Papa and peers: A biosocial approach to conduct disorder

The authors seek to advance the profession's understanding of conduct disorders by illustrating that (a) inappropriate research design frequently results in faulty conclusions regarding etiology, (b) a biosocial approach is most helpful in identifying key interactive variables that place children/adolescents at risk, and (c) future treatment efficacy studies should focus on mitigating these primary risk factors as well as investigating separate intervention models for the two qualitatively distinct categories of delinquents (i.e., chronic vs. transient participation).     

Impulsive and premeditated subtypes of aggression in conduct disorder: differences in time estimation

Research aimed at identifying and studying subtypes of aggression have historically dichotomized aggressive subtypes, although specific nomenclature has varied; one approach has been to classify aggressive behavior as predominantly impulsive or predominantly premeditated. There are a number of behavioral and cognitive differences between those exhibiting these different forms of aggression. This study was designed to extend understanding of the impulsive/premeditated aggression dichotomy by comparing time estimation among adolescents exhibiting predominantly impulsive or predominantly premeditated forms of physical aggression who have a psychiatric diagnosis of conduct disorder (CD). Time estimation has previously been shown to be disrupted in impulsive and some aggressive individuals. Time estimation was compared between healthy Controls (n = 37) and two groups of adolescents with CD, those with histories of either predominantly impulsive (CD-Impulsive, n = 26) or predominantly premeditated (CD-Premeditated, n = 38) aggressive behaviors. Participants completed five computerized trials during which they estimated when 1 min had passed. Among aggressive adolescents with CD, the misperception of time was specific to those with histories of impulsive aggression, although time estimates improved with repeated testing and performance feedback. This study confirms the importance of considering the role and type of physical aggression when studying heterogeneous diagnostic groups like CD and supports the relevance of time estimation to certain subgroups of adolescents with CD.     

Peer rejection and aggression and early starter models of conduct disorder

Peer rejection and aggression in the early school years were examined for their relevance to early starting conduct problems. The sample of 657 boys and girls from 4 geographical locations was followed from 1st through 4th grades. Peer rejection in 1st grade added incrementally to the prediction of early starting conduct problems in 3rd and 4th grades, over and above the effects of aggression. Peer rejection and aggression in 1st grade were also associated with the impulsive and emotionally reactive behaviors found in older samples. Being rejected by peers subsequent to 1st grade marginally added to the prediction of early starting conduct problems in 3rd and 4th grades, controlling for 1st~grade ADHD symptoms and aggression. Furthermore, peer rejection partially mediated the predictive relation between early ADHD symptoms and subsequent conduct problems. These results support the hypothesis that the experience of peer rejection in the early school years adds to the risk for early starting conduct problems.     

Visual orientation in hospitalized boys with early onset conduct disorder and borderline intellectual functioning

The aim of the present study is to investigate visual orientation in hospitalized boys with severe early onset conduct disorder and borderline intellectual functioning. It is tested whether boys with the dual diagnosis have a stronger action-oriented response style to visual-cued go signals than the norm. To this end, boys with the dual diagnosis were compared with a peer control group on Posner's (1980) Posner, M. I. 1980. Orienting of attention. Quarterly Journal of Experimental Psychology, 32: 3–25. [Taylor &; Francis Online], [Web of Science ®] , [Google Scholar] visual-spatial detection test. Here, on each trial, a visual cue points either in the direction of the location of a subsequent go signal (valid cue), or points in the opposite direction away from the location of the subsequent go signal (invalid cue). Findings indicated superior orientation (a strong action-oriented response style) of children with the dual diagnosis in valid-cued trials as well as in invalid-cued trials in both the left and the right visual hemifield. Findings were controlled for attention scores on the Child Behavior Checklist -Teacher Form and IQ scores.     

Conduct disorder and personality

A sample of children with a diagnosis of conduct disorder and a sample of children from a London comprehensive school were investigated. Three questionnaires were administered to assess personality, impulsiveness and anxiety. Of the personality measures contained within the Junior Eysenck Personality Questionnaire only Psychoticism was found to significantly differentiate the conduct disorder and normal control samples. The Impulsiveness scale of the I₆ also differentiated the two samples. There were no significant differences between the two samples in their scores on the anxiety scale of the “What I Think and Feel”. The findings are discussed in relation to theories of personality proposed by Eysenck and Eysenck (1969), Gray (1987) and Quay (1988).     

