Associations between externalizing behavior problems and risky sexual behaviors in adolescence: Attachment as a mediator.

INTRODUCTION: Risky sexual behaviors in adolescence are associated with negative health and psychological functioning outcomes. Although the association between behavior problems and risky sexual behaviors is well established, addressing these problems requires understanding the mechanisms that help explain this association. Adolescent attachment, while related to risky sexual behavior, has not been extensively explored as an outcome of childhood externalizing problems. The two objectives of this study were to explore the links between parental and peer attachment and risky sexual behaviors and to examine the mediating effect of attachment on the links between behavior problems and risky sexual behaviors. METHODS: Five hundred and ninety-eight French-Canadian adolescents (46.2% girls), Mage at T1 = 13.23; Mage at T2 = 14.28; Mage at T3 = 17.35) participated in this longitudinal study. RESULTS: The quality of parental attachment at T2 was significantly and negatively associated with risky sexual behaviors 3 years later, at T3. More specifically, a lower quality parental attachment relationship was associated with having nonexclusive partners as well as with inconsistent condom use. Finally, parental attachment (T2) was a significant mediator between behavior problems (T1) and risky sexual behaviors (T3), but only for younger adolescents. CONCLUSIONS: Findings suggest that in addition to behavior problems in adolescence, the quality of parental attachment relationships may help in understanding risky sexual behaviors in adolescence.

Trajectory Classes of Externalizing and Internalizing Symptoms to Adolescent Gambling Participation: An Exploratory Study.

Engagement in underage gambling remains a public health concern. Risk factors for the development of gambling behaviours in adolescence include the presence of externalizing and/or internalizing problems. This study aims to better understand the role of co-occurrence between externalizing and internalizing symptoms from childhood to adolescence in adolescent gambling. Participants were drawn from an ongoing longitudinal study of children with and without early conduct problems. Externalizing and internalizing problems were measured annually using teacher and parent reports. Gambling behaviours were measured using self-report when participants were approximately 15 years old. Latent class growth trajectory analyses identified five mental health trajectory classes: (1) a co-occurring trajectory characterized by stable clinical levels of both externalizing and internalizing problems, (2) an externalizing trajectory characterized by stable high clinical levels of externalizing problems, (3) an internalizing trajectory characterized by stable at-risk levels of internalizing problems, (4) an at-risk externalizing trajectory characterized by decreasing levels of externalizing problems, and (5) a non-clinical trajectory. Invariance analyses suggested that this model remained valid in both boys and girls. Logistic regression analyses suggested that youth who belonged in the externalizing trajectory reported a greater likelihood of past-year gambling behaviours when compared to youth who belong in the comorbid trajectory. No other mental health trajectory was significantly associated with adolescent gambling. Stable high externalizing behaviours in development appear to increase one's risk of gambling behaviours in adolescence. Efforts to target these throughout development could help decrease one's future risk of engaging in these behaviours.

An examination of the relationship between conduct problems and depressive symptoms comorbidity and temperament among elementary school children.

Although the comorbidity between conduct problems (CP) and depressive symptoms (DS) is associated with a host of negative outcomes, the factors, such as temperament, that might explain this comorbidity in school-aged boys and girls are poorly understood. This study compared elementary school children presenting co-occurring CP and DS to children with DS only, CP only, and those with low-level symptoms on temperament dimensions, and explored the moderating role of child sex in the associations. Participants are 487 children (M = 8.38 years, SD = 0.92, 52.2% girls) divided into four groups (CP + DS, DS only, CP only, control). Findings suggest that boys with CP and DS presented a lower level of fear than boys with DS and boys from the control group. They also presented higher levels of activity than boys with DS. Girls with CP and DS presented lower levels of fear than girls with DS, lower levels of approach and activity than girls with CP, and higher levels of shyness than girls from the control group. These findings suggest that temperament may discriminate children with comorbid CP and DS from those presenting only CP or DS.

