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Biomedical subjects

R Loeber

Publications and source records attributed to R Loeber.

16 recordsLinked to original sources
PubMed1992

Familial risk factors to oppositional defiant disorder and conduct disorder: parental psychopathology and maternal parenting.

In a sample of 177 clinic-referred children aged 7-13, an association was found between a diagnosis of conduct disorder (CD) and several aspects of family functioning: maternal parenting (supervision and persistence in discipline) and parental adjustment (paternal antisocial personality disorder and paternal substance abuse). Children with oppositional defiant disorder (ODD) were intermediate to families of children with CD and clinic control children on all variables, but differed from control children only in having a higher rate of paternal substance abuse and paternal antisocial personality disorder (APD). When both parental APD and deviant maternal parenting were entered into 2 x 2 logit-model analyses predicting CD, only parental APD was significantly associated with CD, and no interactions between parental adjustment and maternal parenting were found. The importance of these findings for understanding the etiology of CD and for disentangling correlated risk factors in future studies is discussed.

Antisocial Personality Disorder↗
PubMed1992

Oppositional defiant and conduct disorders: issues to be resolved for DSM-IV.

Oppositional defiant disorder (ODD) and conduct disorder (CD) are reasonably distinct both in terms of statistical covariation among symptoms and ages of onset. The two disorders are related in similar ways to impairment and family history of antisocial behavior, but the association is stronger for CD than ODD. Virtually all clinic-referred youths with prepubertal onset of CD have retained the symptoms of ODD that emerged at earlier ages. Furthermore, a set of serious antisocial behaviors characteristically emerges at later ages in some youths with CD, suggesting further developmental progression within CD. These findings are consistent with a conceptualization of ODD and CD as developmentally staged, hierarchically organized levels of severity of the same disorder, but two findings argue for distinguishing separate disorders in DSM-IV: (1) many youths with ODD never develop CD, and (2) CD that emerges for the first time in adolescence appears to be independent of ODD.

Acting Out↗
PubMed1992

The nuts and bolts of implementing large-scale longitudinal studies.

Studies that assess large numbers of subjects for longitudinal research, for epidemiological purposes, or for the evaluation of prevention and intervention efforts, are very costly and should be undertaken with the greatest care to ensure their success. The success of a study, apart from its scientific merit, depends largely on the ability of the researcher to plan and set up a smoothly running operation. However, the skills required for such a task are often not acquired in academic training, nor do scientific journals abound with information on the practical aspects of running a large study. This paper summarizes the experience gained in executing a longitudinal study and covers aspects of planning, hiring of staff, training and supervision of interviewers, data collection and data entry and management. The importance of the use of the computer as a management tool is stressed.

Adolescent↗
PubMed1991

Differences and similarities between children, mothers, and teachers as informants on disruptive child behavior.

Prevalence rates of disruptive child behaviors, based on structured psychiatric interviews, are presented for samples of clinic-referred prepubertal boys at two sites to investigate differences and similarities among reports of the behaviors from children, parents, and teachers. Children reported significantly less hyperactive/inattentive and oppositional behaviors than either parents or teachers. In contrast, children did not differ from parents or teachers in their report on the prevalence of more serious conduct problems. These results were well replicated across two sites, despite the fact that there were significant differences between the sites in the level of hyperactive/inattentive child behaviors and conduct problems. The ranking of parents' and teachers' reported prevalence of specific child behavior problems in each of the three domains of disruptive behavior was strikingly similar. With one exception, the concordance between the prevalence ranking based on the children's reports was lower than that based on adults' reports, Children's reports on their own behavior did not predict various child handicaps 1 year later as well as did adults' reports. The results are discussed in relation to the usefulness of certain child behaviors in symptom lists for diagnostic purposes; the reliability of children's reports on their own behavior; and the possible reasons why prevalence rankings, as perceived by adults, are so similar.

Attention Deficit Disorder with Hyperactivity↗
PubMed1991

Disruptive boys with stable and unstable high fighting behavior patterns during junior elementary school.

Boys' fighting was assessed at ages six, eight, and nine. The boys (N = 69) had been selected from the 30% most disruptive children in kindergartens from low socioeconomic neighborhoods. Twenty-three percent of these disruptive boys were rated as high fighters on three assessments ("stable high fighters"), and 28% were rated as high fighters on two of the three assessments ("variable high fighters"). Forty-two percent were rated as high fighters only one out of three assessments ("occasional high fighters") and 7% were never rated as high fighters. Only high fighting in two successive years significantly increased the risk of being rated a high fighter in a following year. At age 10, stable high fighters (high fighters at ages 6, 8, 9) were perceived by teachers, peers, mothers, and the boys themselves as more disruptive and more antisocial than occasional high fighters. These results show an impressive self-other agreement in boys who have adopted a physically aggressive life style from an early age. The three groups did not differ on individual family demographic characteristics, but stable high fighters had a higher mean on an index of family socioeconomic disadvantage. Results indicate that the aggression scales which include only a few physical aggression items and many disruptive items (oppositional behavior, rejection, hyperactivity, inattention, etc.) probably aggregate two kinds of disruptive boys, the high-frequency fighters at high risk for stable disruptive, physically aggressive, and antisocial behaviors, and the disruptive low-frequency fighters who are at a lower risk of stable disruptive behavior and at a lower risk of early antisocial behavior.

Aggression↗
PubMed1991

Diagnostic conundrum of oppositional defiant disorder and conduct disorder.

