Levels Of Behavior Problems Research Articles

Commentary: Childhood conduct problems are a public health crisis and require resources: a commentary on Rivenbark etal. ().

Conduct problems (CP) are actions that violate societal norms and/or the personal/property rights of others, and include behaviors such as vandalism, theft, bullying, and assault. Roughly 8%-10% of children engage in the more severe childhood-onset form of CP, while another 25% initiate clinically-significant levels of CP during adolescence. As deftly observed in Rivenbark etal. (), however, the high prevalence of CP belies its severity: Youth with CP are at increased risk for a number of deleterious individual outcomes, including academic delay/dropout, low professional achievement, psychopathology, addiction, and family instability.

Effects of Intensive Behavioral Treatment for Children With Varying Levels of Conduct Problems and Callous-Unemotional Traits

The purpose of this study was to examine whether callous–unemotional (CU) traits moderated the effects of intensive behavior therapy in elementary school-age children with varying levels of conduct problems (CP). Both treatment response (magnitude of change between pre- and posttreatment) and treatment outcomes (likelihood of normalization from treatment) were examined. Participants were 67 children (n = 49 boys, Mage = 9.6 years) with varying levels of CP and CU who participated in an intensive 8-week summer treatment program (STP) in which behavior therapy was delivered to children in recreational and classroom settings and to parents via weekly parent training sessions. Effects of treatment were measured using parent and teacher ratings of oppositional defiant disorder (ODD), conduct disorder (CD), callous behavior, and impairment. Results showed that CU moderated treatment effects for CD and callous behavior but not ODD or impairment. The moderating effects showed some evidence that participants with high CP and high CU before treatment had better treatment responses (larger change between pre- and posttreatment) but worse treatment outcomes (lower likelihood of normalization after treatment). These results suggest that intensive treatment, such as the STP, may be necessary but not sufficient for children with CP and CU traits.

Comparing Different Approaches for Subtyping Children with Conduct Problems: Callous-Unemotional Traits Only Versus the Multidimensional Psychopathy Construct

The aim of this study was to compare two youth psychopathy models (i.e., callous-unemotional versus multidimensional model) in their ability to predict future and stable conduct problems (CP). At baseline, mothers and fathers of 321 boys and 369 girls (ages 7–12) completed measures that tap callous-unemotional and other psychopathic traits. Parent-reported CP was collected at baseline and at 6- and 12 month follow-ups. Children were assigned to mutually exclusive groups based on their levels of CP and psychopathic traits. Children with CP who manifested callous-unemotional traits (Callous-Unemotional + CP) were occasionally at risk for future and stable CP. Yet, across gender, children with CP scoring high on all psychopathic trait dimensions (Psychopathic Personality + CP) showed the most robust and highest risk for future and stable CP. Also, Callous-Unemotional + CP children, and children who were only high in CP, often were at similar risk for future CP. The findings suggest that the callous-unemotional model is less sufficient than the multidimensional model in predicting future and stable CP. This can be concluded for both boys and girls and calls for more research reconsidering the multidimensional nature of psychopathy for CP subtyping purposes.

Callous-Unemotional Traits Only Versus the Multidimensional Psychopathy Construct as Predictors of Various Antisocial Outcomes During Early Adolescence

The aim of this study was to compare callous-unemotional (CU) traits versus the multidimensional psychopathy construct in their ability to predict future and stable antisocial behavior. At baseline, a community sample of 996 Cypriot 12-year old adolescents (52% girls) completed measures that tap conduct problems (CP) and psychopathic traits, including CU. CP, aggression, and substance use were self-reported at 1–3 year follow-ups. Youths were assigned to six mutually exclusive groups based on their baseline levels of CP and psychopathic traits. Youth with CP scoring high on all three psychopathic traits dimensions (Psychopathic Personality + CP) showed the most robust and highest risk for future and stable CP, aggression, and substance use, followed by youth who were high on all three psychopathic traits dimensions but displayed no concurrent CP (Psychopathic Personality Only) and CP youth with low levels of psychopathic traits (CP Only). Youth with CP who merely manifested callous-unemotional traits (Callous-Unemotional + CP) were only at risk for future CP. The findings suggest that the CU traits-based approach for subtyping children with CP is less informative compared to a subtyping approach using various psychopathic traits dimensions in predicting future and stable forms of various antisocial outcomes. These findings and their consistency with prior work indicate the need for additional research to examine the various psychopathic traits dimensions rather than focusing solely on CU traits, especially for CP subtyping purposes.

