Are Oppositional-Defiant and Hyperactive–Inattentive Symptoms Developmental Precursors to Conduct Problems in Late Childhood?: Genetic and Environmental Links

Inattentive–hyperactive and oppositional behavior have been hypothesized to be developmental precursors to conduct problems. We tested these hypotheses using a longitudinal sample of 6,466 offspring of women selected from nationally representative US households. Conduct problems across 8–13 years were robustly predicted by conduct problems at 4–7 years, but also were independently predicted to a small extent by both inattentive–hyperactive and oppositional behaviors at 4–7 years. Longitudinal multivariate behavior genetic analyses revealed that the genetic and environmental factors that influence conduct problems at both 4–7 and 8–13 years also influence the putative precursors at 4–7 years. After genetic and environmental influences on conduct problems at 4–7 years were taken into account, however, inattentive–hyperactive and oppositional behavior at 4–7 years shared causal influences with conduct problems 8–13 years to a negligible extent. These findings suggest that after early conduct problems are controlled, little is gained in terms of prediction or understanding genetic and environmental influences on later child conduct problems by treating early inattentive–hyperactive and oppositional behavior as developmental precursors to later conduct problems.     

Maternal depression and early positive parenting predict future conduct problems in young children with attention-deficit/hyperactivity disorder

Children with attention-deficit/hyperactivity disorder (ADHD) are at risk for adverse outcomes such as substance abuse and criminality, particularly if they develop conduct problems. Little is known about early predictors of the developmental course of conduct problems among children with ADHD, however. Parental psychopathology and parenting were assessed in 108 children who first met Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for ADHD at 4-7 years old. When demographic variables and baseline ADHD and conduct problems were controlled, maternal depression predicted conduct problems 2-8 years following the initial assessment, whereas positive parenting during the structured parent- child interaction task predicted fewer future conduct problems. These findings suggest that maternal depression is a risk factor, whereas early positive parenting is a protective factor, for the developmental course of conduct problems among children with ADHD.     

The 2nd to 4th digit ratio and developmental psychopathology in school-aged children

Sex steroids have important influences upon brain development and this may lead to sex differences in developmental psychopathology. Digit ratio (2D:4D) – a negative correlate of prenatal testosterone (T) – may provide further insight into the possible role of early organizational effects on such developmental psychopathology. We measured 2D:4D ratios in a group of schoolchildren in two countries (UK and Austria) and gave questionnaires assessing behavioural problems to their parents. Although there were few differences in behavioural measures between sexes (only the externalizing behaviour score was higher in Austrian boys), several correlations existed between 2D:4D and different indices of developmental psychopathology. Low 2D:4D (indicating higher prenatal T) was related to measures of total difficulties and poor conduct in both UK and Austrian children. In the UK sample, prosocial behaviour was positively related to 2D:4D in girls and hyperactivity and conduct correlated negatively with 2D:4D in boys. Associations were generally stronger for boys than for girls. We suggest that early androgen mediation effects during prenatal development increase the probability for gender-related behaviour problems.     

Conduct Problems and Adherence to COVID-19 Guidelines: A Developmental Psychopathology-Informed Approach

COVID-19 underscores the importance of understanding variation in adherence to rules concerning health behaviors. Children with conduct problems have difficulty with rule adherence, and linking early conduct problems with later adherence to COVID-19 guidelines can provide new insight into public health. The current study employed a sample (N = 744) designed to examine the longitudinal consequences of childhood conduct problems (Mean age at study entry = 8.39). The first objective was to link early conduct problems with later adherence to both general and specific COVID-19 guidelines during emerging adulthood (M age = 19.07). The second objective was to prospectively examine how interactional (i.e., callous unemotional traits, impulsivity) and cumulative (i.e., educational attainment, work status, substance use) continuity factors mediated this association. The third objective was to examine differences in sex assigned at birth in these models. Direct associations were observed between childhood conduct problems and lower general, but not specific COVID-19 guideline adherence. Conduct problems were indirectly associated with both general and specific adherence via higher levels of callous unemotional traits, and with specific adherence via higher problematic substance use. No differences in the models were observed across sex assigned at birth. Findings provide insight into both how developmental psychopathology constructs are useful for understanding COVID-19 guideline adherence, and the ways in which conduct problems may shape health outcomes.

