Clinically differentiating life-course-persistent and adolescence-limited conduct problems: Is age-of-onset really enough?

Abstract

One important subtyping of behavior problems is Moffitt's (1993) “life-course-persistent” (LCP) and “adolescent limited” (AL) categories of antisocial behavior, which she differentiated in terms of high impulsivity, poor academic performance, and aggression. These problems may be exacerbated by the cumulative effects of chronic stress. Copious evidence has documented validity and developmental differences between these subtypes, whereas far fewer data exist regarding their clinical utility, in spite of the Diagnostic and Statistical Manual's nomenclature including corresponding subtypes based on age-of-onset of behavioral symptoms. The present study evaluated how well age-of-onset based subtyping identifies distinct developmental patterns of antisocial behavior corresponding to Moffitt's subtypes in terms of risk factors and gender between LCP and AL in a prospective sample of chronically stressed youth. A computerized assessment tool (ALEXSA©) was used to obtain data from 1147 youth aged 8–16. Implications for clinical assessment and intervention strategy, particularly with stressed youth, are discussed.