Effects of Early Education and Care prior to Kindergarten on Child Academic performance and Social Emotional Skills in Primary Grades

This study used a nationally-representative Early Childhood Longitudinal Study of a Kindergarten cohort (ECLS-K: 2011) to examine the relationship between participation in early education and care in the year before children enter kindergarten and the children’s cognitive and social emotional skills from the end of kindergarten to the end of first grade. Early education and care includes home-based care, center-based care and parental care. For the cognitive domain on science scores, results revealed that children in center-based care or in home-based care by a relative or nonrelative, scored higher than children in parental care at the end of kindergarten. They displayed lower levels of behavioral problems. Yet, the pattern did not sustain by the end of first grade. When using the propensity score matching, differences between children in center-based care and their counterparts in home based care or parental care emerged at the end of kindergarten to first grade. In addition, children who attended center-based care displayed behavioral problems at the end of kindergarten, but the patterns were not evident by the end of first grade. Gender differences and disparities in family income were found in the effects of early education and care on children’s cognitive and social emotional measures. Future research and limitations were discussed.

The Influence of Function, Topography, and Setting on Noncontingent Reinforcement Effect Sizes for Reduction in Problem Behavior: A Meta-analysis of Single-Case Experimental Design Data

Richman et al. (J Appl Behav Anal 48:131–152, 2015) completed a meta-analytic analysis of single-case experimental design data on noncontingent reinforcement (NCR) for the treatment of problem behavior exhibited by individuals with developmental disabilities. Results showed that (1) NCR produced very large effect sizes for reduction in problem behavior, (2) NCR implemented with the functional reinforcer resulted in a slightly larger effect size compared to NCR using nonfunctional reinforcers, and (3) schedule thinning for the delivery of reinforcers typically produced temporary and modest increases in levels of problem behavior. The purpose of the current study was to conduct follow-up analyses to determine whether treatment implementation setting, topography, or the function of problem behavior influenced the treatment effect size for problem behavior exhibited by individuals with developmental disabilities. Follow-up analyses showed that NCR effect sizes were very similar across inpatient and outpatient settings and across aggression and property destruction versus self-injurious behaviors. Results showed that NCR effect size for treatment of problem behavior maintained by a form of social reinforcement was slightly greater than problem behavior maintained by automatic reinforcement. Results are discussed in terms of applying NCR in school settings as an initial treatment for problem behaviors that can interfere with academic, adaptive, and vocational skill acquisition for students with developmental disabilities.

Investigation of the Integration of Supports for Youth Thriving Into a Community-Based Mentoring Program.

A randomized control trial involving 806 youth (ages 10-16; 85.4% low-income households) served in U.S. Big Brothers Big Sisters affiliates investigated effects of incorporating activities to promote youth thriving into mentoring relationships over a 15-month period. Outcomes included support for thriving in youths' relationships with adults, youths' personal resources for thriving, and levels of problem behavior. Intent-to-treat analyses revealed no differences in outcomes based on assignment to thriving promotion or standard services. There was substantial variability in youth exposure to thriving promotion activities, primarily in association with premature endings of mentoring relationships. In path analyses, positive engagement with the activities predicted enhanced support for thriving from adults and, via this support, increased personal resources for thriving and reduced problem behavior.

Dysfunctional representation of expected value is associated with reinforcement-based decision-making deficits in adolescents with conduct problems.

Previous work has shown that patients with conduct problems (CP) show impairments in reinforcement-based decision-making. However, studies with patients have not previously demonstrated any relationships between impairment in any of the neurocomputations underpinning reinforcement-based decision-making and specific symptom sets [e.g. level of CP and/or callous-unemotional (CU) traits]. Seventy-two youths [20 female, mean age=13.81 (SD=2.14), mean IQ=102.34 (SD=10.99)] from a residential treatment program and the community completed a passive avoidance task while undergoing functional MRI. Greater levels of CP were associated with poorer task performance. Reduced representation of expected values (EV) when making avoidance responses within bilateral anterior insula cortex/inferior frontal gyrus (AIC/iFG) and striatum was associated with greater levels of CP but not CU traits. The current data indicate that difficulties in the use of value information to motivate decisions to avoid suboptimal choices are associated with increased levels of CP (though not severity of CU traits). Moreover, they account for the behavioral deficits observed during reinforcement-based decision-making in youth with CP. In short, an individual's relative failure to utilize value information within AIC/iFG to avoid bad choices is associated with elevated levels of CP.