     

Childhood conduct problems,attention deficit behaviors,and adolescent alcohol,tobacco, and illicit drug use

The relationships between conduct problems and attention deficit behaviors at age 8 years and the use of alcohol, tobacco, and illicit drugs at 15 years were studied in a birth cohort of over 900 New Zealand children. The analysis showed that while early conduct problems were significantly associated with later substance use there were no significant associations between early attention deficit behaviors and later substance use once the correlations between conduct problems and attention deficit behaviors were taken into account. These associations persisted after control for a range of potentially confounding covariates. Children who showed tendencies to conduct problems at age 8 consumed 1.5 to 1.9 times more alcohol and had rates of alcohol-related problems, daily cigarette smoking, and illicit drug use that were 1.9 to 2.0 times higher than children with low conduct problem scores. It is concluded that attention deficit behaviors, in the absence of conduct problems, are not associated with later substance use. However, even when due allowance is made for social and contextual factors associated with both early conduct problems and later substance use, early conduct problems are a risk factor for later substance use.This research was funded by grants from the Health Research Council of New Zealand and the National Child Health Research foundation.     

Precursors to aggression are evident by 6 months of age

We tested the hypothesis that developmental precursors to aggression are apparent in infancy. Up to three informants rated 301 firstborn infants for early signs of anger, hitting and biting; 279 (93%) were assessed again as toddlers. Informants' ratings were validated by direct observation at both ages. The precursor behaviours were significantly associated with known risk factors for high levels of aggressiveness. Individual differences were stable from early infancy to the third year and predicted broader conduct problems. These findings suggest that some individuals set forth on the trajectory to high levels of aggression by 6 months of age. The findings have implications for developmental studies of aggression, clinical prevention and intervention strategies, and theoretical considerations regarding the detection of precursors in different domains of development.     

Early Adolescent Growth in Depression and Conduct Problem Symptoms as Predictors of Later Substance Use Impairment

Most studies of adolescent substance use and psychological comorbidity have examined the contributions of conduct problems and depressive symptoms measured only at particular points-in-time. Yet, during adolescence, risk factors such as conduct problems and depression exist within a developmental context, and vary over time. Though internalizing and comorbid pathways to substance use have been theorized (Hussong et al. Psychology of Addictive Behaviors 25:390-404, 2011), the degree to which developmental increases in depressive symptoms and conduct problems elevate risk for substance use impairment among adolescents, in either an additive or potentially a synergistic fashion, is unclear. Using a school-based sample of 521 adolescents, we tested additive and synergistic influences of changes in depressive symptoms and conduct problems from 6th to 9th grade using parallel process growth curve modeling with latent interactions in the prediction of late adolescent (12th grade) substance use impairment, while examining gender as a moderator. We found that the interaction between growth in depression and conduct disorder symptoms uniquely predicted later substance use problems, in addition to main effects of each, across boys and girls. Results indicated that adolescents whose parents reported increases in both depression and conduct disorder symptoms from 6th to 9th grade reported the most substance use-related impairment in 12th grade. The current study demonstrates that patterns of depression and conduct problems (e.g., growth vs. decreasing) are likely more important than the static levels at any particular point-in-time in relation to substance use risk.     

Overt and Covert Dimensions of Antisocial Behavior in Early Childhood

The present study was designed to assess both the prevalence and structure of antisocial behavior in a normative sample of preschoolers. Prevalence estimates suggested that 40% of preschoolers exhibit at least one antisocial behavior each day. Furthermore, 10% of preschoolers exhibit six or more antisocial behaviors each day. Consistent with research based on older children, factor analyses provided support for conceptualizing antisocial behavior in early childhood as consisting of both overt and covert dimensions. While both overt and covert behaviors had acceptable test–retest reliability, only overt behaviors had acceptable interrater reliability. Finally both overt and covert dimensions of antisocial behavior were uniquely related to general measures of conduct problems, hyperactivity, and adult and peer conflict in the classroom setting. Findings are discussed with regard to early assessment and the developmental course of antisocial behavior.     

