J Abnorm Child Psychol (2009) 37:375385 DOI 10.

1007/s10802-008-9261-5

Developmental Pathways to Conduct Problems: A Further Test of the Childhood and Adolescent-Onset Distinction
Danielle M. Dandreaux & Paul J. Frick

Published online: 1 August 2008 # Springer Science + Business Media, LLC 2008

Abstract This study tested several theoretically important differences between youth with a childhood-onset and youth with an adolescent-onset to their severe conduct problems. Seventy-eight pre-adjudicated adolescent boys (ranging in age from 11 to 18) housed in two short-term detention facilities and one outpatient program for youth at risk for involvement in the juvenile justice system participated in the current study. The sample was divided into those with a childhood-onset to their serious conduct problem behavior (n=47) and those with an adolescentonset (n=31). The childhood-onset group showed greater levels of dysfunctional parenting, callousunemotional traits, and affiliation with delinquent peers. The only variable more strongly associated with the adolescent-onset group was lower scores on a measure of traditionalism. Keywords Antisocial behavior . Age of onset . Traditionalism . Callousunemotional traits . Parenting . Deviant peers There are a large number of factors that have been linked to conduct problems in youth, including a wide variety of both dispositional (e.g., temperamental vulnerabilities; cognitive deficits) and environmental (e.g., family dysfunction; deviant peer group) risk factors (Frick and Dickens 2006; Moffitt 2003; Raine 2002). As a result, most current causal theories do not focus on a single risk factor but attempt to integrate multiple risk factors into causal theories to explain the development of conduct problems (e.g., Dodge and
D. M. Dandreaux : P. J. Frick (*) Department of Psychology, University of New Orleans, 2001 Geology and Psychology Building, New Orleans, LA 70148, USA e-mail: pfrick@uno.edu

Pettit 2003; Frick 2006; Raine 2002). Another important issue that has proven important for causal theories is the finding that there may be important subgroups of youth with conduct problems who show different types of risk factors which could suggest different causal processes operating across the subgroups (Frick 2006; Frick and Marsee 2006). One model that takes into account both of these issues is the distinction that has been made between a childhoodonset and adolescent-onset to serious conduct problems (American Psychiatric Association 2000; Moffitt 1993: Patterson and Yoerger 1997). There have been a number of studies showing important differences between children in the two developmental trajectories (see Moffitt 2003 for a review). One of the most consistent differences is that children in the childhood-onset group show a more severe, aggressive, and chronic pattern of antisocial behavior than youth with an adolescent-onset (Frick and Loney 1999; Moffitt et al. 2002; Woodward et al. 2002). More importantly for causal theories, there have also been a number of studies to suggest that these two developmental patterns are differentially related to several important risk factors. To summarize these findings, childhood-onset conduct problems seems to be more strongly related to neuropsychological (e.g., deficits in executive functioning) and cognitive (e.g., low intelligence) deficits (Fergusson et al. 1996; Kratzer and Hodgins 1999; Piquero 2001; Raine et al. 2002). Further, the childhood-onset group has been reported to show more temperamental and personality risk factors, such as impulsivity (McCabe et al. 2001; Silverthorn et al. 2001), attention deficits (Fergusson et al. 1996), and problems in emotional regulation (Moffitt et al. 1996). This group has also been shown to come from homes with greater family instability, more family conflict, and with

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parents who use less effective parenting strategies (Aguilar et al. 2000; McCabe et al. 2001; Patterson and Yoerger 1997; Woodward et al. 2002). Based on these findings, there have been several theoretical models developed to explain the different characteristics of the two groups of youth (Frick 2006; Moffitt 2003; Patterson and Yoerger 1997). These models generally propose that childhood-onset conduct problems result from an interaction between a child with a temperament the puts him or her at risk for showing conduct problems (e.g., impulsive; poorly regulated emotions) who also experiences a problematic socializing environment (e.g., ineffective parental discipline). This interaction disrupts the socialization of the child leading to enduring vulnerabilities and problems in adjustment across the lifespan. In contrast, these models generally propose that the behavior of the adolescent-onset group is related to a failure to meet the normal developmental demands of adolescence. That is, adolescents often show some level of rebelliousness to parents and other authority figures and this rebelliousness is part of a normal developmental process by which the adolescent begins to develop his or her autonomous sense of self and his or her unique identity (Moffitt 1993, 2003). According to the proposed models of conduct problems, a child in the adolescent-onset group engages in antisocial and delinquent behaviors as a misguided attempt to obtain a subjective sense of maturity and adult status in a way that is maladaptive (e.g., breaking societal norms). In summary, research comparing youth with a childhood and adolescent onset to their conduct problem behavior is fairly extensive and has been instrumental in many current causal theories of conduct problems. However, there are at least three important limitations in the existing research. First, the findings have not always been consistent, especially on two theoretically important variables. That is, some studies have failed to find differences between the two groups on impulsivity (Aguilar et al. 2000; White et al. 2001) and even have in some cases reported that the adolescent-onset group was more impulsive (Moffitt et al. 2002). Thus, for this one key dispositional risk factor, it has not been consistently shown that the childhood-onset group is more impaired. Similarly, the findings of higher rates of family dysfunction have not always been limited to childhood-onset groups (Patterson and Yoerger 1997; White et al. 2001). In fact, for some theories, problems in parenting (e.g., poor supervision; low parental involvement) are viewed as part of the process leading some adolescents to be more rebellious than is normative (Patterson and Yoerger 1997). Second, there are several theoretically important correlates to conduct problems that have not been studied extensively in terms of their potential differential association with the two conduct problem groups. Specifically, the

