TOWARD A DEVELOPMENTAL EPIDEMIOLOGY OF THE DISRUPTIVE BEHAVIOR DISORDERS

Epidemiology, the study of patterns of disease distribution in time and space, offers a powerful set of theories and methods for understanding and preventing illness. The disruptive behavior disorders (DBDs) can be studied from the point of view of whether or not epidemiological methods could help to understand and prevent them. We suggest that the best approach to the DBDs is one that takes into account both the development of the child and the development of the disorder. Developmental epidemiology is the attempt to use recent advances in developmental psychopathology to help answer questions about how developmental processes increase or decrease vulnerability to DBDs, how risk factors change across childhood, and how the development of the disorder is reflected in rates of onset and patterns of symptomatology. Using examples of primary and secondary prevention studies, we discuss the importance of appropriate sampling strategies and a clearly articulated theoretical background, if intervention trials are to achieve their full utility as tests of a developmental theory of the DBDs.