破壊的行動と冷淡・無感情特性を持つ若者には幅広い治療が必要との研究結果(Youths with disruptive behaviour and callous-unemotional traits need a broad range of treatments, Concordia study shows)

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2026-09-01 カナダ・コンコルディア大学

攻撃性、反抗、重大な規則違反などの問題行動に加え、共感性や罪悪感の低さを特徴とする「冷淡・無感情(CU)特性」を持つ子ども・青年について、治療で優先すべき課題を調査した研究です。Concordia Universityの研究者らは、86人の保護者・臨床家・研究者を対象に修正版デルファイ法を実施し、子どもでは26項目、青年では30項目を高優先度の治療標的として特定しました。子どもでは一貫性のない養育、親の関与、共感や感情調節など家庭・情緒面が重視され、青年ではこれらに加え、仲間関係、感情処理、変化への動機、道徳的推論など認知・社会的要因が重要とされました。研究は、問題行動の抑制だけでなく、CU特性に関連する感情・認知・人間関係への包括的介入が必要であり、年齢や実行可能性に応じて治療を組み合わせることが重要だと示しています。

<関連情報>

問題行動や冷淡・無感情な特性を持つ若者に対する治療目標の優先順位付け:修正デルファイ法による研究 Prioritizing treatment targets for youths with disruptive behaviours and callous-unemotional traits: a modified Delphi study

Jennifer Diep,Ellfie Chen & Joyce H. L. Lui
BMC Psychology  Published:25 June 2026
DOI:https://doi.org/10.1186/s40359-026-05045-9  Early provide

Abstract

Background
Youths with disruptive behaviours (DB) and callous-unemotional (CU) traits experience significant impairments and impose substantial costs on families and society. Treatment outcome studies of current DB treatments highlight the need for tailored treatments. Identifying priority treatment targets that integrate empirical evidence with stakeholder perspectives may inform more effective treatment tailoring.

Method
A modified Delphi study was conducted to establish consensus on priority treatment targets for youths with DB and CU traits. A mixed panel of 86 experts (parents, clinicians, and researchers; Mage = 43.38, SD = 10.44, 76% female) rated the priority of candidate treatment targets across behavioural, emotional, cognitive, parental/home, peer, environmental/school, and temperament/personality domains. Ratings were completed separately for children (ages 3–12) and adolescents (ages 13–18). Experts also rated the feasibility of addressing candidate treatment targets within typical outpatient psychosocial treatment settings.

Results
Overall, 26 treatment targets for children and 30 for adolescents were identified as high priority; no targets reached consensus as low priority. Developmental differences emerged: parental/home targets were consistently prioritized for children, whereas adolescents showed broader priorities including emotional, cognitive, and peer targets. Among consensus priority targets, 13 child and 17 adolescent targets were rated as at least moderately feasible to address within outpatient care. Feasibility ratings did not differ across stakeholder groups.

Conclusions
Findings identify stakeholder prioritized candidate treatment targets for youth with DB + CU, including both well-established and under-addressed targets. These results support consideration of treatment approaches that retain core DB components while extending attention to CU-relevant emotional, cognitive, and relationship processes, particularly for adolescents. By integrating lived experience, clinical expertise, and research expertise, this study provides a stakeholder-informed foundation for future treatment development, tailoring, and empirical evaluation for youths with DB + CU.

医療・健康
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