importance of callousunemotional (CU) traits (i.e., a lack of guilt, absence of empathy) for predicting a more severe and aggressive pattern of conduct problems has been shown in a number of studies (see Frick and Dickens 2006 for a review). These traits have also been associated with a distinct temperamental style characterized by a deficit in arousal to threatening and emotionally distressing stimuli and a preference for novel and dangerous activities (see Frick and White 2008 for a review). Because the childhoodonset group has been shown to exhibit more severe conduct problems and are more likely to show temperamental vulnerabilities, many theories have viewed CU traits as designating a distinct pathway within the childhood-onset group (Frick 2006). However, this assumes that CU traits and the associated predisposing temperament would be more associated with the childhood-onset pattern but the evidence to support this assumption is fairly limited (Moffitt et al. 1996; Silverthorn et al. 2001). Third, and perhaps the most important limitation in this literature, is the failure to consider whether the differential correlates to the childhood-onset and adolescent-onset groups is better explained as reflecting differences in the severity of dysfunction, rather than as reflecting groups with different causal processes. Specifically, as noted previously, children with severe conduct problems that onset in childhood show more severe and stable conduct problems. That is, children in this group exhibit more conduct problems, more aggressive behavior, and they are more likely to continue to show antisocial and criminal behaviors as adults (Moffitt 2003). Thus, an alternative explanation for why this group may also show more temperamental and environmental risk factors is that this group is simply a more severely disturbed group. One way to test this competing explanation would be to propose risk factors on which the adolescent-onset group would be more dysfunctional, despite showing less severe behavior problems. Identifying such risk factors could also suggest possible influences that lead to the exaggeration of the normal adolescent rebellion in this group. There are two possibilities for such risk factors. One is the childs affiliation with antisocial peers. Many theories consider the childs association with a deviant peer group as being a critical causal process to the adolescent-onset group (Moffitt 1993, 2003; Patterson and Yoerger 1997). However, although one study did report that adolescent-onset youth had more deviant peer associations (McCabe et al. 2001), other studies have not found such differences (Fergusson et al. 1996; Moffitt et al. 1996; Moffitt et al. 2002; Patterson and Yoerger 1997). Another possibility is that the children in the adolescent-onset group may show certain personality features that make them more likely to have problems with the transitional period between childhood and adulthood. Specifically, two studies have sug-

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gested that youth with adolescent-onset to their conduct problems show less traditional values, such as viewing societal rules and status hierarchies as less important (Moffitt et al. 1996) and they are more rebellious, such as desiring more autonomy from parents (Piquero and Brezina 2001). Such unconventional values and attitudes may not be problematic for the youth in childhood but could lead to the inappropriate attempts to achieve autonomy that have been hypothesized as leading to the behavior problems in the adolescence. Based on these limitations in the existing research, the current study compared two groups of boys with conduct problems: those with a childhood-onset and those with an adolescent-onset to their severe conduct problems. Only boys were studied, given some concerns that the correlates to the two groups may be different for boys and girls (Frick and Dickens 2006; Silverthorn and Frick 1999). The two groups were compared on measures of impulsivity and dysfunctional parenting. Although most current theoretical models would suggest that these risk factors should be higher in children with a childhood-onset, the existing research is inconsistent in supporting this contention. The two groups were also compared on measures of CU traits and sensationseeking, given past theoretical models linking these characteristics to the childhood-onset group. And finally, the two groups were compared on measures of peer delinquency, rebelliousness, and traditionalism, which are risk factors that could be more deviant in the adolescent-onset group.