Callous-unemotional traits and conduct problems in the prediction of conduct problem severity,aggression, and self-report of delinquency

The role of callous-unemotional (CU) traits and conduct problems in predicting conduct problem severity, severity and type of aggression, and self-reported delinquency at a 1-year follow-up was investigated in a sample of 98 children (mean age 12.43; SD = 1.72) recruited from a community-wide screening. Children with both CU traits and conduct problems had a greater number and variety of conduct problems at follow-up than children who at the screening had high levels of conduct problems alone. However, this poorer outcome for children with CU traits could largely be accounted for by differences in initial level of conduct problem severity. Children with CU traits and conduct problems were also at risk for showing higher levels of aggression, especially proactive aggression, and self-reported delinquency. Importantly, these outcomes could not be solely explained by initial level of conduct problem severity. Finally, CU traits predicted self-reported delinquency in some children who did not initially show high levels of conduct problems and this predictive relationship seemed to be strongest for girls in the sample who were high on CU traits but who did not show significant conduct problems.     

Adolescent outcomes of childhood conduct disorder among clinic-referred boys: predictors of improvement

Much remains to be learned about the adolescent outcomes of clinic-referred boys whose childhood conduct problems are serious enough to meet diagnostic criteria for conduct disorder (CD). Six structured diagnostic assessments were conducted over 7 years of 73 clinic-referred 7–12-year-old boys who met criteria for CD in Wave 1. There were substantial individual differences in the adolescent outcomes of CD, ranging from worsening to sustained recovery, with most boys showing persistent, but fluctuating levels of CD. Improvement in CD was not accounted for by treatment or incarceration, but more positive outcomes over Waves 2–7 were predicted prospectively with substantial accuracy, using a combination of baseline predictors: less initial severity of CD, fewer symptoms of attention-deficit hyperactivity disorder, higher child verbal intelligence, greater family socioeconomic advantage, and not having antisocial biological parents.     

The Importance of Child and Adolescent Psychopathy

In commenting on the five articles in this special issue, this paper discusses (1) the concept of child and adolescent psychopathy, and whether adolescent psychopaths are qualitatively distinct from other young people; (2) the measurement of adolescent psychopathy; (3) the relationship between psychopathy and other personality dimensions; (4) childhood risk factors for psychopathy; (5) psychopathy in the context of risk factors for delinquency; and (6) the prevention and treatment of adolescent psychopathy. It is argued that the three dimensions of an arrogant, deceitful interpersonal style, deficient affective experience, and an impulsive or irresponsible behavioral style are most important at present in the definition of psychopathy. An ambitious research agenda is recommended, investigating the concept of adolescent psychopathy, developing new measures, conducting new longitudinal studies on development and risk factors, and mounting new randomized experiments on prevention and treatment.     

Marital discord and psychiatric disorder in children and adolescents

The relationship between marital discord and any DISC-2.1/DSM-III-R child psychiatric diagnosis was explored. Interview data from a community sample of 90 parent/child pairs and a clinic sample of 37 parent/child pairs were analysed. The data were collected at Columbia University/the New York State Psychiatric Institute as part of the pilot project of a multi-site methodological study. Rates of marital discord and DISC diagnoses were found higher in the clinic sample than in the community sample. The association between marital discord and any diagnosis remained significant when other risk and protective factors were controlled. Policy implications and recommendations for future research strategies suggested by the current exploratory study were discussed.     

The neurocognition of conduct disorder behaviors: specificity to physical aggression and theft after controlling for ADHD symptoms

There is growing evidence that among the different conduct disorder (CD) behaviors, physical aggression, but not theft, links to low neurocognitive abilities. Specifically, physical aggression has consistently been found to be negatively related to neurocognitive abilities, whereas theft has been shown to be either positively or not related to neurocognition. The specificity of these links needs further examination because attention deficit hyperactivity disorder (ADHD) links to both physical aggression and neurocognitive variation. The development of self-reported physical aggression and theft, from age 11 to 17 years, was studied in a prospective at-risk male cohort via a dual process latent growth curve model. Seven neurocognitive tests at age 20 were regressed on the growth parameters of physical aggression and theft. The links between neurocognition and the growth parameters of physical aggression and theft were adjusted for ADHD symptoms at ages 11 and 15 (parent, child and teacher reports). Results indicated that verbal abilities were negatively related to physical aggression while they were positively associated with theft. However, inductive reasoning was negatively associated with increases in theft across adolescence. Symptoms of ADHD accounted for part of the neurocognitive test links with physical aggression but did not account for the associations with theft. These differences emphasize the importance of examining specific CD behaviors to better understand their neurodevelopmental mechanisms. They also suggest that youth who engage in different levels of physical aggression or theft behaviors may require different preventive and corrective interventions.     