Trajectories leading to school-age conduct problems

The present study applied a semiparametric mixture model to a sample of 284 low-income boys to model developmental trajectories of overt conduct problems from ages 2 to 8. As in research on older children, 4 developmental trajectories were identified: a persistent problem trajectory, a high-level desister trajectory, a moderate-level desister trajectory, and a persistent low trajectory. Follow-up analyses indicated that initially high and low groups were differentiated in early childhood by high child fearlessness and elevated maternal depressive symptomatology. Persistent problem and high desister trajectories were differentiated by high child fearlessness and maternal rejecting parenting. The implications of the results for early intervention research are discussed, with an emphasis on the identification of at-risk parent-child dyads.     

Reciprocal Influences Between Girls’ Conduct Problems and Depression,and Parental Punishment and Warmth: A Six year Prospective Analysis

Although the reciprocal effects of parenting and child behavior have long been recognized, the emphasis of empirical study in the field of developmental psychopathology has been on parenting effects on children. For girls in particular, little is known about unique parenting effects on conduct problems in comparison to depression, or vice versa. In the current study, data from the large-scale (n = 2,451) Pittsburgh Girls Study were used to examine the reciprocal relations between parenting and child behavior over a six year period (child ages 7-12 years). Girls and their caregivers (85% of whom were biological mothers) were interviewed annually in their homes. Girls reported on symptoms of conduct disorder and depression, and caregivers reported on level of parent-child warmth and use of harsh punishment. The results of generalized estimating equation regression models demonstrated that both parenting behaviors were uniquely predictive of changes in girls' conduct problems and depressed mood. When the effects of race and poverty on these associations were controlled for, both parenting effects on girls' conduct problems remained significant, but only low parental warmth remained as a significant predictor of depressed mood. Girls' conduct problems, but not depressed mood, predicted changes in harsh punishment over time. The small effect of girls' depressed mood, on changes in parental warmth, was further weakened when socio-demographic factors were also included in the model.     

Childhood Peer Relationship Problems and Young People's Involvement with Deviant Peers in Adolescence

Using prospective longitudinal data from the Christchurch Health and Development Study, this article examined the relationship between children's peer relationship problems in middle childhood and their subsequent risk of forming deviant peer affiliations in adolescence. The analysis proceeded in three steps. First, a structural equation model demonstrated a moderate association between early peer relationship problems and later deviant peer affiliations (r = .27). Second, the model was extended to include a latent variable measure of early conduct problems. This analysis revealed that when the confounding effects of concurrently measured conduct problems were taken into account, peer relationship problems in middle childhood were no longer significantly related to young people's choice of deviant peers in adolescence. Third, the model was further extended to include lagged variables, permitting an examination of possible reciprocal relationships between early conduct problems and peer relationship problems. Results suggested that both early peer relationship problems and adolescent deviant peer involvement are symptomatic of early child behavioral adjustment. The implications of these findings for explanations of deviant peer selection are discussed.     

Structure of conduct problems in adolescence

Scholars disagree about whether adolescent conduct problems (CPs) form a single behavioral syndrome or whether such problems are better conceptualized as different dimensions. The arguments raised by both sides are addressed and tested empirically by analysing data from a large general population sample of Norwegian adolescents (n = 9,342). Confirmatory factor analyses show that a single syndrome of CPs may be subdivided into three highly correlated factors. The first dimension, destructive covert, includes theft and vandalism, whereas the second, nondestructive covert, reflects avoidance of arenas under adult control. The last dimension, overt, includes school opposition and fighting. This three-factor model fits well for both girls and boys, and individuals in their early and late teens. Results from scale analyses are modestly to moderately indicative of a developmental continuum of severity of CPs ranging from nondestructive covert to overt to destructive covert. Taken together the findings imply that both a unidimensional and a multidimensional perspective on CPs are applicable in the general youth population.     

Depression, learning disability, and school behavior problems

It is possible that recurrent depression (primary affective illness) is the most significant variable related to school problems of a behavioral nature in children manifesting developmental specific learning disabilities. The association of school problems and depression was investigated at a private school for children with developmental specific learning disabilities. These children were of normal intelligence and were free of primary conduct or thought disturbances. Prior to entering school, 95% of the students fulfilled criteria for developmental specific learning disabilities and 64% for depression with or without hyperactivity. Students manifesting no diagnosable behavioral condition prior to entrance continued to be relatively free of behavioral problems during their stay at school. Students with both depression and hyperactivity showed the most problematic behavior followed by students with depression without hyperactivity.     

