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Disruptive behavior in young children: what does it mean?

J M Thomas1, K A Guskin

  • 1Department of Psychiatry and Behavioral Sciences, Children's National Medical Center, 111 Michigan Avenue N.W., Washington, DC 20010-2970, USA.

Journal of the American Academy of Child and Adolescent Psychiatry
|February 24, 2001
PubMed
Summary

In young children with disruptive behaviors, co-occurring externalizing and internalizing symptoms are common. Disordered relationships are linked to more severe symptoms and affect disorders, guiding early childhood mental health treatment.

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Area of Science:

  • Child and Adolescent Psychiatry
  • Developmental Psychology
  • Clinical Psychology

Background:

  • Early childhood disruptive behaviors present diagnostic challenges.
  • The Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC 0-3) offers a complementary diagnostic framework.
  • Understanding the interplay between behavioral symptoms and relational dynamics is crucial for effective intervention.

Purpose of the Study:

  • To investigate how DC 0-3 diagnoses, parent-infant relationship assessments, and symptom checklists augment existing diagnostic systems (DSM-III-R/IV).
  • To explore the relationship between behavioral symptoms and parent-infant relationship quality in young children.
  • To inform treatment strategies for early childhood disruptive behaviors.

Main Methods:

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  • A cohort of 82 children (18-47 months) with disruptive behaviors was assessed.
  • Diagnoses were made using DSM-III-R/IV, DC 0-3, and the Child Behavior Checklist/2-3 (CBCL/2-3).
  • Parent-Infant Relationship Global Assessment Scale was used to evaluate relationship quality.

Main Results:

  • Children diagnosed with DSM-III-R/IV disruptive disorders often received DC 0-3 diagnoses of regulatory disorders, disorders of affect, or traumatic stress disorder.
  • Co-occurring externalizing and internalizing symptoms were present in 45.1% of the children.
  • Disordered parent-infant relationships were significantly associated with higher levels of both externalizing and internalizing symptoms, and disorders of affect.

Conclusions:

  • Co-presentation of externalizing and internalizing symptoms is a frequent clinical presentation in young children with disruptive behaviors.
  • Increased relational risk is associated with more severe behavioral symptoms and a higher prevalence of disorders of affect.
  • Integrating DC 0-3, relational assessments, and symptom checklists provides a comprehensive understanding to guide early intervention.