A sensation seeking scale for children: Further refinement and psychometric development

A revision of the Sensation Seeking Scale for Children (SSSC) was standardized and validated on a community sample of 660 elementary- and middle-school children and 168 clinic-referred male children. Factor analysis of the combined samples yielded three unique factors, entitled Thrill and Adventure Seeking, Drug and Alcohol Attitudes, and Social Disinhibition. Psychometric indices of reliability and validity were acceptable, but test-retest reliability was only moderate. Differences in SSSC scores according to sex, ethnic group, age, and intellectual status were similar to those found previously with the adult Sensation Seeking Scales. Consistent with documented relations between adult antisocial personality and sensation seeking, the SSSC distinguished boys with conduct disorder (CD) from clinic controls, but the SSSC scores of boys with CD did not differ from those of the community sample boys. Discussion includes suggestions as to the continued study of the assessment of sensation seeking in children.This research was supported by National Institutes of Health Grant 1-R01-MH42529-04 and is based on the doctoral research of the first author.     

Timing of Onset and Correlates of Severe Conduct Problems in Adjudicated Girls and Boys

An influential model for explaining the development of conduct disorder (CD) in boys proposed that there are two distinct trajectories through which boys develop CD that differ on the timing of onset, correlates, and outcome. In this study, the applicability of this two trajectory approach to the development of CD in girls was tested. Participants were 72 adolescents (mean = 15.17 years of age; SD = 1.32) who were adjudicated for serious patterns of illegal behavior in a secure detention facility, nearly all of whom (94.4%) met criteria for a diagnosis of CD. Based on a combination of youth self-report and file review, boys in the sample were fairly evenly split between a childhood-onset to their CD symptoms and an adolescent-onset to their symptoms. In contrast, girls more uniformly exhibited an adolescent-onset to their severe antisocial behavior. Despite this later age of onset, the antisocial girls tended to resemble the childhood-onset boys on personality traits such as showing problems of impulse control and showing combination of both a callous and unemotional interpersonal style and poor impulse control. These findings suggest modifications of or alternatives to the two-trajectory model may be needed to explain the development of CD in girls.     

The effects of ethnicity and acculturation on early adolescent delinquency

We examined the influence of ethnicity and acculturation status on the relationship between parental monitoring, susceptibility to antisocial peer pressure, and delinquency. The sample consisted primarily of Caucasian (63%) and Mexican-American (24%) early adolescents. Self-report data were collected from 1021 sixth and seventh graders, equally divided by gender (mean age =12.7 years). The Mexican-American adolescents were categorized into one of three acculturation groups: (a) acculturated; (b) unacculturated by choice; and (c) recent immigrants. Acculturated Mexican-American early adolescents reported significantly more delinquent behaviors than the Caucasian, unacculturated by choice, and recent immigrant youth. Recent immigrant early adolescents reported more parental monitoring than the acculturated Mexican-American early adolescents. Level of perceived susceptibility to antisocial peer pressure did not differ between ethnic or acculturation groups. Regression analyses revealed that the relationship between parental monitoring and delinquency was mediated by susceptibility to antisocial peer pressure for all the groups regardless of ethnicity or level of acculturation. Findings emphasize the importance of: (a) examining level of acculturation when sampling ethnically diverse populations; and (b) comparing global mean level differences and specific relationships among independent variables.     

Patterns of adolescent involvement in problem behaviors: Relationship to self-efficacy,social competence,and life events

Using a sample of 556 adolescents from a suburban community, patterns of various adolescent problem behaviors (e.g., delinquent behavior, smoking, use of alcohol or drugs) and their links to self-efficacy, social competence, and life events were examined. Cluster analysis was conducted to identify four subgroups of adolescents who showed distinct patterns of problem behaviors. These clusters were compared on the measures of self-efficacy, social competence, and life events. Overall results suggest there are meaningful links between adolescents’ problem behavior patterns and self-efficacy, the amount and quality of participation in various after school activities, and life events. For example, a subgroup of adolescents who showed uniformly low prevalence of all problem behaviors reported more positive academic self-efficacy, more active participation in sports and nonsports activities, more positive life events, and fewer negative events than adolescents who were involved in multiple problem behaviors. Implications for prevention and future research on adolescent problem behaviors are discussed.     

Initial Reliability and Validity of the Life Satisfaction Scale for Problem Youth in a Sample of Drug Abusing and Conduct Disordered Youth

Responses to Life Satisfaction Scale for Problem Youth (LSSPY) items were examined in a sample of 193 substance abusing and conduct disordered adolescents. In responding to the LSSPY, youth endorse their percentage of happiness (0 to 100%) in twelve domains (i.e., friendships, family, school, employment/work, fun activities, appearance, sex life/dating, use of drugs, use of alcohol, money/material possessions, transportation, control of one's life). Results indicated that the LSSPY yielded three factor structures (i.e., Social Satisfaction, External Obligations Satisfaction, Substance Use Satisfaction), demonstrated good initial psychometric properties, and appears to be a useful instrument in the evaluation of treatment outcome in problem youth. Males were more satisfied in the Social and External Obligations domains than females, although no gender differences were indicated in Substance Use Satisfaction. Caucasian, African-American, and Hispanic youths responded to LSSPY items similarly. Future directions are discussed in light of these results.     

