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Conduct Problems Prevention Research Group

Publications and source records attributed to Conduct Problems Prevention Research Group.

At least 19 recordsLinked to original sources

Can a costly intervention be cost-effective?: An analysis of violence prevention.

OBJECTIVES: To examine the cost-effectiveness of the Fast Track intervention, a multi-year, multi-component intervention designed to reduce violence among at-risk children. A previous report documented the favorable effect of intervention on the highest-risk group of ninth-graders diagnosed with conduct disorder, as well as self-reported delinquency. The current report addressed the cost-effectiveness of the intervention for these measures of program impact. DESIGN: Costs of the intervention were estimated using program budgets. Incremental cost-effectiveness ratios were computed to determine the cost per unit of improvement in the 3 outcomes measured in the 10th year of the study. RESULTS: Examination of the total sample showed that the intervention was not cost-effective at likely levels of policymakers' willingness to pay for the key outcomes. Subsequent analysis of those most at risk, however, showed that the intervention likely was cost-effective given specified willingness-to-pay criteria. CONCLUSIONS: Results indicate that the intervention is cost-effective for the children at highest risk. From a policy standpoint, this finding is encouraging because such children are likely to generate higher costs for society over their lifetimes. However, substantial barriers to cost-effectiveness remain, such as the ability to effectively identify and recruit such higher-risk children in future implementations.

Adolescent↗

Family instability and child maladjustment trajectories during elementary school.

This study examines the relation between family instability and child maladjustment over a 6-year period in 369 children from four communities. Measures were collected annually from kindergarten through fifth grade. In associative growth curve models, family instability trajectories predicted children's externalizing and internalizing behavior trajectories during this time period. High levels of family instability also incrementally predicted the likelihood of meeting criteria for a DSM IV diagnosis during elementary school, above and beyond prediction from earlier measures of maladjustment. However, the timing of family instability had a different effect on externalizing versus internalizing disorders. In general, stronger relations were found between family instability and externalizing behaviors relative to internalizing behaviors, although children with comorbid disorders experienced the highest levels of family instability.

Adaptation, Psychological↗

Conduct problems, depressive symptomatology and their co-occurring presentation in childhood as predictors of adjustment in early adolescence.

The present study investigated patterns in the development of conduct problems (CP), depressive symptoms, and their co-occurrence, and relations to adjustment problems, over the transition from late childhood to early adolescence. Rates of depressive symptoms and CP during this developmental period vary by gender; yet, few studies involving non-clinical samples have examined co-occurring problems and adjustment outcomes across boys and girls. This study investigates the manifestation and change in CP and depressive symptom patterns in a large, multisite, gender-and ethnically-diverse sample of 431 youth from 5th to 7th grade. Indicators of CP, depressive symptoms, their co-occurrence, and adjustment outcomes were created from multiple reporters and measures. Hypotheses regarding gender differences were tested utilizing both categorical (i.e., elevated symptom groups) and continuous analyses (i.e., regressions predicting symptomatology and adjustment outcomes). Results were partially supportive of the dual failure model (Capaldi, 1991, 1992), with youth with co-occurring problems in 5th grade demonstrating significantly lower academic adjustment and social competence two years later. Both depressive symptoms and CP were risk factors for multiple negative adjustment outcomes. Co-occurring symptomatology and CP demonstrated more stability and was associated with more severe adjustment problems than depressive symptoms over time. Categorical analyses suggested that, in terms of adjustment problems, youth with co-occurring symptomatology were generally no worse off than those with CP-alone, and those with depressive symptoms-alone were similar over time to those showing no symptomatology at all. Few gender differences were noted in the relations among CP, depressive symptoms, and adjustment over time.

Adolescent↗

The impact of classroom aggression on the development of aggressive behavior problems in children.

Prior research suggests that exposure to elementary classrooms characterized by high levels of student aggression may contribute to the development of child aggressive behavior problems. To explore this process in more detail, this study followed a longitudinal sample of 4,907 children and examined demographic factors associated with exposure to high-aggression classrooms, including school context factors (school size, student poverty levels, and rural vs. urban location) and child ethnicity (African American, European American). The developmental impact of different temporal patterns of exposure (e.g., primacy, recency, chronicity) to high-aggression classrooms was evaluated on child aggression. Analyses revealed that African American children attending large, urban schools that served socioeconomically disadvantaged students were more likely than other students to be exposed to high-aggressive classroom contexts. Hierarchical regressions demonstrated cumulative effects for temporal exposure, whereby children with multiple years of exposure showed higher levels of aggressive behavior after 3 years than children with primacy, less recent, and less chronic exposure, controlling for initial levels of aggression. Implications are discussed for developmental research and preventive interventions.