Self and parent-reported sleep problems of adolescents with childhood conduct problems and comorbid psychological problems.

INTRODUCTION: Childhood conduct problems (CP) are characterized by maladaptive externalizing behaviors and are linked with poor sleep. CP are highly comorbid with other psychological problems, including attention deficit/hyperactivity disorder and depression, which are also associated with disturbed sleep. The present study examined if childhood CP and comorbid depressive and/or attentional-hyperactivity problems were prospectively associated with parent and self-reported sleep difficulties in adolescence. METHODS: Participants (N = 744; 53% boys) from an ongoing longitudinal study in Québec, Canada were assessed for CP and comorbidities when they were between 6 and 9 years old. Participants were classified as without CP, CP only, CP and depressive symptoms, CP and attention-hyperactivity problems, or CP, depressive symptoms, and attention-hyperactivity problems. Regressions were conducted to examine the associations between comorbidity groups, parent, and self-reported sleep problems 7 years later (Median age = 15.33 years), controlling for sex, age, family income, primary caregiver education and medication. RESULTS: Adolescents in all CP groups had higher self and parent-reported sleep problems compared to adolescents without histories of CP. Adolescents with histories of CP, depressive symptoms and attention-hyperactivity problems had more sleep problems than all other groups according to self-reports, but not parent-reports. CONCLUSION: Childhood CP was prospectively linked to sleep problems in adolescence, and comorbid conditions exacerbated these problems, according to youth but not parents.

Understanding Youth Perceptions of Neighborhood Disorder: The Role of Conduct Problems.

While research addresses neighborhood disorder as leading to conduct problems, the role of individual-level differences in shaping adolescent perceptions of neighborhood has been overlooked. Data on youth, over-selected for childhood conduct problems (N = 744, 58% childhood conduct problems, 47% girls), were used to examine the link between conduct problems (time 1: Mean age = 12.23) and perceived neighborhood disorder (time 3: M = 14.30). The mediating role of delinquent friends, peer victimization, depressive symptoms, and observer-rated neighborhood disorder (time 2: M = 13.23) were also tested. Conduct problems were associated with higher levels of perceived neighborhood disorder, via delinquent peers and peer victimization. These findings offer new insight into the consequences of perceived neighborhood disorder for health and wellbeing.

Exploring childhood temperament as a moderator of the association between adolescent sexual minority status and internalizing and externalizing behavior problems.

INTRODUCTION: Sexual minority youth experience worse mental health compared to their heterosexual peers, reflecting the consequences of sexual minority-based stigma. Previous research has focused on contextual variation to understand variability within this vulnerability. Childhood temperament factors such as negative affect, effortful control and surgency/extraversion are important for understanding differential susceptibility to environmental stressors. The objective of the current study was to understand how childhood temperament factors, measured prior to the most difficult developmental period for sexual minority youth, moderated the association between sexual minority status and internalizing and externalizing behavior problems. METHODS: Youth reporting same-sex attraction in an ongoing longitudinal project on the development of conduct problems in Quebec, Canada were matched with heterosexual peers, for an analytic sample of 280 youth (62% girls). Structural equation models were used to examine (1) the association between youth-reported same-sex attraction (ages 13-16) and parent and youth-reported internalizing and externalizing problems a year later at ages 14-17, and (2) the moderating role of temperament (ages 6-9) in this association between sexual minority status and internalizing and externalizing problems. RESULTS: Same-sex attraction was associated with higher levels of youth-reported internalizing and externalizing behavior problems. Surgency/extraversion moderated the association between sexual minority status and youth-reported internalizing and externalizing problems. CONCLUSIONS: These findings suggest that temperament linked to individual visibility may be important for understanding variation in self-reported mental health among sexual minority youth, and supports the use of developmental constructs like temperament to better understand vulnerability to psychosocial difficulties within this population.