Ideal body shape preferences and eating disorder scores in adolescent women

Abstract

Using the body figure-preference ratings of Fallon and Rozin (1985), this study investigated the relationship between body shape preferences and eating disorder scores in a sample of adolescent women. These young women were found to express a large degree of body dissatisfaction, which was positively related to eating disorder symptomology. For the sample as a whole, there was no difference between ratings of the ideal figure and that perceived as most attractive. However, the Bulimia and Perfectionism scales did offer unique prediction of the ideal figure, over and above the Attractive figure. It was concluded that young women with high bulimic scores wish to be thinner than what they perceive as attractive. The present study suggests that what motivates this wish is the search for perfectionism.     

Gender Differences in Risk and Promotive Classifications Associated With Adolescent Delinquency

How likely are children exposed to multiple risk factors to engage in delinquent behavior, to what extent do promotive factors mitigate exposure to these risk factors, and do the predictors of delinquent behavior differ by gender? To address these questions, the authors analyzed data from youths (229 boys, 187 girls) who completed the third wave of the Lehigh Longitudinal Study using Latent Profile Analysis. A unique risk and promotive class with slightly elevated rates of exposure to parental violence, mean levels of other risk factors and low levels of promotive factors was present for girls but not for boys. Additionally, for boys and girls, high-risk, low-promotive individuals were significantly more likely to engage in delinquent behavior than low-risk, high-promotive cases. Findings suggest the need to examine risk and promotive factors in combination to account for their shared influences on developmental outcomes for youth.     

Obsessive-compulsive disorder subtypes: an attempted replication and extension of a symptom-based taxonomy

A symptom-based subgroup taxonomy for obsessive-compulsive disorder (OCD) was evaluated and refined. The Yale-Brown Obsessive-Compulsive Scale symptom checklist was scored and cluster analysis was conducted with a sample of OCD patients (N = 114). Results were compared to Calamari et al.'s (Behaviour Research and Therapy 37 (1999) 113) five subgroup model. Rules for determining the number of subgroups supported a more complex model. In between sample comparisons, a stable contamination subgroup was found in both a five and seven subgroup taxonomy. Between sample stability was not as strong for Harming, Obsessionals, Symmetry, and Certainty subgroups. Hoarding, as a distinctive subgroup, was unstable in separate samples. When the Calamari et al. sample and the present sample were combined (N = 220), we found a reliable Hoarding subgroup. More interpretable and stable models emerged with the combined samples suggesting that large clinical samples are needed to identify OCD subgroups. Greater support was found for a seven subgroup taxonomy based subgroup interpretability and validation measure differences. The potential utility of symptom-based subgroup models of OCD and alternative approaches are discussed. Identification of reliable and valid OCD subtypes may advance theory and treatment.     

Comparing the Family Environments of Adolescents with Conduct Disorder or Depression

We attempted to differentiate the family environments of youth with Conduct Disorder (CD) compared to youth with a depressive disorder. Participants were 34 adolescents from a residential treatment facility. The K-SADS-P was used to determine the youth's diagnosis, while their family environment was assessed by the Self Report Measure of Family Functioning Child Version. A MANOVA was used to compare the two diagnostic groups on seven family environment variables. Results indicate that adolescents with CD described their parents as having a permissive and ambiguous discipline style, while adolescents with a depressive disorder described their relationship with their parents as enmeshed. A discriminant function analysis, using the two family environment variables of enmeshment and laissez-faire family style as predictors, correctly classified 82% of the participants. Implications for treatment of youth with both types of diagnoses and their families are discussed.     

Executive cognitive functioning mediates the relation between language competence and antisocial behavior in conduct‐disordered adolescent females

The purpose of this study was to determine (1) whether adolescent females with a conduct disorder (CD) demonstrate inferior language skills and lower executive cognitive functioning (ECF) compared with controls and (2) whether the relations between language abilities and different forms of antisocial behavior (ASB) are mediated by ECF. Language skills were measured using the Test of Language Competence–Expanded, ECF was measured using multiple neuropsychological tests, and ASB was assessed using various self‐report and psychiatric interview indices reflecting mild delinquency to severe violence. Subjects were 223 adolescent females with a CD and 97 normal controls ranging between 14 and 18 years of age (N = 320). The CD group demonstrated significantly poorer language skills and lower ECF compared with the controls. Moreover, even when controlling for chronological age and socioeconomic status, ECF still fully mediated the relations between language competence and each measure of ASB. The results are discussed in relation to a neurobehavioral model of ASB. Aggr. Behav. 26:359–375, 2000. © 2000 Wiley‐Liss, Inc.