and 18. All parents and youth referred to this program, that serves a mixed rural and suburban region, agreed to have the information provided as part of their standard intake procedures used in this research project. From the detention centers, parents or legal guardians of all male residents were contacted by detention center staff and asked for permission for the researcher to contact them for potential participation. Of this initial pool, parents of seven youth could not be contacted for consent purposes and eight youth were released from detention before data collection, leading to a participation rate of 85% (n=83) for the entire sample. Approximately half (57%) of the participants were recruited from a detention facility in a rural area, while the other half were recruited from a detention facility (29%) and an outpatient program (14%) in an adjacent large urban area. One youth was excluded from the outpatient program based on self and parental report of no severe conduct problems. Four youth who had a Peabody Picture VocabularyThird Edition (PPVT-III; Dunn and Dunn 1997) score of less than 65 were also excluded from analyses due to concerns about their ability to understand the questionnaires and all four of these participants came from the detained sample. Thus, the final sample included 78 boys that ranged in age from 11 to 18 (M=15.15; SD= 1.40). The self-reported ethnic breakdown of the sample was 56.4% African-American and 33.3% Caucasian (the rest reporting biracial ethnicity or other ethnicities, not including Hispanic or Asian), which is representative of the demographic distribution of the region served by the three programs. Procedures

Methods Participants Ninety-eight pre-adjudicated adolescent boys housed in two short-term detention facilities or who participated in an outpatient treatment program for boys at risk for delinquent behavior due to behavioral problems and/or status offenses were recruited for participation. These two data collection sites were chosen for a number of reasons. First, both sites served children with behavior problems that had already led to legal problems or that put them at risk for such problems. Thus, this allowed us to recruit a sample in which the participants had a very high likelihood of having significant conduct problems. Second, the detention facility served youth whose behavior was judged to be severe enough to warrant being detained for the safety of the community, whereas the outpatient program primarily served youth who would be considered at lower risk of dangerousness. Thus, the inclusion of both samples allowed for participants with a greater range of severity of conduct problem behavior. Youth in the outpatient program were consecutive referrals to this program who were between the ages of 11 All procedures were approved by the Institutional Review Board of the sponsoring university. For the detention center samples, a center staff member contacted all parents of boys currently living at the centers. Parents who agreed to be contacted by the research team were provided with informed consent by phone. This consent process was tape-recorded and the parents were subsequently mailed a copy of the consent form for their records. Once parental consent had been obtained, youth assent procedures were conducted in a group format with two to eight youth in a private room at the facility. For the one youth who did not require parental consent because he was 18 years old, youth consent procedures were conducted individually in a private room at the facility. At the outpatient treatment center, parental consent and youth assent were obtained individually at a room at the facility. The measures for the current study were part of a standard mental health screening that was required by the center. The parents and children were informed that the treating social workers would receive a screening report summarizing results of the

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measures. This screening report was explicitly written to aid the social worker in designing interventions for the youth and his family. For both samples, all data collection occurred in a private room within the facility and was conducted by a data collection team of at least three persons. Questionnaires were administered in small groups (two to eight participants per group) and all measures were read aloud to the group. While the questions were read, research assistants were stationed in the room to ensure that (a) participants understood the questions, (b) participants were answering the questions privately, (c) participants were answering the questions one at a time, and (d) participants were able to ask questions. The participants were then individually administered the Peabody Picture Vocabulary Test (Dunn and Dunn 1997). Following participation in the study and collection of the measures, youth received a candy bar and beverage for their participation. Measures Group Formation Age of onset was estimated by determining the earliest age at which any delinquent act or serious conduct problem was reported from two sources. First, the Self-Reported Delinquency Scale (SRD; Elliott and Ageton 1980) was used to assess the number and types of delinquent acts committed and earliest age that these acts were committed from the youth self-report. The SRD was developed from a list of all offenses reported in the Uniform Crime Report with a juvenile base rate of greater than 1% (Elliott and Huizinga 1984) and has been used in several past studies of delinquent behavior (Frick et al. 2005; Krueger et al. 1994). For the purpose of the current study, only serious delinquent acts that would likely lead to police contact if caught were considered. Second, during the initial phone contact, parents of all youth reported on the presence of all conduct disorder symptoms listed in the Diagnostic and Statistical Manuscript of Mental Disorder 4th Edition Text Revision (DSM-IV-TR; American Psychiatric Association 2000). Also during this phone interview, the parents reported on the age at which the child had his first police contact. The age of onset that was utilized for group formation was the youngest age reported based on these sources of information (i.e., serious self-reported delinquent act, first parent reported conduct disorder symptom, first parent reported police contact). Use of both parent and child report to determine earliest age of onset was based on past research showing that both parent report and adolescent self-report showed similar median age of onset for antisocial behaviors and both were independently correlated with external criteria (e.g. severity of impairment) (Lahey et al. 1999a). Additionally, Farrington et al. (1996) reported