Evidence for a diagnostic distinction of oppositional defiant disorder (ODD) and conduct disorder (CD) is reviewed, and alternative conceptualizations and definitions for the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders are considered. Studies suggest that CD and ODD are strongly and developmentally related but clearly different. Factor analyses indicate that distinct covarying groups of ODD and CD symptoms can be identified, but certain symptoms relate to both (particularly mild aggression and lying). Age of onset for ODD is earlier than for most CD symptoms. Nearly all youths with CD have a history of ODD, but not all ODD cases progress to CD. The disorders demonstrate the same forms of parental psychopathology and family adversity but to a greater degree for CD than for ODD. Alternative conceptualizations for the disorders are presented for further study before the introduction of the DSM-IV.

Aggression↗
PubMed1991

Stability of mothers' recall of the age of onset of their child's attention and hyperactivity problems.

The stability of mothers' recall of age of onset of attention deficit and hyperactive behaviors was assessed over a 1-year interval. The paper reports on which behaviors have the highest stability and the stability of a psychiatric diagnosis of attention deficit hyperactive disorder using different age cut-offs. The data showed a moderate degree of stability over a 1-year period, with school-related symptoms showing the least amount of change. An argument is made for keeping the current DSM-III-R diagnostic cut-off at age 6.

Attention↗
PubMed1991

Anxiety, inhibition, and conduct disorder in children: I. Relations to social impairment.

Jeffrey A. Gray has proposed a model in which conduct disorder (CD) is viewed as the result of both excessive activity of a behavioral activation system that mediates appetitive and aggressive behavior and deficient activity of a behavioral inhibition system that mediates both anxiety and the inhibition of behavior in the presence of cues signalling impending punishment or frustration. The relation of anxiety to antisocial behavior was examined in 177 clinic-referred boys, aged 7 to 12 years, 68 of whom met DSM-III-R criteria for CD. As predicted by Gray's model, boys with CD and comorbid anxiety disorder were markedly less impaired than boys with CD alone.

Aggression↗
PubMed1991

Anxiety, inhibition, and conduct disorder in children: II. Relation to salivary cortisol.

The relation of symptoms of conduct disorder (CD) and anxiety to salivary cortisol was explored in 67 clinic-referred boys aged 8 to 13 years. Children with anxiety disorder had higher levels of cortisol, but this main effect was qualified by a significant CD x anxiety disorder interaction. Consistent with Gray's biological model of the behavioral inhibition system (BIS), children with both CD and anxiety disorder had higher levels of salivary cortisol than children with CD without comorbid anxiety disorder. In the absence of CD, however, anxiety disorder was not clearly associated with higher cortisol. This result suggests that cortisol may be a useful biological marker of arousal associated with BIS activity in children with CD.

Adolescent↗
PubMed1991

Antisocial behavior: more enduring than changeable?

This paper challenges the notion that many children outgrow early conduct problems. It explores factors that may have led to researchers' underestimating the stability of antisocial behaviors, especially because these behaviors manifest themselves differently in various phases of the life course. In addition, data suggest that the malleability of child behaviors decreases as children grow older, contributing to a higher continuity of antisocial behavior possibly from early adolescence onward. Implications are discussed for the study and intervention of antisocial behavior.

Adolescent↗
PubMed1991

Pervasive and situational hyperactivity--confounding effect of informant: a research note.

Several studies of children with problems of hyperactivity, impulsivity, and inattention (HIA) have suggested that when such behaviour occurs in more than one setting, associated conduct problems, emotional symptoms, and functional impairment are more serious than when HIA problems are seen in one situation only. Analyses of parent and teacher reports on a community sample of 480 children aged 7-11 are presented to show that in some cases this conclusion may have resulted from a confound between informant and information. When children with situational HIA were divided into 'home situational' and 'school situational' subgroups, their scores on other measures of psychopathology and impairment varied, depending on whether the informant was the parent or the teacher. When the source of information was independent of parents' or teachers' judgments, no differences were found between situationally and pervasively HIA children. Implications for future studies of situational and prevasive HIA are discussed.

Affective Symptoms↗
PubMed1990

Serious conduct problems in the children of adolescent mothers: disentangling confounded correlations.

Early motherhood (less than 20 years of age) was found to be significantly correlated (r = .33) with the number of DSM-III symptoms of conduct disorder in a sample of 253 boys aged 6-13 years who had been referred to outpatient clinics. The following models were compared using path analysis: (a) Teenage motherhood, parental antisocial personality, and SES each contribute uniquely to the prediction of childhood conduct problems; (b) teenage motherhood mediates the association of SES and parental antisocial personality with child conduct problems; and (c) teenage motherhood is spuriously related with child conduct problems because of common associations with SES and parental antisocial personality. Model (c) best fit our data. Similar results were obtained whether maternal age at the birth of the firstborn child or the proband child was used to define maternal age and when teenage motherhood was defined as giving birth at less than 18 years.

Adolescent↗
PubMed1990

Comparison of DSM-III and DSM-III-R diagnoses for prepubertal children: changes in prevalence and validity.

A structured and reliable diagnostic procedure based on a revised version of the Diagnostic Interview Schedule for Children for children, parents, and teachers was used to assign both DSM-III and DSM-III-R diagnoses to 177 outpatient boys aged 7 to 12 years. Compared to their DSM-III counterparts, DSM-III-R oppositional defiant disorder was 25.5% less prevalent, DSM-III-R dysthymia was 37.8% less prevalent, and DSM-III-R conduct disorder (CD) was 44.3% less prevalent. However, DSM-III-R attention deficit hyperactivity disorder was 14.4% more prevalent than DSM-III attention deficit disorder with hyperactivity. The two definitions of CD were compared to exemplify an empirical approach to diagnostic validation. The DSM-III-R diagnosis of CD appears to be more valid as it is more strongly associated with police contacts, school suspensions, and history of antisocial personality disorder in the biological father, but both CD diagnoses are associated with family histories of criminal convictions.

Child↗