The contribution of parental discipline, parental monitoring, and school risk to early-onset conduct problems in African American boys and girls

The association of parental discipline and monitoring with the early conduct problems of 123 boys and girls was assessed in a highly disadvantaged, African American sample. Prospective analyses indicated that, after earlier conduct problems were controlled for, coercive parent discipline and poor parental monitoring at age 4 1/2 were independent, reliable predictors of age 6 conduct problems for both boys and girls. The association of parental monitoring with later child conduct problems was mediated, in part, by parents' choice of higher risk schools for their children's kindergarten education. The association of family income with child conduct problems was mediated by parental discipline and monitoring. These models are consistent with previous research on older, European American, more advantaged, male samples, which supports the generality of the association of family processes with child conduct problems across child gender, age, and ethnicity.     

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.     

Commentary: Prevention/Intervention Trials and Developmental Theory: Commentary on the Fast Track Special Section

Well-conducted prevention and intervention research has the potential to serve the dual ends of enhancing children's adaptive outcomes and elucidating important developmental processes and mechanisms related to change. Admirably, the Fast Track preventive intervention was conceived in accord with explicit developmental theory related to the development of conduct problems. Herein, I consider how the present reports of grade-3 outcomes allow examination of causal processes and developmental mechanisms related to the effects uncovered, featuring the constructs of prediction, moderation, and particularly mediation. The multifaceted, intensive nature of the Fast Track preventive intervention is at once a clinical strength and a liability in terms of isolating causal processes underlying child change. I also consider issues related to the random assignment of the investigation and to policies that may emerge from the findings. In all, research that aims to identify relevant developmental and causal processes must incorporate both experimental and nonexperimental paradigms that are conceptualized from the outset with explanatory purposes in mind.     

Preventing Serious Conduct Problems in School-Age Youth: The Fast Track Program

Children with early-starting conduct problems have a very poor prognosis and exact a high cost to society. The Fast Track project is a multisite, collaborative research project investigating the efficacy of a comprehensive, long-term, multicomponent intervention designed to prevent the development of serious conduct problems in high-risk children. In this article, we (a) provide an overview of the developmental model that serves as the conceptual foundation for the Fast Track intervention and describe its integration into the intervention model; (b) outline the research design and intervention model, with an emphasis on the elementary school phase of the intervention; and (c) summarize findings to date concerning intervention outcomes. We then provide a case illustration, and conclude with a discussion of guidelines for practitioners who work with children with conduct problems.     

Developmental sequences in the age of onset of disruptive child behaviors

Retrospective and prospective reports of the onset of disruptive child behaviors were analyzed in a sample of clinic-referred boys. The younger boys (ages 7–9 years), compared with the older boys (ages 10–12 years), showed the highest level of disruptive behavior and, judging from mothers' reports, had the fastest progression of onsets from less serious to more serious problem behaviors. Despite some overlap, developmental sequences in problem behavior within the domains of hyperactivity/inattention, oppositional behavior, and conduct problems were similar across the two age groups. This was also the case for developmental sequences of overt or confrontive problem behaviors and covert or concealing conduct problems. Sequences of the onset of oppositional behavior and conduct problems were validated through prospective data, based on the information from mothers, teachers, and boys themselves. The implications of the findings are discussed for the formulation of developmental pathways of behavior and the analysis of causal factors.     

A biopsychosocial model of the development of chronic conduct problems in adolescence

A biopsychosocial model of the development of adolescent chronic conduct problems is presented and supported through a review of empirical findings. This model posits that biological dispositions and sociocultural contexts place certain children at risk in early life but that life experiences with parents, peers. and social institutions increment and mediate this risk. A transactional developmental model is best equipped to describe the emergence of chronic antisocial behavior across time. Reciprocal influences among dispositions, contexts, and life experiences lead to recursive iterations across time that exacerbate or diminish antisocial development. Cognitive and emotional processes within the child, including the acquisition of knowledge and social-information-processing patterns, mediate the relation between life experiences and conduct problem outcomes. Implications for prevention research and public policy are noted.