PDF(Pubmed)
Abstract：
Oppositional defiant symptoms are some of the most common developmental symptoms in children and adolescents with and without oppositional defiant disorder. Research has addressed the close association of the parent-child relationship (PCR) with oppositional defiant symptoms. However, it is necessary to further investigate the underlying mechanism for forming targeted intervention strategies. By using a machine learning-based causal forest (CF) model, we investigated the heterogeneous causal effects of the PCR on oppositional defiant symptoms in children in Chinese elementary schools. Based on the PCR improvement in two consecutive years, 423 children were divided into improved and control groups. The assessment of oppositional defiant symptoms (AODS) in the second year was set as the dependent variable. Additionally, several factors based on the multilevel family model and the baseline AODS in the first year were included as covariates. Consistent with expectations, the CF model showed a significant causal effect between the PCR and oppositional defiant symptoms in the samples. Moreover, the causality exhibited heterogeneity. The causal effect was greater in those children with higher baseline AODS, a worse family atmosphere, and lower emotion regulation abilities in themselves or their parents. Conversely, the parenting style played a positive role in causality. These findings enhance our understanding of how the PCR contributes to the development of oppositional defiant symptoms conditioned by factors from a multilevel family system. The heterogeneous causality in the observation data, established using the machine learning approach, could be helpful in forming personalized family-oriented intervention strategies for children with oppositional defiant symptoms.
摘要：
对立挑衅症状是有或没有对立挑衅障碍的儿童和青少年中最常见的发育症状。研究已经解决了亲子关系（PCR）与对立挑衅症状的紧密联系。然而,有必要进一步探讨形成针对性干预策略的潜在机制。通过使用基于机器学习的因果森林(CF)模型，我们调查了PCR对中国小学儿童对立挑衅症状的异质性因果效应。根据PCR连续两年的改进，423例患儿分为改良组和对照组。第二年对对立挑衅症状（AODS）的评估被设置为因变量。此外,基于多水平家庭模型和第一年基线AODS的几个因素作为协变量被纳入。与期望一致，CF模型在PCR和样本中的对立挑衅症状之间显示出显着的因果关系。此外，因果关系表现出异质性。在AODS基线较高的儿童中，因果效应更大，更糟糕的家庭氛围,和较低的情绪调节能力在他们自己或他们的父母。相反，父母教养方式在因果关系中起着积极的作用。这些发现增强了我们对PCR如何促进受多层次家庭系统因素制约的对立挑衅症状发展的理解。观测数据中的异质性因果关系，使用机器学习方法建立的，可能有助于为有对立挑衅症状的儿童形成个性化的面向家庭的干预策略。