Longitudinal associations between conduct problems and depressive symptoms among girls and boys with early conduct problems

Youth with conduct problems (CP) may experience high rates of depressive symptoms (DS). However, little is known about the direction of the longitudinal associations between CP and DS in this specific population. Although girls with CP appear at greater risk than boys for presenting comorbid depression, empirical research on gender differences in these associations is even sparser. The current study used autoregressive latent trajectory models to compare four perspectives with hypotheses regarding the longitudinal associations between CP and DS, while taking into account the evolution of both problems. We also examined gender differences in the longitudinal associations. A total of 345 children (40.6% female) presenting with a high level of CP in early elementary school (mean age at study inception=8.52; SD=.94) were evaluated annually over a four-year period (5 measurement time points). The results revealed that CP and DS were quite stable over time. Moreover, CP and DS showed strong covariation at each measurement time point, but only one significant positive cross-lagged association between the two processes, indicating that higher levels of DS at time 3 were associated with higher levels of CP 1 year later. No differences were observed in the longitudinal associations between CP and DS in boys and girls. Given the comorbidity and stability of CP and DS, these findings suggest that DS should be systematically evaluated among children with early clinically significant CP, and treatment plans should include interventions aimed at both CP and DS among children who present with both types of problems.

Teaching with Massed Versus Interspersed Trials: Effects on Acquisition, Maintenance, and Problem Behavior

The current study evaluated the effects of teaching three programs using massed‐trial teaching (MTT) versus interspersed‐trial teaching (ITT) for three participants diagnosed with autism. Specifically, we compared the (i) rate of response acquisition, (ii) percentage of trials per session with problem behavior, and (iii) number of acquisition targets maintained following mastery. For all three participants, the rate of acquisition was higher under MTT than ITT, and levels of problem behavior were similar in both conditions for each participant. Perhaps the only advantage of ITT over MTT was maintenance of targets at the follow‐up probes for two participants; however, neither approach yielded consistently high levels of correct responding across 2‐, 4‐, and 6‐week follow‐up probes. Collectively, results for these three participants provide some evidence for the additive benefit of MTT over ITT. Copyright © 2014 John Wiley & Sons, Ltd.

The association between perception of relationship with caregivers and behaviours of youth in foster care: a child and caregiver perspective

The transition into foster care can be difficult for children. Research has consistently shown an increased risk for children in foster care to exhibit higher levels of problem behaviours in comparison to youth in the general population. The purpose of this study was to analyse the associations between the youths' perception of their relationship with their caregiver on their perception of their own internalizing and externalizing behaviours as well as the youths' perception of the relationships with caregivers and how caregivers report of youths' internalizing and externalizing behaviours. This study utilized the secondary data from the general release version of the National Survey of Child and Adolescent Well-Being [National Survey of Child and Adolescent Well-Being (2009) Introduction to the wave 1 general and restricted use releases, Nation Data Archive on Child Abuse and Neglect, Ithaca, NY]. Significant relationships between youths' perception of relationship with their caregiver were found with both youth perception of internalizing behaviours and caregiver perception of internalizing and externalizing behaviours. Results are explained with implications for practice, training, research and policy.

Methylation of the oxytocin receptor gene and oxytocin blood levels in the development of psychopathy

Child conduct problems (CPs) are a robust predictor of adult mental health; the concurrence of callous-unemotional (CU) traits confers specific risk for psychopathy. Psychopathy may be related to disturbances in the oxytocin (OXT) system. Evidence suggests that epigenetic changes in the OXT receptor gene (OXTR) are associated with lower circulating OXT and social-cognitive difficulties. We tested methylation levels of OXTR in 4- to 16-year-old males who met DSM criteria for a diagnosis of oppositional-defiant or conduct disorder and were stratified by CU traits and age. Measures were DNA methylation levels of six CpG sites in the promoter region of the OXTR gene (where a CpG site is a cytosine nucleotide occurs next to a guanine nucleotide in the linear sequence of bases along its lenth, linked together by phosphate binding), and OXT blood levels. High CU traits were associated with greater methylation of the OXTR gene for two cytosine nucleotide and guanine nucleotide phosphate linked sites and lower circulating OXT in older males. Higher methylation correlated with lower OXT levels. We conclude that greater methylation of OXTR characterizes adolescent males with high levels of CU and CPs, and this methylation is associated with lower circulating OXT and functional impairment in interpersonal empathy. The results add genetic evidence that high CU traits specify a distinct subgroup within CP children, and they suggest models of psychopathy may be informed by further identification of these epigenetic processes and their functional significance.

