Disruptives Verhalten bei verschiedenen Störungen: Untersuchung einer klinischen Stichprobe mit dem Eyberg Child Behavior Inventory
Abstract
Abstract.Objective: The study reports the prevalence of disruptive behaviors in a help-seeking sample of young children across a diverse range of clinical diagnoses (based on ICD-10). Method: The Eyberg Child Behavior Inventory (ECBI), a parent rating scale of disruptive behaviors, was completed on 310 children (2–11 years) at three child and adolescent psychiatry clinics in three German states (Bavaria, Hesse, Lower Saxony); the majority of children were outpatients. Results: Mean intensity scores of disruptive behaviors differed significantly by diagnostic group, with the lowest ratings within a community sample, and increasingly higher scores in children with a diagnosis from the internalizing spectrum, those with pervasive developmental disorders, and finally, those with externalizing disorders (e. g. hyperkinetic disorder, conduct disorders). Seventy percent of the clinical sample, compared to only 17 % of the community sample, exceeded the normative cut-off score of 111, indicating that disruptive behaviors are common in young German children seeking help for different mental health problems. Conclusions: These findings support the Research Domain Criteria approach by showing that disruptive behaviors cross our current diagnostic labels and may need to be assessed and conceptualized in treatment planning, even in children without a primary diagnosis from the externalizing spectrum.
Zusammenfassung.Zielsetzung: Die Studie berichtet über die Häufigkeit von disruptiven Verhaltensweisen in einer klinischen Stichprobe von jungen Kindern, für die wegen verschiedener klinischer Diagnosen (nach ICD-10) Hilfe gesucht wurde. Methode: An drei kinder- und jugendpsychiatrischen Kliniken in drei Bundesländern (Bayern, Hessen, Niedersachsen) wurde disruptives Verhalten mittels des Eyberg Child Behavior Inventory (ECBI), eines Elternfragebogens, bei 310 Kindern (2–11 Jahre) erfasst; die Mehrzahl der Kinder wurde ambulant behandelt. Ergebnisse: Die mittleren Intensitätswerte für disruptives Verhalten unterschieden sich signifikant in Abhängigkeit von der diagnostischen Gruppe. Der niedrigste Wert ergab sich für eine Stichprobe aus der Allgemeinbevölkerung, gefolgt von Kindern mit einer Störung aus dem internalisierenden Spektrum, Kindern mit tiefgreifenden Entwicklungsstörungen, und den höchsten Werten für Kinder mit externalisierenden Störungen (z. B. hyperkinetische Störung, Störung des Sozialverhaltens). Siebzig Prozent der klinischen Stichprobe, im Vergleich zu 17 % in der Allgemeinstichprobe, überschritten den normativen Cutoff-Wert von 111, was indiziert, dass disruptive Verhaltensweisen bei jungen Kindern in kinder- und jugendpsychiatrischer Versorgung in Deutschland sehr häufig vorkommen. Schlussfolgerungen: Diese Ergebnisse unterstützen den Research Domain Criteria-Ansatz, indem sie zeigen, dass disruptive Verhaltensweisen über unsere gegenwärtigen Diagnosesysteme hinweg auftreten. Sie sollten daher regelmäßig erfasst und in der Therapieplanung berücksichtigt werden, selbst dann, wenn ein Kind keine primäre Diagnose aus dem externalisierenden Spektrum aufweist.
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