Risk factors for disruptive behaviours: protocol for a systematic review and meta-analysis of quasi-experimental evidence.

Lucy Karwatowska,Simon Russell,Essi Viding,Bianca Lucia De Stavola,Sara Jaffee,Jean-Baptiste Pingault,Francesca Solmi

doi:10.1136/bmjopen-2020-038258

Abstract

IntroductionDisruptive behaviour disorders, including oppositional defiant disorder and conduct disorder, are a common set of diagnoses in childhood and adolescence, with global estimates of 5.7%, 3.6% and 2.1% for any disruptive disorder, oppositional defiant disorder and conduct disorder, respectively. There are high economic and social costs associated with disruptive behaviours and the prevalence of these disorders has increased in recent years. As such, disruptive behaviours represent an escalating major public health concern and it is important to understand what factors may influence the risk of these behaviours. Such research would inform interventions that aim to prevent the development of disruptive behaviours. The current review will identify the most stringent evidence of putative risk factors for disruptive behaviour from quasi-experimental studies, which enable stronger causal inference.Methods and analysisThe review will be carried out according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An electronic search of references published between 1 January 1980 and 1 March 2020 will be conducted using Medline, Embase, PsycINFO and Web of Science. Initial abstract and title screening, full-text screening and data extraction will be completed independently by two reviewers using Evidence for Policy and Practice Information (EPPI)-Reviewer 4 software. Quasi-experimental studies in the English language examining the association between any putative risk factor and a clearly defined measure of disruptive behaviour (eg, a validated questionnaire measure) will be included. We will conduct meta-analyses if we can pool a minimum of three similar studies with the same or similar exposures and outcomes.Ethics and disseminationThe proposed review does not require ethical approval. The results will help to identify risk factors for which there is strong evidence of causal effects on disruptive behaviours and also highlight potential risk factors that require further research. The findings will be disseminated via publication in a peer-reviewed scientific journal and through presentations at international meetings and conferences.PROSPERO registration numberCRD42020169313.

Highlights

Disruptive behaviour disorders, including oppositional defiant disorder and conduct disorder, are a common set of diagnoses in childhood and adolescence, with global estimates of 5.7%, 3.6% and 2.1% for any disruptive disorder, oppositional defiant disorder and conduct disorder, respectively
Much of the existing evidence draws on research that has used unrepresentative samples, has explored a restricted number of risk factors and/or has only focused on identifying associations between putative risk factors and outcomes.[6 7]
Given the high societal cost of disruptive behaviours it is important that research attempts to identify the causal, as opposed to correlational, risk factors associated with these behaviours

Summary

Introduction

Disruptive behaviour disorders, including oppositional defiant disorder and conduct disorder, are a common set of diagnoses in childhood and adolescence, with global estimates of 5.7%, 3.6% and 2.1% for any disruptive disorder, oppositional defiant disorder and conduct disorder, respectively. Much of the existing evidence draws on research that has used unrepresentative samples (ie, high-risk or clinical samples), has explored a restricted number of risk factors and/or has only focused on identifying associations between putative risk factors and outcomes.[6 7] In comparison, quasi-experimental studies can address most of these limitations: they often use large, representative samples, they are able to investigate risk factors for which classical randomised control trials are unethical, impractical or too costly, and, under certain assumptions, they can produce causal estimates.[8] Given the high societal cost of disruptive behaviours it is important that research attempts to identify the causal, as opposed to correlational, risk factors associated with these behaviours. Such research would inform efforts to design more effective interventions that aim to prevent the development of disruptive behaviour and its associated adverse long-term outcomes

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