Identity Development in German Adolescents with and without Visual Impairments

Introduction The study reported here assessed the exploration of identity and commitment to an identity in German adolescents with and without visual impairments. Methods In total, 178 adolescents with visual impairments (blindness or low vision) and 526 sighted adolescents completed the Ego Identity Process Questionnaire. Results The levels of identity exploration and making commitments, as well as the distribution of identity statuses, did not differ between the two groups. However, adolescents with congenital visual impairments showed lower levels of identity exploration than their peers with acquired visual impairments. In addition, more severe disability was associated with less exploration of identity. Furthermore, levels of identity exploration and commitment varied by age, parental education, levels of social support, and levels of problem behavior. Discussion The findings indicate that adolescents with visual impairments do not fall behind sighted adolescents in developing a sense of identity. Implications for practitioners Adolescents who are congenitally blind or have a high level of disability may need support in exploring and accessing information on future opportunities.

Childhood callous-unemotional traits moderate the relation between parenting distress and conduct problems over time.

The present short-term longitudinal study examines the bidirectional effects among paternal-reported and maternal-reported involvement, distress and conduct-problems (CP) in children ages 7–12 years with callous-unemotional (CU) traits as a potential moderator. Latent profile analysis revealed four groups: high, moderate, decreasing, and low on CU traits. Findings suggested that children high on CU traits were at higher risk to exhibit CP and were more likely to experience low parental-involvement and high parental-distress compared to children with low, decreasing, and moderate CU traits. Findings from the cross-lagged structural equation model suggested that high levels of CP predicted increases in parenting distress, and this was shown for youth with high levels of CU traits. In turn, parental-reported distress predicted increases in CP for children in the low and decreasing CU groups. A negative bidirectional association between maternal-involvement and CP was also identified. Findings extend cross-sectional research showing parents become distressed by CP behaviors, particularly when accompanied by high CU traits.

Individual, Social, and Behavioral Factors Associated with Co-Occurring Conduct Problems and Callous-Unemotional Traits

Conduct problems (CP) and callous-unemotional (CU) traits can have a long-lasting negative impact into adulthood. Importantly, among youth with CP, those high on CU traits engage in a more severe, aggressive, and persistent pattern of antisocial behavior. The current study investigates the co-occurrence between CP and CU traits among a large sample of Greek-Cypriot adolescents (N = 1,674; 50.1% girls). Five distinct groups were identified with Latent Profile Analysis: low risk (48.7%), average risk (33.8%), co-occurring high CP-high CU (5.4%), high CP-low CU (5.2%), and low CP-high CU (6.9%). Although more boys were identified in the higher risk groups, boys and girls within each group were not differentiated on levels of CP or CU traits during early adolescence. Youth in the identified groups were compared on early (Mean age = 12.12) and middle (Mean age = 14.02) adolescence individual and contextual factors. Youth with high CP-high CU were at higher risk for behavioral (bullying and substance use), individual (inattention, impulsivity, narcissism), and contextual (low family-support) problems compared to youth in the high CP-low CU and low CP-high CU groups, providing evidence that the combination of CP and CU traits might constitute a pathological group. These findings demonstrate the usefulness of sub-typing CP based on CU traits for the forthcoming fifth edition of the Diagnostic and Statistical Manual. Additional novel findings suggested that adolescents scoring high on CP, irrespective of CU, were not differentiated on hyperactivity, victimization, and anxiety/depression, and adolescents scoring high on CU traits, with or without CP, reported similar low levels of self-esteem and peer and family social-support.

Gender Differences in Reading Skill and Problem Behavior in Elementary School

The purpose of this study was to explore interactions among reading skill, problem behavior, and gender across elementary school. A 6-year, longitudinal study ( N = 473) was conducted to identify the relations among these variables and change in relations from kindergarten to Grade 5. Students’ reading skills and levels of problem behavior were examined. Mixed model analyses of variance indicated no differences in reading skill by gender, but a significant gender interaction for problem behavior. Correlations by grade level showed weak, negative correlations between reading and behavior for female students and statistically significant, negative correlations for male students. Results did not support the need to differentiate reading instruction by gender but suggest that multimethod assessment of problem behavior would be beneficial for all students.