that self-report may tap behaviors that may not have come to the attention of authorities or parents. Alternatively, parental report may capture events that the youth may be unwilling to report. There has been little consistency in past research concerning the operational definition of early versus adolescent-onset, with age cut-offs ranging from 10 (American Psychiatric Association 2000) to 14 (Patterson and Yoerger 1993; Tibbetts and Piquero 1999) for the onset of the first serious conduct problem. In one of the strongest tests of the differential predictive utility of different age cutoffs, Robins (1966) found that youth age 11 years or younger at the onset of their serious conduct problems were over twice as likely to be diagnosed with Antisocial Personality Disorder as adults. As a result, age 11 was used as a cut-off between early onset (n=47) and adolescent onset (n=31) groups for this study. Impulsivity Impulsivity was rated using two measures. First, the Behavioral Assessment System for Children 2nd Edition Self-Report of Personality (BASC-2 SRP; Reynolds and Kamphaus 2004) is a standardized behavior rating scale that assesses a broad range of both adaptive and maladaptive child behavior. The seven-item Hyperactivity scale includes items such as, Acts without thinking, Is restless during movies and was used as one measure of poor impulse control. In the current BASC-2 standardization sample, this scale had a coefficient alpha of 0.76 in adolescents aged 1214 and 0.74 in adolescents aged 1518 and scores on this scale correlated with other measures of impulsivity (Reynolds and Kamphaus 2004). The coefficient alpha for this scale in the current sample was 0.74. The second measure of impulsivity was the Control subscale of the Multidimensional Personality QuestionnaireBrief Form (MPQ-BF; Patrick et al. 2002). This subscale has 13 items, which are answered by selecting either True or False to an item (e.g., I like to stop and think things over before I do them) and has been related to conduct problems in past research (Moffitt et al. 1996). In the present sample, one item was eliminated from this scale due to a low itemtotal correlation (r=0.01) resulting in a coefficient alpha of 0.77. Dysfunctional Parenting Practices Dysfunctional parenting practices were assessed using the youth global self-report format of the Alabama Parenting Questionnaire (APQ; Shelton et al. 1996). The APQ measures five domains of parenting that have been consistently related to conduct problems: poor monitoring/supervision, parental involvement, inconsistent discipline, corporal punishment, and positive reinforcement (Shelton et al. 1996). The youth global self-report of the APQ consists of 42 items and items are rated on a frequency scale of 1 to 5 (1=Never, 5=

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Always). The five factor structure has been supported in past studies (Essau et al. 2006a) and scores on the APQ have been correlated with observations of parenting behavior (Hawes and Dadds 2006). A number of studies have also shown that the APQ scales are associated with conduct problems with youth in community (Dadds et al. 2003), clinic-referred (Frick et al. 1999a; Hawes and Dadds 2006), and inpatient samples (Blader 2004). In the current sample, the coefficient alphas for the APQ scales were: Parental Involvement=0.87; Poor Monitoring/Supervision= 0.79; Positive Reinforcement=0.77; Corporal Punishment= 0.72; and Inconsistent Discipline=0.58. As in past research (e.g., Frick et al. 2003), a composite score was formed from the APQ that involved converting all five subscales to zscores, inverting the two positive parenting dimensions, and summing all five scales to form a dysfunctional parenting composite. CallousUnemotional Traits CU traits were assessed using the 24-item Inventory of CallousUnemotional Traits (ICU; Frick 2004). The ICU was developed using items from the CallousUnemotional scale of the Antisocial Process Screening Device (APSD; Frick and Hare 2001), which is a widely used scale to assess these traits in children and adolescents. However, the self-report CU scale from the APSD has demonstrated only moderate internal consistency in past studies (e.g., Loney et al. 2003; Pardini et al. 2003), which is likely due to its small number of items (n=6) and three-point rating system. The ICU was designed to overcome these psychometric limitations. The four items from the APSD CU scale that loaded consistently on this factor in clinic and community samples (Frick et al. 2000) were expanded to include three similar positively worded items and three similar negatively worded items. These 24 items were then put on a four-point Likert scale from 0 (Not at all true) to 3 (Definitely true). The construct validity of the ICU was supported in a large community sample (n=1,443) of 13- to 18-year-old non-referred German adolescents (Essau et al. 2006b), as well as an American sample (n=248) of juvenile offenders between the ages of 12 and 20 (Kimonis et al. 2008). In both samples, the total scale showed adequate internal consistency ( of 0.77 and 0.81) and expected associations with aggression, delinquency, conduct disorder, personality traits (e.g., sensation seeking, Big Five dimensions), emotional reactivity, and psychosocial impairment (Essau et al. 2006b; Kimonis et al. 2008). In the current sample, one item was deleted due to a low item-total correlation (r= 0.12) resulting in an alpha coefficient of 0.81. Sensation Seeking The Sensation Seeking scale on the BASC-2 SRP was used to measure sensation seeking (Reynolds and Kamphaus 2004). This scale measures the

