Early onset of conduct problems, predictors, pathways and prevention

Abstract

The early onset of disruptive, externalizing behaviour symptoms is associated with an increased risk for serious and persistent conduct disorder and antisocial behaviour. This link, along with the limited evidence that established cases of conduct disorder and antisocial behaviour can be effectively treated, argues for the provision of prevention interventions as early as possible. Theoretical arguments in support of early intervention are strong and some evidence exists that early intervention does in fact reduce the risk of conduct disorder in adolescence and adulthood. However, there is a need for further empirical evaluations of new and better interventions that take advantage of advances in our understanding of underlying mechanisms and risk and protective factors.

The design of successful prevention interventions depends upon the validity of the assumptions upon which they are based. This thesis focuses on two questions that constitute prerequisites for the design of early interventions to prevent conduct disorder. The first question concerns risk assessment, that is whether children at risk for later clinically significant conduct problems can be accurately identified in kindergarten and grade one based on the presence of externalizing behaviour symptoms. The second question concerns whether academic achievement and familial functioning factors that are present in kindergarten and grade one children increase risk for conduct disorder. Both questions are addressed in a prospective, followup study, using a random sample of kindergarten and grade one children derived from the Helping Children Adjust: A Tri-Ministry Study.