Clinical Utility of the Limited Prosocial Emotions Specifier in the Childhood-Onset Subtype of Conduct Disorder.

OBJECTIVE: Clinicians may specify the diagnosis of conduct disorder (CD) as "with limited prosocial emotions" (LPE). This specifier is thought to identify youths with particularly severe and stable symptomatology. However, few studies have examined the clinical usefulness of the LPE specifier among children with childhood-onset CD. The current study examines whether the LPE specifier distinguishes children with particularly severe and persistent symptoms among those with childhood-onset CD. The study also aims to test whether the LPE specifier aids in identifying children with subclinical CD whose conduct problems are at risk of increasing. METHOD: Two hundred sixty-four children showing at least one CD symptom before age 10 were divided based on the presence of CD and the specifier. Children with and without the specifier were compared on number of CD symptoms (assessed at study inception) and trajectory of conduct problems (assessed over 4 years). The analyses controlled for oppositional defiant and attention deficit hyperactivity symptomatology. RESULTS: Compared with children with CD but without LPE, children with CD and the LPE specifier did not differ on likelihood of endorsing most symptoms nor on total numbers of symptoms. Moreover, they did not show a more stable pattern of conduct problems across the 4 years. Children with subclinical CD with and without the LPE specifier were also similar in terms of their symptoms, severity, and evolution of their problems. CONCLUSIONS: Among youths with childhood-onset CD, the specifier appears to offer limited value in identifying those with particularly severe and stable CD symptomatology.

Continuity and Change in Psychopathic Traits Among School-Aged Children with Conduct Problems.

The three dimensions of psychopathic traits in childhood have been consistently associated with high levels of conduct problems among children. However, little is known about the continuity and change in psychopathic traits among children with conduct problems. This study aimed to examine the homotypic continuity and change of the three dimensions of psychopathic traits from 8 to 14 years old among 370 children (40.3% girls) who were identified at school as having conduct problems at study inception. Results supported the structural continuity of the tridimensional model of psychopathic traits and revealed that the callous-unemotional dimension is more stable than the two other dimensions. However, the levels of the three dimensions of psychopathic traits remained high over time among a substantial number of children with conduct problems. This study has implications regarding the longitudinal assessment of psychopathic traits within this specific population.

Trajectories of Verbal and Physical Peer Victimization Among Children with Comorbid Oppositional Defiant Problems, Conduct Problems and Hyperactive-Attention Problems.

The high levels of comorbidity between oppositional/conduct problems and hyperactivity/attention problems underscore the need for assessing how vulnerability for peer victimization is shaped by overlap among these behavior problems. Children (mean age 8.39, SD = 0.93) participating in a longitudinal study of the development of conduct problems (N = 744; 348 girls) in Quebec, Canada, were evaluated by their teachers regarding experiences of peer verbal and physical victimization every year for 6 years. Parent and teacher ratings of clinically significant oppositional/conduct problems, and hyperactivity/attention problems, as well as cormorbid opposition defiant/conduct problems and hyperactivity/attention problems were regressed onto trajectories of verbal and physical victimization. While behavior problems (both alone and together) were associated with higher levels of verbal and physical victimization, some variation was observed across rater and type of victimization. Ultimately, these findings suggest the importance of adapting programming for reducing victimization to children with oppositional and conduct problems.

Predictors of childhood trajectories of overt and indirect aggression: An interdisciplinary approach.

The aim of this study was to advance our understanding of the development of aggression in boys and girls by testing a model combining insights from both evolutionary theory and developmental psychology. A sample of 744 children (348 girls) between six and 13 years old was recruited in schools with high deprivation indices. Half of the sample (N = 372; 40.1% girls) had received special educational services for behavioral and/or socio-emotional problems. Two trajectories for overt aggression and two trajectories for indirect aggression were identified and binomial logistic regressions were used to identify environmental predictors and sex-specific patterns of these trajectories. Results indicated that peer rejection predicted overt aggression and indirect aggression and that extraversion and male sex predicted overt aggression. The results also showed that interaction between parental practices and some child temperament traits predicted overt aggression (coercion and lack of supervision associated with extraversion or low effortful control) or indirect aggression (coercion and neglect associated with negative affect or low effortful control), and the absence of a father figure predicted high indirect aggression in girls.