Aggression↗

Examining clinical judgment in an adaptive intervention design: The fast track program.

Although clinical judgment is often used in assessment and treatment planning, rarely has research examined its reliability, validity, or impact in practice settings. This study tailored the frequency of home visits in a prevention program for aggressive- disruptive children (n = 410; 56% minority) on the basis of 2 kinds of clinical judgment: ratings of parental functioning using a standardized multi-item scale and global assessments of family need for services. Stronger reliability and better concurrent and predictive validity emerged for the 1st kind of clinical judgment than for the 2nd. Exploratory analyses suggested that using ratings of parental functioning to tailor treatment recommendations improved the impact of the intervention by the end of 3rd grade but using more global assessments of family need did not.

Aggression↗

Aggressive marital conflict, maternal harsh punishment, and child aggressive-disruptive behavior: evidence for direct and mediated relations.

Direct associations between aggressive marital conflict and child aggressive-disruptive behavior at home and school were explored in this cross-sectional study of 360 kindergarten children. In addition, mediated pathways linking aggressive marital conflict to maternal harsh punishment to child aggressive-disruptive behavior were examined. Moderation analyses explored how the overall frequency of marital disagreement might buffer or exacerbate the impact of aggressive marital conflict on maternal harsh punishment and child aggressive-disruptive behavior. Hierarchical regressions revealed direct pathways linking aggressive marital conflict to child aggressive-disruptive behavior at home and school and a partially mediated pathway linking aggressive marital conflict to child aggressive-disruptive behavior at home. Further analyses revealed that rates of marital disagreement moderated the association between aggressive marital conflict and child aggressive-disruptive behavior at home, with an attenuated association at high rates of marital disagreement as compared with low rates of marital disagreement.

Aggression↗

Decoupling the relation between risk factors for conduct problems and the receipt of intervention services: participation across multiple components of a prevention program.

This study examined whether the link between risk factors for conduct problems and low rates of participation in mental health treatment could be decoupled through the provision of integrated prevention services in multiple easily-accessible contexts. It included 445 families of first-grade children (55% minority), living in four diverse communities, and selected for early signs of conduct problems. Results indicated that, under the right circumstances, these children and families could be enticed to participate at high rates in school-based services, therapeutic groups, and home visits. Because different sets of risk factors were related to different profiles of participation across the components of the prevention program, findings highlight the need to offer services in multiple contexts to reach all children and families who might benefit from them.

Black or African American↗

The impact of first-grade "friendship group" experiences on child social outcomes in the fast track program.

Many interventions for children's behavior problems successfully utilize a group format for social skills training, providing opportunities for practice and performance feedback from peers. Recent studies however, suggest that grouping aggressive children together may reduce intervention effectiveness or even increase risk. The present study examined the relative impact of children's own behavior and their experiences with peers in the first-grade "friendship groups" of Fast Track, a multi-component preventive intervention program. Two-hundred sixty-six children (56% minority, 29% female) participated in 55 friendship groups. Children's own positive and negative behavior in friendship groups was related to relative improvements in social cognitive skills, prosocial behavior, and aggression, assessed through child interviews, teacher ratings, and peer sociometric nominations. Results from hierarchical linear models also revealed that the amount of peer escalation children received for their disruptive behavior during sessions impeded some intervention gains, whereas mere exposure to other children's positive or negative behavior was rarely related to outcomes.

Aggression↗

The impact of tutoring on early reading achievement for children with and without attention problems.

This study examined whether the benefits of reading tutoring in first grade were moderated by children's level of attention problems. Participants were 581 children from the intervention and control samples of Fast Track, a longitudinal multisite investigation of the development and prevention of conduct problems. Standardized reading achievement measures were administered after kindergarten and 1st grade, and teacher ratings of attention problems were obtained during 1st grade. During 1st grade, intervention participants received three 30-min tutoring sessions per week to promote the development of initial reading skills. Results replicated prior findings that attention problems predict reduced 1st grade reading achievement, even after controlling for IQ and earlier reading ability. Intervention was associated with modest reading achievement benefits for inattentive children without early reading difficulties, and substantial benefits for children with early reading difficulties who were not inattentive. It had no discernible impact, however, for children who were both inattentive and poor early readers. Results underscore the need to develop effective academic interventions for inattentive children, particularly for those with co-occurring reading difficulties.

