Conduct disorder (CD)
symptoms often emerge during the preschool years, but it is not clear whether
they predict later symptoms.
The present study examined whether age 3 CD
symptoms predict age 6 CD symptoms beyond oppositional defiant disorder (ODD)
and attention-deficit/hyperactivity disorder—hyperactive/impulsive (ADHD HI)
symptoms. Participants were 216 preschool children (MAge = 44.19
months), including an externalizing sample (n = 161) and a comparison group (n
= 55). Parents were administered a diagnostic interview when children were 3
years old and again three years later.
The externalizing sample exhibited more
CD symptoms than the comparison sample. In the externalizing sample, initial CD
symptoms predicted later CD symptoms above and beyond ODD and ADHD HI symptoms;
this relation was stronger for boys than girls. Stealing, property destruction,
and fighting independently predicted later CD symptoms. CD symptoms also
predicted subsequent ADHD HI symptoms and predicted ODD symptoms at level that
approached significance.
Results support the predictive validity of CD symptoms in preschool.
...First,
CD symptoms significantly discriminated 3-year-old children with and without
externalizing problems, and were quite rare among children without problems,
suggesting these behaviors are not developmentally normative. Second,
consistent with recent findings that early CD diagnosis predicts later
diagnosis [13,16], CD symptoms at
age 3 predicted CD symptoms three years later, even above baseline ODD and ADHD
HI symptoms. This result further suggests that early CD symptoms may be of
clinical concern and not merely a normative developmental phase. Third, results
suggested that three symptoms were particularly useful in predicting later CD
symptoms: breaking things, stealing, and fighting. These results are consistent
with Loeber et al.’s finding that fighting is an important symptom in
school-age children [38]. Fourth, CD symptoms appear to have
utility not only in predicting future CD, but also in predicting subsequent
ADHD HI and ODD symptoms. In contrast, children with more early symptoms of
ADHD HI and ODD were not more likely to show later symptoms of CD. Finally,
consistent with previous research [13,16], early CD
symptoms more strongly predicted later problems for boys than for girls, though
the relationship between early and later CD symptoms was also significant for
girls.
The results of this study did not support existing
theory and research on older children that suggest that either ODD or ADHD are
developmental precursors to CD [3,23–24]. The findings in
relation to ADHD HI are in line with a number of studies with younger [42] and older
children [28] that suggest that
hyperactivity may not predict future CD/aggression once early symptoms are
controlled. In fact, for boys in this study, there was an unexpected negative
relation between ADHD HI symptoms at age 3 and CD symptoms at age 6 once
initial ODD and CD symptoms were controlled. We are not sure how to account for
this surprising finding, but we propose two possibilities. First, this could be
an instance of suppressor variables. That is, because initial ODD and CD
symptoms were controlled for in this analysis, our finding estimates the
relation between ADHD HI symptoms and later CD symptoms in boys with equivalent levels of
ODD and CD. When early problem behaviors exist, perhaps it is
better if these are due to impulsivity that might be somewhat outgrown, than to
other, perhaps even more entrenched causes. Second, given the unexpected nature
of this finding, it could simply be a Type I error. This study also does not
support the notion that ODD may be a developmental precursor to CD, at least
during the preschool years. Co-occurrences among these problem types may be the
result of common influences, such as coercive parenting cycles or biological
risk factors, rather than heterotypic continuity. If in fact ODD and CD develop
in parallel, rather than sequentially, it is not clear that CD should preclude
a diagnosis of ODD, as is currently specified in DSM-5 [43]. More research is needed to better
understand the developmental progression of ADHD HI, ODD, and CD symptoms...
Full article at: http://goo.gl/wIei8A
University of
Massachusetts Amherst
Rolon-Arroyo, B. Department of Psychology (http://www.psych.umass.edu/), University of
Massachusetts, 135 Hicks Way, Amherst, 01003, USA ude.ssamu.hcysp@ranolorb
Arnold, D. H. Department of Psychology, University of
Massachusetts, 135 Hicks Way, Amherst, 01003, USA ude.ssamu.hcysp@dlonrad
Harvey, E. A. Department of Psychology, University of
Massachusetts, 135 Hicks Way, Amherst, 01003, USA ude.ssamu.hcysp@yevrahe
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