Predicting Depression and Anxiety from Oppositional Defiant Disorder Symptoms in Elementary School-Age Girls and Boys with Conduct Problems.

This study investigated the relationship between the three DSM-5 categories of oppositional defiant disorder (ODD) symptoms (irritable mood, defiant behavior, vindictive behavior) and anxiety/depression in girls and boys with conduct problems (CP) while controlling for comorbid child psychopathology at baseline. Data were drawn from an ongoing longitudinal study of 6- to 9-year-old French-Canadian children (N = 276; 40.8 % girls) receiving special educational services for CP at school and followed for 2 years. Using linear regression analysis, the results showed that irritable mood symptoms predicted a higher level of depression and anxiety in girls and boys 2 years later, whereas the behavioral symptoms of ODD (e.g., defiant, vindictive symptoms) were linked to lower depression scores. The contribution of ODD symptoms to these predictions, while statistically significant, remained modest. The usefulness of ODD irritable symptoms as a marker for identifying girls and boys with CP who are more vulnerable to developing internalizing problems is discussed.

Precocious Initiation into Smoking, Alcohol Use, and Gambling among Children with Conduct Problems.

OBJECTIVE: Adolescent participation in risky and addictive behaviours, such as smoking, substance use, and gambling has the potential to lead to many serious problems. The presence of conduct problems (CPs) and early initiation into risky and addictive behaviours have been independently shown to be associated with adolescent and young adult smoking, drinking, and gambling. Nevertheless, the relation between early initiation into risky and addictive behaviours and CPs remains to be explored among pre-adolescents. Our study aims to examine the prospective relation between CPs in early primary school and pre-adolescent initiation into smoking, alcohol use, and gambling. METHOD: Our study used data from participants in an ongoing prospective, longitudinal study at the Université de Sherbrooke to examine cigarette, alcohol, and gambling initiation among primary school-aged boys and girls with CPs. Children were recruited between the ages of 6 and 9 years from several low socioeconomic status public schools in diverse geographical regions of Quebec. Initiation into cigarettes, alcohol, and gambling was measured 1 year later. RESULTS: Children with CPs were found to be at greater risk for early initiation into smoking, alcohol, and gambling. These effects remained even once other known risk factors, such as poor parental supervision and child effortful control, were controlled for. CONCLUSIONS: These results suggest that CPs present in early elementary school can predict early initiation in to potentially addictive behaviours among boys and girls. Implications for targeted preventive intervention are discussed.

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.

Primary and Secondary Variants of Callous-Unemotional Traits in Children with Conduct Problems: A Longitudinal Follow-up During Adolescence.

Recent empirical work has suggested that youths with conduct problems and presenting high levels of callous-unemotional (CU) traits can be divided in two variants (i.e., primary, secondary) presenting specific characteristics and needs, but studies examining outcomes associated longitudinally with variants memberships remain scarce. Building on a previous investigation in which we identified variants of CU traits among children with conduct problems, we examined differences between groups on a wide range of behavioral/psychological, relational/social, and educational outcomes assessed during adolescence (n = 309, mean age = 17.4, SD = 0.96). When compared to those from the primary variant, youths from the secondary variant reported higher levels of conduct, opposition, attention deficit/hyperactivity and anxiety problems, had lower teacher-reported academic performance, experienced more conflictual relationships with their teachers, and were at higher risk of being victimized by their intimate partner. These results shed light on the specific clinical characteristics of children from the secondary variant that are likely to persist until adolescence. Providing these children with intensive preventive interventions targeting these long-term consequences could be particularly beneficial.

