August G J, Braswell L, Thuras P
Division of Child and Adolescent Psychiatry, University of Minnesota Medical School, Minneapolis 55455, USA.
J Abnorm Child Psychol. 1998 Oct;26(5):345-56. doi: 10.1023/a:1021999722211.
A large school-based sample of children in Grades 1, 2, 3, and 4 were screened for disruptive behavior and subsequently assessed over a 5-year period for DSM-III-R symptoms of attention deficit hyperactivity disorder (ADHD) and other externalizing and internalizing behavior disorders. Parents completed structured diagnostic interviews in Years 1, 4, and 5, and teachers completed Behavioral Assessment for Children-Teacher Rating Scales behavioral ratings annually. For parent-derived diagnostic data, both inattention and hyperactivity/impulsivity symptom groups declined from Year 1 to Year 4, with hyperactivity showing more significant decline. For teacher-rated behavioral dimensions, the Attention Problems scale declined from Year 1 to Year 3 and stabilized thereafter. The Hyperactivity scale showed stability during the first 3 years before declining in Year 4. Of those children diagnosed with ADHD in Year 1, 69% still met criteria for ADHD in either Year 4 or 5. Persisters were more likely to exhibit coexisting conduct disorder in Year 1 and oppositional defiant disorder in Years 1, 4, and 5. Parents of persisters reported more psychosocial adversity on measures of parenting and marital satisfaction.
对一至四年级的大量在校儿童样本进行了破坏性行为筛查，随后在5年时间里对其进行评估，以确定是否存在注意力缺陷多动障碍（ADHD）的《精神疾病诊断与统计手册》第三版修订版（DSM-III-R）症状以及其他外化和内化行为障碍。家长在第1年、第4年和第5年完成了结构化诊断访谈，教师每年完成儿童行为评估-教师评定量表的行为评分。对于家长提供的诊断数据，从第1年到第4年，注意力不集中和多动/冲动症状组均有所下降，多动症状下降更为显著。对于教师评定的行为维度，注意力问题量表从第1年到第3年下降，此后趋于稳定。多动量表在前3年保持稳定，在第4年下降。在第1年被诊断为ADHD的儿童中，69%在第4年或第5年仍符合ADHD的标准。持续存在症状的儿童在第1年更有可能同时出现品行障碍，在第1年、第4年和第5年更有可能出现对立违抗性障碍。持续存在症状儿童的家长在养育方式和婚姻满意度方面报告了更多的心理社会逆境。