youths desire to engage in potentially dangerous or exciting activities (e.g., I like it when my friends dare me to do something, I like to drive in a car that is going fast). In the BASC-2 standardization sample, the Sensation Seeking scale yielded a coefficient alpha of 0.69 in adolescents aged 1214 and 0.70 in adolescents aged 15 18 (Reynolds and Kamphaus 2004). In the current sample, the coefficient alpha for this scale was 0.65. Affiliation with Delinquent Peers The Peer Delinquency Scale (PDS; Keenan et al. 1995) was used to assess deviant peer association. The PDS was developed for use in the Pittsburgh Youth Study to assess the level of deviant peer group affiliation in a high-risk community sample (Loeber et al. 1998). On the PDS, participants were asked to rate how many of their friends engaged in a number of deviant behaviors (e.g. shoplifting, skipping school, selling drugs) in the last 6 months on a five-point rating scale, ranging from none (0) to all (4). Consistent with past research assessing delinquent peer affiliation, any rating above none was considered as indicating some level of delinquent peer association and the number of behaviors in which there was some level of peer involvement was summed (Henry et al. 2001; Lahey et al. 1999b; Simons et al. 1991). In the current sample, the coefficient alpha for the PDS was 0.91. Rebelliousness Rebelliousness was assessed using the Parent Intrusiveness Scale (PIS; Goldstein et al. 2005). The PIS was based on items from the Philadelphia Family Management Study (Furstenberg et al. 1999). It measures adolescents perceptions that their parents allow them too little autonomy. This scale includes six items such as, Your parent treats you more like a kid than like an adult and Your parent always tells you what to do and how to act. In a sample of 1,357 adolescents, scores on the PIS were negatively associated with positive family affect and positively associated with unsupervised time with peers (Goldstein et al. 2005). Scores on this scale also predicted problem behavior 4 years later. In the current sample, the coefficient alpha for the PIS was 0.76. Traditionalism The Traditionalism subscale of the Multidimensional Personality QuestionnaireBrief Form (MPQBF; Patrick et al. 2002) was developed to tap one facet of the higher order personality dimension of Constraint. Constraint encompasses tendencies toward behavioral restraint versus impulsiveness and adventuresomeness (Tellegen 1985). The Traditionalism facet focuses specifically on a persons tendency to endorse conventional attitudes towards authority and traditional institutions, as opposed to showing rebellious non-conformity (Patrick et al. 2002). Youth who score high on this subscale describe themselves as endorsing high moral standards and needing a conserva-

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tive, predictable social environment; whereas low scorers are described as unconventional (Patrick et al. 2002). Importantly, the content of the traditionalism scale, unlike many other measures of rebelliousness, does not include items directly related to antisocial behavior. Thus, it is a more appropriate measure of a potential personality risk factor for such behavior. The scale includes 12 items that are either answered as true or false (e.g., It is a pretty unfeeling person who does not feel love and gratitude toward her/his parents) or to which the respondent selects from one of two statements (e.g., I would prefer to see: (A) Stricter observance of major religious holidays or (B) Greater acceptance of nontraditional families, like single parent families.) Three items were eliminated from the current scale due to item-total correlations of 0.09, 0.06, and 0.08 in the current sample. The resulting alpha coefficient for the remaining nine items on the Traditionalism subscale was 0.51.

participants with higher levels of verbal ability reported greater levels of sensation seeking. The childhood-onset and adolescent-onset groups were compared on demographic variables and self-report of delinquency. These results are reported in Table 2. As indicated in this table, the groups did not differ on major demographic variables (e.g., current age, ethnicity, verbal ability). Importantly, the groups also did not differ by recruitment site. Specifically, 87.2% of the childhood-onset group were recruited from one of the two detention facilities, compared to 83.9% of the adolescent-onset group (2 (df=76)=0.40, p=ns). However, the childhood-onset group reported more self-reported delinquency (T (df=76)= 2.09, p<0.05) and this was largely due to more selfreported violent delinquency (T (df=76)=3.06, p<0.01). Main Group Comparisons The results of the main group comparisons are provided in Table 3. The two groups differed on the measure of dysfunctional parenting (T (df=73)=2.24, p<0.05), with the childhood-onset group showing higher scores on the composite measure of ineffective parenting. In contrast, the two groups did not differ on either measure of impulsivity nor did they differ on the measure of sensation seeking. However, the childhood-onset group did show higher levels of CU traits than the adolescent-onset group (T (df=76)=2.48, p<0.01). On the three variables hypothesized to be higher in the adolescent group, there were two significant differences. The groups differed on their level of peer delinquency (T (df=76)=2.77, p<0.01) and on the measure of traditionalism (T (df=76)=2.39, p<0.01). However, for peer delinquency, it was the childhood-onset group that showed a greater level of affiliation with delinquent peers. In contrast, the adolescent-onset group showed lower scores on the measure of traditionalism.