Impacts of psychopathic traits dimensions on the development of indirect aggression from childhood to adolescence.

Children who show elevated levels of indirect aggression (IA) from childhood to adolescence are at increased risks of experiencing detrimental outcomes. Some studies suggest that psychopathic traits could act as a predisposing vulnerability in the development of IA, but the contributions of all three dimensions of psychopathic traits in explaining developmental trajectories of IA from childhood to adolescence remain unclear. This study aimed to determine if the three dimensions of psychopathic traits during childhood (i.e., callous-unemotional, narcissism-grandiosity, and impulsivity-irresponsibility at 6-9 years old) increase the risk of following a high IA trajectory across preadolescence, and whether sex moderated these associations. Participants were 744 children (47% girls; 93% born in Quebec, Canada, and over 50% from low socioeconomic backgrounds) assessed annually over 5 years. Approximately half of them (n = 370; 40.3% girls) were referred to school-based services for conduct problems (CP) at study intake. Latent class growth analyses revealed four developmental trajectories of IA, which were regressed on psychopathic traits dimensions using a three-step approach. After adjusting for demographic confounders, CP, and other dimensions of psychopathic traits, only narcissism-grandiosity traits significantly predicted memberships to a high and stable trajectory of IA use. The associations between the other dimensions of psychopathic traits and IA trajectories were not significant when considering confounders. No moderating effects by child sex were observed. These results suggest that narcissism-grandiosity traits could be of use for clinicians aiming to detect children most at risk of showing high and persistent levels of IA. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Longitudinal relationships between conduct problems, depressive symptoms, and school dropout.

School dropout can be an ongoing process of academic failure and disengagement starting as early as elementary school. Given the multitude of factors involved and the importance of early identification of vulnerabilities, this study examined whether (a) initial levels of conduct problems and depressive symptoms predicted school dropout, (b) the rate of change in conduct problems and depressive symptoms predicted dropout, (c) the interaction between trajectories of conduct problems and depressive symptoms affected the likelihood of dropout, and (d) whether there were sex differences in these associations. Using a dataset of 364 children ages 6-9 (T1) years who had displayed conduct problems, mean trajectories of conduct problems and depressive symptoms over 6 years were drawn using parallel process latent growth curve modeling. Results showed that both the initial levels of and rate of change in conduct problems predicted dropout, whereas trajectories of depressive symptoms did not. The interaction between trajectories of conduct problems and depressive symptoms was non-significant and sex differences were not observed. These results suggest that, for boys and girls presenting early conduct problems, although a higher initial levels of conduct problems increases the risk of school dropout, a larger decrease in these problems over time may reduce this likelihood. Recognizing and treating conduct problems consistently may be crucial in reducing the risk of dropout in children with early-onset issues.

Developmental Trajectory of Conduct Problems Among Boys and Girls Receiving Psychoeducational Services at Elementary Schools.

Elementary public schools remain the most common venues for addressing children's severe conduct problems. Nevertheless, very few longitudinal studies have examined association between receiving psychoeducational services for conduct problems in school and subsequent conduct problem severity. This study explored if psychoeducational service reception contributed to reduce conduct problems in a sample of 434 elementary school-aged boys and girls presenting a high level of conduct problems. The study used a repeated measures design at 12-month intervals, for 4 years. Information regarding the severity of children's conduct problems and services was provided by parents and teachers. Latent Growth Modeling was used to identify a mean trajectory of conduct problems. Results revealed that psychoeducational services were associated with a decrease in conduct problems over time, but this association was only observed in boys. There was no association between service reception at study inception and the trajectory of conduct problems among girls. These results suggests that psychoeducational services are well suited to the difficulties of boys with conduct problems; however, they may call for a review of the services offered to girls in schools, both in terms of the detection of conduct problems in young girls, and in terms of their treatment options.

