Subgrouping children and adolescents with disruptive behaviors: symptom profiles and the role of callous-unemotional traits

被引：11

作者：

Rosa-Justicia, Mireia ^{[1
]}

Saam, Melanie C. ^{[2
]}

Flamarique, Itziar ^{[3
]}

Borras, Roger ^{[1
]}

Naaijen, Jilly ^{[4
,15
]}

Dietrich, Andrea ^{[5
]}

Hoekstra, Pieter J. ^{[5
]}

Banaschewski, Tobias ^{[6
]}

Aggensteiner, Pascal ^{[6
]}

Craig, Michael C. ^{[7
]}

Sethi, Arjun ^{[7
]}

Santosh, Paramala ^{[8
]}

Sagar-Ouriaghli, Ilyas ^{[8
]}

Arango, Celso ^{[9
]}

Penzol, Maria Jose ^{[9
]}

Brandeis, Daniel ^{[5
,6
,10
]}

Werhahn, Julia E. ^{[10
,11
,12
]}

Glennon, Jeffrey C. ^{[4
]}

Franke, Barbara ^{[13
,14
]}

Zwiers, Marcel P. ^{[4
]}

Buitelaar, Jan K. ^{[4
,15
,16
]}

Schulze, Ulrike M. E. ^{[2
]}

Castro-Fornieles, Josefina ^{[17
]}

机构：

[1] IDIBAPS, Hosp Clin Barcelona, Clin Inst Neurosci, Dept Child & Adolescent Psychiat & Psychol, Barcelona, Spain

[2] Univ Ulm, Univ Hosp, Dept Child & Adolescent Psychiat Psychotherapy, Ulm, Germany

[3] CIBERSAM, Hosp Clin Barcelona, Clin Inst Neurosci, Dept Child & Adolescent Psychiat & Psychol,2017SG, Barcelona, Spain

[4] Radboud Univ Nijmegen, Donders Inst Brain Cognit & Behav, Dept Cognit Neurosci, Med Ctr, Nijmegen, Netherlands

[5] Univ Groningen Med Ctr, Dept Child & Adolescent Psychiat, Groningen, Netherlands

[6] Heidelberg Univ, Med Fac Mannheim, Dept Child & Adolescent Psychiat & Psychotherapy, Cent Inst Mental Hlth, Mannheim, Germany

[7] Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Neuroimaging, London, England

[8] Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Child Psychiat, London, England

[9] Univ Complutense, Hosp Gen Univ Gregorio Maranon, Child & Adolescent Psychiat Dept, Sch Med,IiSGM,CIBERSAM, Madrid, Spain

[10] Univ Zurich, Univ Hosp Psychiat Zurich, Dept Child & Adolescent Psychiat & Psychotherapy, Zurich, Switzerland

[11] Univ Zurich, Neurosci Ctr Zurich, Zurich, Switzerland

[12] Swiss Fed Inst Technol, Zurich, Switzerland

[13] Radboud Univ Nijmegen, Med Ctr, Donders Inst Brain Cognit & Behav, Dept Human Genet, Nijmegen, Netherlands

[14] Radboud Univ Nijmegen, Med Ctr, Donders Inst Brain Cognit & Behav, Dept Psychiat, Nijmegen, Netherlands

[15] Radboud Univ Nijmegen, Ctr Cognit Neuroimaging, Donders Inst Brain Cognit & Behav, Nijmegen, Netherlands

[16] Karakter Child & Adolescent Psychiat Univ Ctr, Nijmegen, Netherlands

[17] Univ Barcelona, Dept Child & Adolescent Psychiat & Psychol, Clin Inst Neurosci, Hosp Clin Barcelona,2017SGR881,CIBERSAM,IDIBAPS, Barcelona, Spain

来源：

EUROPEAN CHILD & ADOLESCENT PSYCHIATRY | 2022年 / 31卷 / 01期

关键词：

Callous– unemotional traits; Oppositional defiant disorder; Conduct disorder; Aggression; Psychopathology; Subtyping; ATTENTION-DEFICIT/HYPERACTIVITY DISORDER; OPPOSITIONAL DEFIANT DISORDER; CONDUCT DISORDER; SECONDARY VARIANTS; DEVELOPMENTAL PATHWAYS; REACTIVE AGGRESSION; PROACTIVE AGGRESSION; PSYCHOPATHIC TRAITS; ANTISOCIAL-BEHAVIOR; PHYSICAL AGGRESSION;

D O I：

10.1007/s00787-020-01662-w

中图分类号：

B844 [发展心理学（人类心理学）];

学科分类号：

040202 ;

摘要：

Disruptive behavior during childhood and adolescence is heterogeneous and associated with several psychiatric disorders. The identification of more homogeneous subgroups might help identify different underlying pathways and tailor treatment strategies. Children and adolescents (aged 8-18) with disruptive behaviors (N = 121) and healthy controls (N = 100) were included in a European multi-center cognition and brain imaging study. They were assessed via a battery of standardized semi-structured interviews and questionnaires. K-means cluster-model analysis was carried out to identify subgroups within the group with disruptive behaviors, based on clinical symptom profiles, callous-unemotional (CU) traits, and proactive and reactive aggression. The resulting subgroups were then compared to healthy controls with regard to these clinical variables. Three distinct subgroups were found within the group with disruptive behaviors. The High CU Traits subgroup presented elevated scores for CU traits, proactive aggression and conduct disorder (CD) symptoms, as well as a higher proportion of comorbidities (CD + oppositional defiant disorder + attention deficit hyperactivity disorder (ADHD). The ADHD and Affective Dysregulation subgroup showed elevated scores for internalizing and ADHD symptoms, as well as a higher proportion of females. The Low Severity subgroup had relatively low levels of psychopathology and aggressive behavior compared to the other two subgroups. The High CU Traits subgroup displayed more antisocial behaviors than the Low Severity subgroup, but did not differ when compared to the ADHD and Affective Dysregulation subgroup. All three subgroups differed significantly from the healthy controls in all the variables analyzed. The present study extends previous findings on subgrouping children and adolescents with disruptive behaviors using a multidimensional approach and describes levels of anxiety, affective problems, ADHD, proactive aggression and CU traits as key factors that differentiate conclusively between subgroups.

引用

页码：51 / 66

页数：16

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