Results Descriptive Analyses The distribution of main study variables and their correlations with major demographic variables (i.e., age, ethnicity, and verbal ability) are provided in Table 1. There were few significant correlations with demographic variables with the exception that CU traits were negatively correlated with ethnicity and sensation seeking was positively correlated with verbal ability. For these analyses, ethnicity was coded into two categories with Caucasian youth in one category and non-Caucasian youth collapsed into a minority category. These correlations indicated that Caucasian participants tended to score lower on the measure of CU traits and that

Table 1 Distribution of Main Study Variables and Correlations with Demographic Variables Variable Dysfunctional parenting Impulsivity Control Hyperactivity CU traits Sensation seeking Peer delinquency Parental intrusiveness Traditionalism Mean (SD) 4.53 (3.53) 17.52 55.56 25.99 53.65 10.88 17.40 12.53 (3.07) (12.63) (9.52) (10.46) (3.34) (5.70) (1.82) Minmax 116 1224 3384 752 3374 215 630 917 Age 0.09 0.03 0.15 0.20 0.00 0.22 0.08 0.01 Ethnicity 0.19 0.01 0.14 0.26* 0.17 0.12 0.02 0.07 PPVT-III 0.18 0.16 0.00 0.09 0.23* 0.21 0.03 0.02

Ethnicity was coded dichotomously as Caucasian=0 /Ethnic Minority=1 SD standard deviation, Min minimum, Max maximum, PPVT-III Peabody Picture VocabularyThird Edition, CU callousunemotional *p<0.05

J Abnorm Child Psychol (2009) 37:375385 Table 2 Comparisons of Childhood-Onset and Adolescent-Onset Groups on Demographic Variables and Self-Report of Delinquency Variable Childhood-onset, M (SD)/% Adolescent-onset, M (SD)/% Mean difference (SE) 95% confidence interval 2 (df=1)

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Eta2

Demographics/history of charges Data site (% detention) 87% Ethnicity (% Caucasian) 30% Age PPVT-III Self-report delinquency Delinquency Violent offenses Non-violent offenses **p<0.01; ***p<0.001 14.91 (1.50) 86.47 (14.09) 15.09 (6.72) 3.49 (1.71) 11.60 (5.52)

84% 39% 15.52 (1.15) 85.35 (12.83) 11.94 (6.17) 2.32 (1.56) 9.61 (5.23) 0.60 (0.32) 1.11 (3.15) 3.15 (1.51) 1.17 (0.38) 1.98 (1.25) 1.230.03 2.965.18 0.156.15 0.411.93 0.514.48

0.40 0.42 T (df=76) 1.89 0.35 2.09* 3.06** 1.58

0.05 0.00 0.05 0.11 0.03

Logistic regression analyses were performed to test the independent contribution of all variables that significantly differentiated groups. The regression equation including four predictors (e.g., CU traits, peer delinquency, traditionalism, and dysfunctional parenting) correctly placed 69.3% of the sample into the two conduct problem groups. The correct identification of the childhood-onset group was greater (84.8%) than the correct identification of the adolescent-onset group (44.8%). However, the individual regression coefficients for these logistic analyses indicated that none of the four variables showed a significant independent contribution to the prediction of group membership. Specifically, the odds ratios for predicting group memberships were as follows: CU traits (odds ratio=0.98; p=ns), peer delinquency (odd ratio=0.61; p=ns), traditionalism (odds ratio=0.77; p=ns), and dysfunctional parenting (odds ratio=0.90; p=ns). Thus, each predictor differentiated groups individually (see Table 3) and overall, there was a high rate of classification accuracy. However, none of the predictors made significant unique contributions to predicting group membership.
Table 3 Group Comparison on Main Study Variables Variable Childhood-onset, M (SD) 5.24 (3.41) 17.54 56.49 28.09 54.89 1.92 17.34 12.91 (3.09) (12.97) (9.98) (10.60) (0.93) (5.28) (1.63) Adolescent-onset, M (SD) 3.41 (3.49) 17.48 54.16 22.80 51.77 1.36 17.48 11.94 (3.08) (12.17) (7.89) (10.13) (0.81) (6.38) (1.94)

