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Relational Aggression in Adolescents with Conduct Disorder: Sex Differences and Behavioral Correlates

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Abstract

As most research on conduct disorder (CD) has been conducted on male participants, it has been suggested that female-specific symptoms may be underestimated based on current DSM-5 criteria. In particular, relational aggression, i.e. the hurtful, often indirect, manipulation of relationships with the intention of damaging the other’s social position, has been proposed as a characteristic of CD that is more common in females. In addition, sex-specific studies on correlates of relational aggressive behavior are lacking. Relational aggression may be strongly related to the correlates of proactive aggression, namely low affective empathy, and high levels of callous-unemotional (CU) traits and relational victimization. Thus, the present study investigated sex differences in relational aggression, and associations between relational aggression and correlates of proactive aggression in 662 adolescents with CD (403 females) and 849 typically-developing controls (568 females) aged 9–18 years (M = 14.74, SD = 2.34) from the European multi-site FemNAT-CD study. Females with CD showed significantly higher levels of relational aggression compared to males with CD, whereas no sex differences were seen in controls. Relational aggression was only partly related to correlates of proactive aggression in CD: Independent of sex, CU traits showed a positive association with relational aggression. In females only, cognitive, but not affective empathy, was negatively associated with relational aggression. Relational victimization was more strongly associated with relational aggression in males compared to females. Despite interesting sex specific correlates of relational aggression, effects are small and the potential clinical implications should be investigated in future studies.

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Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstraße 50, 60528, Frankfurt am Main, Germany

    Katharina Ackermann, Anka Bernhard, Anne Martinelli & Christine M. Freitag

  2. Department of Medical Biometry, Institute of Medical Biometry and Informatics (IMBI), Heidelberg University, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany

    Marietta Kirchner & Ronald Limprecht

  3. Children and Adolescents Mental Health Unit of Athens University, Thivon & Mikras Asias, 11527, Athens, Greece

    Chrysanthi Anomitri & Helen Lazaratou

  4. School of Psychology, Centre for Human Brain Health, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK

    Rosalind Baker, Jack C. Rogers & Stephane A. De Brito

  5. Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Neuenhofer Weg 21, 52074, Aachen, Germany

    Sarah Baumann, Beate Herpertz-Dahlmann, Gregor Kohls & Kerstin Konrad

  6. Faculty of Medicine, Child and Adolescent Psychiatry, Department of the Child Health Center, Szeged University, Boldogasszony sgt. 15, Szeged, 6725, Hungary

    Roberta Dochnal, Kristina Kapornai & Réka Siklósi

  7. Basurto University Hospital, Avda. Montevideo 18, 48013, Bilbao, Vizcaya, Spain

    Aranzazu Fernandez-Rivas & Esther Vivanco-Gonzalez

  8. Department of Psychology, University of Southampton, Highfield, Southampton, SO17 1BJ, UK

    Karen Gonzalez-Madruga

  9. Child and Adolescent Mental Health Unit, University Hospital Mutua Terrassa, Plaza Dr Robert 5, 08221, Terrassa, Spain

    Amaia Hervas

  10. Departments of Child and Adolescent Psychiatry, VU University Medical Centre, De Boelelaan 1117, 1081, Amsterdam, HV, Netherlands

    Lucres Jansen, Helena Oldenhof & Arne Popma

  11. Department of Child and Adolescent Psychiatry, University of Basel Psychiatric Hospital, Petersplatz 1, 4003, Basel, Switzerland

    Linda Kersten & Christina Stadler

  12. Department of Psychiatry, St. James Hospital, James’s Street, Dublin, 8, Ireland

    Ana McLaughlin

  13. Centre for Addiction and Mental Health, Toronto, Ontario, M5T1R8, Canada

    Areti Smaragdi

  14. Department of Psychology, University of Bath, Claverton Down Bath, BA2 7AY, UK

    Graeme Fairchild

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Correspondence to Katharina Ackermann.

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Author C.M Freitag declares royalties on books on ASD, ADHD, and MDD and is consultant for Roche and Desitin (ASD). Author G. Fairchild has received funding from the European Commission, the MRC, ESRC, CONACYT and Kids’ Company.

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Ackermann, K., Kirchner, M., Bernhard, A. et al. Relational Aggression in Adolescents with Conduct Disorder: Sex Differences and Behavioral Correlates. J Abnorm Child Psychol 47, 1625–1637 (2019). https://doi.org/10.1007/s10802-019-00541-6

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