儿童品行障碍的家庭治疗综述

A Review of Family Therapy for Childhood Conduct Disorder

摘要: 儿童品行障碍是儿童青少年高发的外化性行为障碍，以反复违反社会规范、侵害他人权益为核心特征，症状稳定、远期危害大，重症患儿成年后反社会人格风险显著升高。当前临床单一干预多聚焦个体症状矫正，存在远期疗效有限、复发率高的局限，家庭因素是疾病发生与维持的核心环境诱因。本文梳理相关研究，围绕家庭致病机制、主流循证治疗技术、干预疗效及影响因素展开综述，剖析家庭冲突、教养缺陷等核心风险及本土特征，介绍四类主流技术的循证依据与适用场景，明确家庭治疗在症状改善与长效预防上的相对优势。针对当前研究本土化适配不足、长期随访缺失等局限，本文提出构建本土化治疗体系、推进分层分型干预等方向，为临床干预与家庭教育指导提供理论参考。

Abstract: Conduct disorder is a common externalizing behavioral disorder among children and adolescents, characterized primarily by repeated violations of social norms and infringement upon others’ rights. It features stable symptoms and significant long-term consequences, with severe cases showing a markedly increased risk of antisocial personality disorder in adulthood. Current clinical interventions often focus narrowly on correcting individual symptoms, resulting in limited long-term effectiveness and high relapse rates. Family factors are recognized as key environmental contributors to both the onset and maintenance of the disorder. This article reviews relevant research, summarizing the familial mechanisms underlying the disorder, mainstream evidence-based treatment approaches, intervention outcomes, and influencing factors. It analyzes core risks such as family conflict and parenting deficits, along with their unique local characteristics, and presents the empirical foundations and appropriate applications of four major therapeutic techniques. The article highlights the relative advantages of family therapy in symptom improvement and long-term prevention. Addressing current limitations—including insufficient adaptation to local contexts and lack of long-term follow-up—the article proposes directions for developing culturally adapted treatment systems and advancing tiered, typified interventions, offering theoretical guidance for clinical practice and family education.