Supplementary Analyses Several supplementary analyses were conducted to clarify the results of the main group comparisons. First, analyses comparing groups on the various dysfunctional parenting dimensions separately revealed very similar results across the different dimensions, with the childhood-onset group tending to show greater levels of dysfunctional parenting. Second, analyses were repeated for each dependent variable dividing the variables into elevated or non-elevated ratings based on either normative or sample-specific cut-offs. For example, the scales from the BASC-2 (i.e., impulsivity and sensation seeking) were divided into those with and without a T-score over 65 based on the scales normative sample and the other variables were divided based on whether or not the score was over 1 SD of the current sample mean. The two conduct problem groups were then compared on the proportion elevated using chi-square analyses. The same pattern of significant findings reported in Table 3 emerged from these non-parametric analyses. Third, several different methods for using the age-of-onset to define groups were

Mean difference (SE)

80% confidence interval

Eta2

Dysfunctional parenting Impulsivity Control Hyperactivity CU traits Sensation seeking Peer delinquency Parental intrusiveness Traditionalism

1.82 (0.82) 0.06 2.33 5.29 3.12 0.56 0.14 0.98 (0.71) (2.93) (2.13) (2.41) (0.20) (1.33) (0.41)

0.772.88 0.860.98 1.466.11 2.538.05 0.006.24 0.300.83 1.861.57 0.451.51

2.24* 0.08 0.80 2.48** 1.29 2.77*** 0.11 2.39**

0.06 0.00 0.01 0.08 0.02 0.09 0.00 0.07

All df=76 except for dysfunctional parenting with a df=73 CU callousunemotional *p<0.05; **p<0.01; ***p<0.001

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tested (e.g., using a cut-off of age 10, using a cut-off of age 12, eliminating children whose onset of first severe conduct problem fell into a questionable range 1113). The results were quite consistent across these various methods of forming groups. Finally, the BASC-2 includes several validity scales designed to detect potential biased (i.e., tendencies to portray either excessively negative or extremely positive characteristics) and inconsistent responding. Based on the BASC-2 classification system, eight participants fell into a range that would recommend caution in interpreting their scores. When analyses were repeated by eliminating these cases, the same pattern of significance emerged as those reported in Table 3.

Discussion Our results were consistent in a number of respects with previous research comparing youth with either a childhoodonset or an adolescent-onset to their severe conduct problems (see Frick 2006; Moffitt 2003 for reviews). Perhaps the most consistent finding in past research is that the childhood-onset group displays more severe and aggressive antisocial behavior (Moffitt et al. 2002; Woodward et al. 2002). This finding was supported by our current results using self-report of delinquency. Also consistent with past research was the finding that the childhood-onset group experience high levels of family dysfunction (Aguilar et al. 2000; McCabe et al. 2001; Patterson and Yoerger 1997; Woodward et al. 2002). This latter finding is important because most theoretical models used to explain the behavior of the childhood-onset group focus on family dysfunction either alone (Patterson and Yoerger 1997), or in combination with dispositional risk factors (Moffitt 1993, 2003), as a critical factor leading to the deficits in socialization experienced by this group. Another characteristic of the childhood-onset group that emerged in our study was the higher rates of callous unemotional (CU) traits (Moffitt et al. 1996; Silverthorn et al. 2001). This finding is important because the presence of CU traits has been shown to predict a more severe and chronic course of antisocial behavior (Frick and Dickens 2006) and may be a primary contributor to the higher rate of aggression and violence exhibited by this group (Frick and Marsee 2006; Frick and Morris 2004). Thus, the current findings help to link two important bodies of research on developmental pathways to conduct problems that either focus on the age of onset to the severe conduct problems or that use CU traits to designate an important subgroup of youth with severe conduct problems. Perhaps one of the most important findings in support of the distinction between the childhood-onset and adolescentonset groups was the finding that the adolescent-onset

