmental disorder. The advantages of viewing this syndrome as a developmental disorder are discussed and compared with alternative formulations such as childhood schizophrenia or borderline syndrome of childhood.
An inpatient cohort (26 boys, 4 girls) was ascertained using specific, defined criteria. Using standardized measures on retrospective chart reviews, these subjects were compared with two different inpatient samples: one diagnosed with dysthymic disorder, the other with conduct disorder.
The criteria readily distinguished between developmentally disordered children and comparison groups. Findings also supported the hypotheses in the predicted directions; index subjects had earlier onset of symptoms, poorer social and overall adjustment, longer hospitalizations, and poorer outcomes.
Findings support the validity of this developmental concept for a multiple complex developmental disorder and give preliminary, "first-cut" validity to these specified criteria.
这是首次尝试定义并验证一种关于情感调节、社会关系及思维障碍的早发性慢性综合征的标准。本研究提出并检验了五个假设，这些假设源自将该综合征概念化为一种发育障碍。文中讨论了将该综合征视为发育障碍的优势，并与诸如儿童精神分裂症或儿童边缘性综合征等其他表述进行了比较。
通过特定的、明确的标准确定了一个住院患者队列（26名男孩，4名女孩）。利用回顾性病历审查中的标准化测量方法，将这些受试者与两个不同的住院患者样本进行比较：一个样本被诊断为恶劣心境障碍，另一个样本被诊断为品行障碍。
这些标准能够轻松区分出发育障碍儿童与对照组。研究结果也在预测的方向上支持了这些假设；指标受试者症状出现更早，社会适应和整体适应更差，住院时间更长，预后更差。
研究结果支持了这种针对多种复杂发育障碍的发育概念的有效性，并为这些特定标准赋予了初步的、“初步的”有效性。