Student-teacher relationship quality moderates longitudinal associations between child temperament and behavior problems.

Relatively few studies have focused on relational factors within the school environment that could moderate the associations between temperament and behavior problems. The purpose of this longitudinal study was to examine whether student-teacher relationship quality (i.e., Closeness, Conflict, and Dependency) moderated longitudinal associations between child temperament (i.e., Negative Affectivity, Surgency/Extraversion, and Effortful Control) and externalizing and internalizing problems. The participants were 744 elementary school students (mean age 8.4 years at study entry) followed over 3 years (four measurement times). Parents assessed their child's temperament at study entry (T1) and the children reported their self-perceptions of problems 3 years later (T4). Student-teacher relationship quality was constructed as a latent variable based on ratings from three different teachers over 3 years (T1, T2, T3). Latent moderated structural equations revealed that a low level of Surgency/Extraversion was associated with less internalizing problems but only for children experiencing a high level of Closeness with their teachers. A high level of Negative Affectivity was associated with more internalizing problems, but only for children experiencing a high level of Conflict or a high level of Dependency with their teachers. Student-teacher relationship quality did not moderate the associations between temperament and externalizing problems. Improving student-teacher relationship quality through focused interventions thus represents a useful strategy.

Maternal Functioning and Child's Externalizing Problems: Temperament and Sex-Based Driven Effects.

This study examines how maternal adverse parenting (hostility, neglect, low warmth) and psychological distress explain the associations between child temperament factors and externalizing problems. It also examines if these associations differ according to the child's biological sex. The sample consists of 339 school-age children receiving in-school services for conduct problems. Data were collected through questionnaires completed by mothers at 3 time points, at one-year intervals. Results from path analyses revealed that maternal psychological distress partly explained the associations between each child temperamental factors (negative affectivity, surgency/extraversion, effortful control) and levels of externalizing problems. Specifically, the indirect effect of psychological distress between child negative affectivity and externalizing problems was only significant for boys, not girls. Maternal hostility, on the other hand, mediated the association between child surgency/extraversion and externalizing problems in both boys and girls. Interestingly, neglectful parenting and maternal warmth did not explain the association between child temperamental factors and externalizing problems. The findings suggest small but significant temperament child-driven effects on maternal psychological distress and hostility, in turn, translating into higher levels of externalizing problems. These findings support the relevance of temperament-based interventions for children with conduct problems and of increased mental health support for their mothers. By aiding mothers in developing a larger repertoire of parenting strategies, mothers may be better equipped to respond appropriately to their child's various temperamental characteristics, hence, reducing their psychological distress and hostile behaviors and limiting the development of child externalizing problems.

Trajectories of medical service use among girls and boys with and without early-onset conduct problems.

Background: Children with conduct problems (CP) have been found to be heavy and costly medical service users in adulthood. However, there is little knowledge on how medical service use develops during childhood and adolescence among youth with and without childhood CP. Knowing whether differences in developmental trajectories of medical service use for specific types of problems (e.g., injuries) are predicted by childhood CP would help clinicians identify developmental periods during which they might intensify interventions for young people with CP in order to prevent later problems and associated increased service use. Methods: Participants were drawn from an ongoing longitudinal study of boys and girls with and without childhood CP as rated by parents and teachers. Medical service use was assessed using administrative data from a public single payer health plan. Latent growth modeling was used to estimate the mean trajectory of four types of medical visits (psychiatric, injury-related, preventative, total visits) across time and evaluate the effect of CP and other covariates. Results: Support the hypothesis that early CP predicts higher medical service use at nine years old, and that this difference persists in a chronic manner over time, even when controlling the effects of ADHD and family income. Girls had fewer medical visits for psychiatric reasons than boys at baseline, but this difference diminished over time. Conclusions: Clinicians should be aware that childhood CP already predicts increased medical service use in elementary school. Issues specific to different contexts in which injuries might occur and sex differences are discussed.