group showed lower levels of endorsement of traditional values and status hierarchies (Moffitt et al. 1996). This difference was not found on a measure focusing specifically on their desire for more autonomy from parents. However, the finding of lower levels of traditionalism in this group indicates that there is at least one risk factor in which this group is more deviant than the childhood-onset group, despite their less severe behavioral disturbance. Further, it provides one potential reason for the behavior of the adolescent-onset group that seems to be largely confined to a single developmental stage. That is, their endorsement of nonconventional values could contribute to a level of adolescent rebellion that may exceed the level expressed by other adolescents. We also had several findings that need to be reconciled with many existing theoretical models proposed to explain the development of conduct problems. Most importantly, our primary measures related to the childs temperament (i.e., impulsivity and sensation seeking) did not differ between groups, despite the fact that many theories emphasize the importance of temperamental risk as being a critical part of the developmental process leading the problem behavior in the childhood-onset group (Frick 2006; Frick and Morris 2004; Moffitt 1993, 2003). One possible explanation for this finding is that the measures used in the current study did not tap the dimensions of temperament that are specific to this group. For example, several studies have shown that it is specifically the thrill and adventure seeking component of sensation seeking that seems related to CU traits (Frick et al. 1999b; Pardini 2006). Further, it may be certain specific temperaments that lead to problems in impulse control (e.g., emotional dysregulation; executive control of behavior) that are unique to the childhood-onset group (Frick and Morris 2004). Testing these possibilities awaits future research but it is important that theoretical models recognize that differences in levels of impulsivity do not consistently distinguish between the two conduct problem groups (see also Aguilar et al. 2000; Moffitt et al. 2002; White et al. 2001). A second important finding that needs to be reconciled with current theories is that, despite the fact that many theoretical models emphasize deviant peer affiliation as a primary causal factor for the adolescent-onset group (Moffitt 1993, 2003; Patterson and Yoerger 1997), our results indicated that it was the childhood-onset group who reported the highest level of delinquent peer affiliation. This finding would be consistent with past research showing that youth with CU traits, which were higher in the childhood-onset group, often associate with deviant peers (Kimonis et al. 2004). It is also important to note that several other studies have not found differences between childhood-onset and adolescent-onset groups in their level of deviant peer affiliation (Fergusson et al. 1996; Moffitt et

J Abnorm Child Psychol (2009) 37:375385

383

al. 1996; Moffitt et al. 2002; Patterson and Yoerger 1997). Taken together, there is very little support for the contention that the adolescent-onset group shows greater delinquent peer affiliation. However, it is still possible that delinquent peer affiliation is important as a causal factor for this group, even if the absolute level is lower than what is found for the childhood-onset group. For example, the delinquent peer affiliation in the childhood-onset group may be secondary to their rejection from a non-deviant peer group and/or a consequence of their more frequent involvement in antisocial behaviors, whereas it may contribute more directly to the antisocial behavior of the adolescent-onset group (Kimonis et al. 2004). Future research, especially longitudinally research, needs to consider possible differences in the direction of effects for the two groups. All of these findings need to be interpreted in light of several important limitations to the current study. First, the sample used in this study is relatively small and consisted only of boys. As mentioned previously, there has been some concern expressed over the appropriateness of the childhood-onset and adolescent-onset distinction in girls (Frick and Dickens 2006; Silverthorn and Frick 1999). By excluding girls, this study cannot provide any data to address this issue. Second, although group formation utilized both self and parent-report, all of the dependent measures were based on self-report. We tested whether questionable response sets may have influenced results. Also, it is not clear that any self-presentation biases would be different across the two conduct problem groups. However, the tests of differential correlates to the two groups would have been strengthened by including measures using a different assessment method. Third, this study did not include a normal control group. Thus, comparative statements can only be made between the two conduct problem groups and no statements can be made as to whether the groups differed from typically developing adolescents. Fourth, the measure of sensation seeking and traditionalism both had low internal consistency (coefficient alpha below 0.70). Thus, the failure to find significant differences in the sensation seeking scale could have been due to the low reliability of the scale. Also, although the traditionalism scale did demonstrate group differences, the effect size may be an underestimate due to measurement error. Fifth, the current study was a correlational study and, as a result, group differences cannot be assumed to be causal. As noted previously, some variables, such as affiliation with delinquent peers, could be a consequence of the youths behavior, as well as a cause of the problem behavior. Within the context of these limitations, the current study supports the distinction between youth who show a childhood-onset and those who show an adolescent-onset to their conduct problems. Specifically, the childhood-onset

group showed higher levels of dysfunctional parenting and callousunemotional traits. In contrast, the adolescent-onset group showed higher scores on a measure of traditional values. Such differences are not only important for causal theories but also could provide clues for tailoring interventions to the unique needs of these subgroups of youth with conduct problems (Frick 2006). For example, some of the more effective interventions for adolescents with serious conduct problems involve some method of tailoring the content of treatment to the specific needs of the individual youth (Henggeler et al. 1998). Findings such as those in the current study, could help to highlight some factors that may be important to target for most youth with serious conduct problems (e.g., problems of impulse control) and others that may be specific to only certain subgroups of youth (e.g., CU traits; identity formation in the context of nonconventional values).

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