儿童品行障碍的认识、应对及预防

Understanding,prevention and coping strategies of children's conduct disorder

品行障碍(conduct Disorder,CD)是一种起病于儿童或青少年时期的精神障碍,以反复的持续的攻击性和反社会行为为特征,部分会迁延为成年后的反社会人格障碍。CD在学龄儿童中发病率为1%~3%,男孩罹患率高于女孩。根据发病年龄(儿童期发病和青少年期发病)以及有无冷酷-无情特质(缺乏共情和内疚感)分为不同亚型。CD的病因很复杂,存在较多遗传、环境高危因素以及遗传环境交互作用。CD的干预主要涉及针对个体、父母或基于家庭的社会心理干预,有时需要联合精神药物治疗。CD的预防措施应分别针对一般人群、高危因素暴露人群及存在前驱问题行为的人群实施。

Conduct disorder(CD)is a mental disorder which usually emerges in childhood or adolescents and might lead to antisocial personality disorder in adulthood in some cases.It is characterized by repeated and continuous aggressive and antisocial behavioral pattern.CD affects about 1%~3%of school-aged children and is more seen in boys than in girls.It can be subtyped according to age of onset(childhood onset and adolescence onset)and the presence or absence of callous-unemotional traits(lack of empathy and guilt).The etiology of CD is complex,with lots of genetic and environmental risk factors and the interaction of genetic and environmental factors.Management of CD mainly involves individual-specific,parent-based or family-based psychosocial interven-tions.Psychiatric medication is sometimes used.The prevention of CD should be targeted to the general population,those exposed to high risk factors and those with prodromal problem behaviors respectively.