ABSTRACT

Objective

Aggression with impulsivity and reactivity (AIR) may distinguish a subset of youth from those with attention problems, rule-breaking behavior, or mood disorders, potentially with differential treatment response. Yet, DSM-5 and ICD-10 do not include an AIR diagnosis. Thus, we empirically grouped youths into profiles based on AIR, manic, depressive, rule-breaking, and self-harm behaviors; examined which profiles replicated across three samples; and characterized profile sets on demographic and clinical features.

Method

After harmonizing data from three samples (n = 679, n = 392, n = 634), Latent Profile Analysis (LPA) assigned youth to profiles based on caregiver-reported measures of AIR, manic, depressive, rule-breaking, and self-harm behaviors. Profiles from each sample were grouped into sets based on profile similarity. Analyses tested differences in diagnoses, sex, and race, age, functioning, and mood severity.

Results

Eight-profile solutions fit best. Seven profiles replicated across samples: high AIR and self-harm, lower depressive and manic scores; high AIR, manic symptoms, and self-harm; high depression symptoms; three smaller sets with high manic and depressive symptoms and moderate AIR; and two high rates of bipolar diagnoses and family bipolar history. Two sets were high on both AIR and mood symptoms, were the most impaired, and had the highest comorbidity.

Conclusions

Analyses support an empirical definition of AIR, separate from mood disorders. Profile sets distinguished by level of AIR and mood symptoms differed in demographic and diagnostic characteristics as well as functioning. Importantly, a set emerged with high AIR but low mood indicators and with high rates of ADHD and ODD, but not mood disorder.

中文翻译：

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在三个门诊样本中开发青少年冲动攻击和情绪的经验潜在概况

摘要

客观的

具有冲动性和反应性的攻击性 (AIR) 可以将一部分青少年与有注意力问题、违规行为或情绪障碍的青少年区分开来，可能具有不同的治疗反应。然而，DSM-5 和 ICD-10 不包括 AIR 诊断。因此，我们根据经验将青少年分为 AIR、躁狂、抑郁、违反规则和自残行为的概况；检查哪些配置文件在三个样本中复制；以及关于人口统计和临床特征的特征概况集。

方法

在协调来自三个样本（n = 679、n = 392、n = 634）的数据后，潜在概况分析 (LPA) 根据护理人员报告的 AIR、躁狂、抑郁、违反规则和自我-害行为。来自每个样本的配置文件根据配置文件相似性分组到集合中。分析诊断、性别、种族、年龄、功能和情绪严重程度方面的测试差异。

结果

八配置文件解决方案最适合。跨样本复制的七个配置文件：高 AIR 和自我伤害，较低的抑郁和躁狂分数；高气、躁狂症状和自残；高度抑郁症状；三个较小的组，具有高度躁狂和抑郁症状以及中度 AIR；以及两个高比率的双相情感诊断和家族双相情感史。两组在 AIR 和情绪症状上都很高，受损最严重，合并症也最高。

结论

分析支持 AIR 的经验定义，与情绪障碍分开。根据 AIR 水平和情绪症状区分的配置文件集在人口统计和诊断特征以及功能方面有所不同。重要的是，出现了一组 AIR 高但情绪指标低、ADHD 和 ODD 发生率高但没有情绪障碍的集合。