Attention Deficit Disorder with Hyperactivity↗

The effects of the fast track program on serious problem outcomes at the end of elementary school.

This study examines the effects of the Fast Track program, which is a multicomponent, intensive intervention for children with early-onset conduct problems and continues from 1st grade through high school. Prior research has shown that Fast Track produces small positive effect sizes on children's social and behavioral outcomes at the end of 1st and 3rd grades in comparison to control children. This study addresses the important question of whether this intervention reduces cases of serious problems that can occur during the 4th- and 5th-grade years. Fast Track did have a significant but modest influence on children's rates of social competence and social cognition problems, problems with involvement with deviant peers, and conduct problems in the home and community, compared to children in the control condition. There was no evidence of intervention impact on children's serious problems in the school setting at Grades 4 and 5. This evaluation indicates that Fast Track has continued to influence certain key areas of children's adjustment throughout the elementary school years, reducing children's likelihood of emerging as cases with problems in their social, peer, or home functioning. The stage is set to examine potential prevention effects on these youths' serious antisocial behaviors during adolescence.

Achievement↗

Mediators of the relation between maternal depressive symptoms and child internalizing and disruptive behavior disorders.

Drawing on a normative sample of 224 youth and their biological mothers, this study tested 4 family variables as potential mediators of the relationship between maternal depressive symptoms in early childhood and child psychological outcomes in preadolescence. The mediators examined included mother-child communication, the quality of the mother-child relationship, maternal social support, and stressful life events in the family. The most parsimonious structural equation model suggested that having a more problematic mother-child relationship mediated disruptive behavior-disordered outcomes for youths, whereas less maternal social support mediated the development of internalizing disorders. Gender and race were tested as moderators, but significant model differences did not emerge between boys and girls or between African American and Caucasian youths.

Attention Deficit and Disruptive Behavior Disorder↗

Using the Fast Track randomized prevention trial to test the early-starter model of the development of serious conduct problems.

The Fast Track prevention trial was used to test hypotheses from the Early-Starter Model of the development of chronic conduct problems. We randomly assigned 891 high-risk first-grade boys and girls (51% African American) to receive the long-term Fast Track prevention or not. After 4 years, outcomes were assessed through teacher ratings, parent ratings, peer nominations, and child self-report. Positive effects of assignment to intervention were evident in teacher and parent ratings of conduct problems, peer social preference scores, and association with deviant peers. Assessments of proximal goals of intervention (e.g., hostile attributional bias, problem-solving skill, harsh parental discipline, aggressive and prosocial behavior at home and school) collected after grade 3 were found to partially mediate these effects. The findings are interpreted as consistent with developmental theory.

Age Factors↗

Child, parent, and peer predictors of early-onset substance use: a multisite longitudinal study.

The purpose of this study was to identify kindergarten-age predictors of early-onset substance use from demographic, environmental, parenting, child psychological, behavioral, and social functioning domains. Data from a longitudinal study of 295 children were gathered using multiple-assessment methods and multiple informants in kindergarten and 1st grade. Annual assessments at ages 10, 11, and 12 reflected that 21% of children reported having initiated substance use by age 12. Results from longitudinal logistic regression models indicated that risk factors at kindergarten include being male, having a parent who abused substances, lower levels of parental verbal reasoning, higher levels of overactivity, more thought problems, and more social problem solving skills deficits. Children with no risk factors had less than a 10% chance of initiating substance use by age 12, whereas children with 2 or more risk factors had greater than a 50% chance of initiating substance use. Implications for typology, etiology, and prevention are discussed.

Adolescent↗

Peer rejection and aggression and early starter models of conduct disorder.

Peer rejection and aggression in the early school years were examined for their relevance to early starting conduct problems. The sample of 657 boys and girls from 4 geographical locations was followed from 1st through 4th grades. Peer rejection in 1st grade added incrementally to the prediction of early starting conduct problems in 3rd and 4th grades, over and above the effects of aggression. Peer rejection and aggression in 1st grade were also associated with the impulsive and emotionally reactive behaviors found in older samples. Being rejected by peers subsequent to 1st grade marginally added to the prediction of early starting conduct problems in 3rd and 4th grades, controlling for 1st grade ADHD symptoms and aggression. Furthermore, peer rejection partially mediated the predictive relation between early ADHD symptoms and subsequent conduct problems. These results support the hypothesis that the experience of peer rejection in the early school years adds to the risk for early starting conduct problems.