Engaging Parents in the Family Check-Up in Middle School: Longitudinal Effects on Family Conflict and Problem Behavior Through the High School Transition

Adolescence is a time of significant developmental change. During this period, levels of problem behavior that had been relatively innocuous may escalate in the company of peers, with simultaneous reductions in parental monitoring and involvement. In this article, we report the results of a randomized controlled trial of the Family Check-Up (FCU), a family-centered, school-based intervention designed to forestall the escalation of adolescent problem behavior by promoting and motivating skillful parenting through the transition to high school. In this study, 593 ethnically diverse families were randomized to be offered the FCU when their youth were in seventh and eighth grades of middle school. We used complier average causal effect analysis to examine change in family conflict, antisocial behavior, involvement with deviant peers, and alcohol use from sixth through ninth grades. Analyses revealed that when compared with a matched control group, youths whose parents had engaged in the FCU demonstrated significantly lower rates of growth in family conflict (p = .052), antisocial behavior, involvement with deviant peers, and alcohol use. Our results extend current research on the FCU and provide support for theory that links family conflict with a variety of youth problem behavior. These results and the extant research on the FCU suggest that traditional school-based service delivery models that focus on the individual child may benefit from a shift in perspective to engage parents and families.

Examination of Negative Peer Contagion in a Residential Care Setting

There has been ongoing concern about the negative impact of residential treatment on youth in care. Research examining the impact of negative peer influence in juvenile justice, education, and residential care settings is reviewed. A study was conducted to examine the impact of negative peer contagion on the level of problem behavior in a residential care program, and the extent to which caregiver experience and youth time-in-program mediated that relationship. The study used archival data for 1,438 first-time admissions to a large Midwestern out-of-home residential program for youth with emotional and behavioral problems. Hierarchical Linear Modeling was used to examine the relationship between daily reports of conduct and oppositional defiant disorder (CD/ODD) behaviors and the percentage of conduct disorder youth living in a home. Greater exposure to conduct disordered peers was not related to increased rates of CD/ODD behavior. CD/ODD behavior was directly related to direct care staff level of experience and youth time in program. Implications for residential care are discussed.

Hyperactivity/Inattention Problems Moderate Environmental but Not Genetic Mediation Between Negative Parenting and Conduct Problems

This study investigated the association between negative parenting (NP) and conduct problems (CP) in 6-year-old twins, taking into account the severity of hyperactivity/inattention problems (HIAP). Analyses of the data from 1,677 pairs of twins and their parents revealed that the shared environmental covariance between NP and CP was moderated by the level of HIAP but not by CP or NP, where the shared environmental covariance was larger in children with higher levels of HIAP than in children with lower levels of HIAP. The genetic covariance between NP and CP was not moderated by the level of HIAP, whereas it was larger in the group with lower levels of CP and NP than in the group with higher levels. These results suggest that severe HIAP strengthens shared environmental associations between NP and CP and that interventions focusing on the shared environmental component of NP would be effective for parents and children with severe HIAP.

Predictors and outcomes of joint trajectories of callous–unemotional traits and conduct problems in childhood.

Callous-unemotional (CU) traits are associated with antisocial and delinquent behaviors in children and represent a potential risk factor for adult psychopathy. However, there is a paucity of longitudinal research that explores the development of these traits, their longitudinal association with conduct problems (CP), and their psychosocial predictors and outcomes. Using a large sample of children followed longitudinally from the Twins Early Development Study (N=9,578), we described the joint developmental trajectories of CU traits and CP during childhood (between ages 7 and 12) and examined the child- and family-level predictors (4 years old) and concomitant outcomes (12 years old) associated with the trajectories. The developmental trajectories were characterized with teachers' ratings of CU traits and CP from ages 7 to 12. Using general growth mixture modeling, we identified four trajectories of CU traits (stable high, increasing, decreasing, and stable low) and two trajectories of CP (high and low). Compared with the children who followed a low trajectory of CU traits and CP, those who followed a high trajectory of CU traits and CP had more negative child- and family-level predictors at 4 years (including CP, hyperactivity, negative parental discipline, and chaos in the home). Children with high or increasing levels of CU traits and concomitant high levels of CP presented the most negative outcomes at 12 years (including hyperactivity, peer problems, emotional problems, and negative parental feelings). Children with high CU traits and concomitant high levels of CP in childhood should be prioritized for targeted intervention.