Aggression↗

Early identification of children at risk for costly mental health service use.

Children and adolescents with serious and persistent conduct problems often require large public expenditures. Successfully diverting one high risk child from unfortunate outcomes may result in a net savings to society of nearly $2 million, not to mention improving the life of that child and his or her family. This figure highlights the potential of prevention, which often rests on the ability to identify these children at a young age. This study examined the ability of a short conduct-problems screening procedure to predict future need for mental health assistance, special education services, and the juvenile justice system during elementary school ages. The screen was based on teacher and parent report of child behavioral habits in kindergarten, and was used to identify children as either at risk or not at risk for behavioral problems. Service outcomes were derived from a service-use assessment administered to parents at the end of the sixth grade, while special education information was gathered through a survey of school records. Study participants (463 kindergarten children; 54% male, 44% African American) were from economically disadvantaged neighborhoods in four diverse communities across the United States. Results indicated that, while controlling for demographic background variables, the risk indicator strongly predicted which children would require services related to conduct disorder or behavioral/emotional problems. Additional analyses revealed that the dichotomous high risk indicator was nearly as strong as the continuous screening variable in predicting the service-use outcomes, and that the screening of both parents and teachers may not be necessary for determining risk status.

Adolescent↗

Multidimensional latent-construct analysis of children's social information processing patterns: correlations with aggressive behavior problems.

Social information processing (SIP) patterns were conceptualized in orthogonal domains of process and context and measured through responses to hypothetical vignettes in a stratified sample of 387 children (50% boys; 49% minority) from 4 geographical sites followed from kindergarten through 3rd grade. Multidimensional, latent-construct, confirmatory factor analyses supported the within-construct internal consistency, cross-construct discrimination, and multidimensionality of SIP patterns. Contrasts among nested structural equation models indicated that SIP constructs significantly predicted children's aggressive behavior problems as measured by later teacher reports. The findings support the multidimensional construct validity of children's social cognitive patterns and the relevance of SIP patterns in children's aggressive behavior problems.

Aggression↗

Predictors and consequences of aggressive-withdrawn problem profiles in early grade school.

Identified first-grade children who exhibited 4 different behavior problem profiles from an initial sample of 754: aggressive-withdrawn (n = 63.8%) aggressive only (n = 165, 22%), withdrawn only (n = 94, 12%), and nonproblem (n = 432, 57%). Group comparisons revealed that children who became aggressive-withdrawn in first grade exhibited deficits in attention and social skills in kindergarten. Furthermore, these kindergarten deficits contributed to the emergence of their aggressive-withdrawn behavior problems in first grade, after accounting for kindergarten levels of aggressive and withdrawn behaviors. In later grades, aggressive-withdrawn first-grade children were more likely than children in any other group to demonstrate poor peer relations and poor academic performance. In addition, kindergarten skill deficits added to first-grade aggressive and withdrawn behavior problems to predict third-grade social and academic adjustment difficulties. The results document the key role of early inattention and social skill deficits in the prediction of aggressive-withdrawn problem profiles, validate the significance of this problem profile at school entry, and identify potential developmental mechanisms that have implications for preventive interventions.

Achievement↗

Friendship as a moderating factor in the pathway between early harsh home environment and later victimization in the peer group. The Conduct Problems Prevention Research Group.

Two prospective investigations of the moderating role of dyadic friendship in the developmental pathway to peer victimization are reported. In Study 1, the preschool home environments (i.e., harsh discipline, marital conflict, stress, abuse, and maternal hostility) of 389 children were assessed by trained interviewers. These children were then followed into the middle years of elementary school, with peer victimization, group social acceptance, and friendship assessed annually with a peer nomination inventory. In Study 2, the home environments of 243 children were assessed in the summer before 1st grade, and victimization, group acceptance, and friendship were assessed annually over the next 3 years. In both studies, early harsh, punitive, and hostile family environments predicted later victimization by peers for children who had a low number of friendships. However, the predictive associations did not hold for children who had numerous friendships. These findings provide support for conceptualizations of friendship as a moderating factor in the pathways to peer group victimization.

Child↗