European Child & Adolescent Psychiatry

, Volume 19, Issue 7, pp 577–585 | Cite as

Predicting adult emotional and behavioral problems from externalizing problem trajectories in a 24-year longitudinal study

  • Joni ReefEmail author
  • Sofia Diamantopoulou
  • Inge van Meurs
  • Frank Verhulst
  • Jan van der Ende
Original Contribution


The aim of this study was to examine the prediction of adult behavioral and emotional problems from developmental trajectories of externalizing behavior in a 24-years longitudinal population-based study of 2,076 children. The adult psychiatric outcome of these trajectories has not yet been examined. Trajectories of the four externalizing behavior types: aggression, opposition, property violations and status violations were determined separately through latent class growth analysis using data of five waves, covering ages 4–18 years. We used regression analyses to determine the associations between children’s trajectories and adults’ psychiatric problems based on the Adult Self-Report. The developmental trajectories of the four types of externalizing behavior mostly predicted intrusive, aggressive and rule-breaking behavior in adulthood. Non-destructive behaviors in childhood such as opposition and status violations predict adult problems to a larger extent than destructive behaviors such as aggression and property violations. In general, children who develop through high-level trajectories are likely to suffer from both internalizing and externalizing problem behavior in adulthood, regardless the direction of change (i.e. increasing/decreasing/persisting) of the high-level trajectory. We can conclude that the level rather than the developmental change of externalizing behavior problems has a larger impact on adult outcome.


Externalizing behavior Child behavior checklist Trajectory Longitudinal development Adult Self-Report 


  1. 1.
    Achenbach TM (1991) Manual for the child behavior checklist/4–18 and 1991 child profile. Department of Psychiatry, University of Vermont, BurlingtonGoogle Scholar
  2. 2.
    Achenbach TM (1997) Manual for the young adult self-report and young adult behavior checklist. Department of Psychiatry, University of Vermont, BurlingtonGoogle Scholar
  3. 3.
    Achenbach TM, Dumenci L, Rescorla LA (2001) Ratings of relations between DSM-IV diagnostic categories and items of the CBCL/6-18, TRF, and YSR. University of Vermont, Research center for children, youth, and families, Burlington, VermontGoogle Scholar
  4. 4.
    American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders (4th edn). Washington, DC, USAGoogle Scholar
  5. 5.
    Angold A, Costello EJ, Erkanli A (1999) Comorbidity. J Child Psychol Psychiatry 40:57–87CrossRefPubMedGoogle Scholar
  6. 6.
    Bongers IL, Koot HM, van der Ende J, Verhulst FC (2004) Developmental trajectories of externalizing behaviors in childhood and adolescence. Child Dev 75:1523–1537CrossRefPubMedGoogle Scholar
  7. 7.
    Bongers IL, Koot HM, van der Ende J, Verhulst FC (2003) The normative development of child and adolescent problem behavior. J Abnorm Psychol 112:179–192CrossRefPubMedGoogle Scholar
  8. 8.
    Bongers IL, Koot HM, van der Ende J, Verhulst FC (2008) Predicting young adult social functioning from developmental trajectories of externalizing behaviour. Psychol Med 38:989–999CrossRefPubMedGoogle Scholar
  9. 9.
    Brame B, Nagin DS, Tremblay RE (2001) Developmental trajectories of physical aggression from school entry to late adolescence. J Child Psychol Psychiatry 42:503–512CrossRefPubMedGoogle Scholar
  10. 10.
    Broidy LM, Nagin DS, Tremblay RE, Bates JE, Brame B, Dodge KA, Fergusson D, Horwood JL, Loeber R, Laird R, Lynam DR, Moffitt TE, Pettit GS, Vitaro F (2003) Developmental trajectories of childhood disruptive behaviors and adolescent delinquency: a six-site, cross-national study. Develop Psychol 39:222–245CrossRefGoogle Scholar
  11. 11.
    Dodge KA, Coie JD (1987) Social-information-processing factors in reactive and proactive aggression in children’s peer groups. J Pers Soc Psychol 53:1146–1158CrossRefPubMedGoogle Scholar
  12. 12.
    Dodge KA, Lochman JE, Harnish JD, Bates JE, Pettit GS (1997) Reactive and proactive aggression in school children and psychiatrically impaired chronically assaultive youth. J Abnorm Psychol 106:37–51CrossRefPubMedGoogle Scholar
  13. 13.
    Fergusson DM, Horwood LJ, Ridder EM (2007) Conduct and attentional problems in childhood and adolescence and later substance use, abuse and dependence: results of a 25-year longitudinal study. Drug Alcohol Depend 88(Suppl 1):S14–S26CrossRefPubMedGoogle Scholar
  14. 14.
    Fergusson DM, Horwood LJ, Ridder EM (2005) Show me the child at seven: the consequences of conduct problems in childhood for psychosocial functioning in adulthood. J Child Psychol Psychiatry 46:837–849CrossRefPubMedGoogle Scholar
  15. 15.
    Frick PJ, Lahey BB, Loeber R, Tannenbaum L, Van Horn Y, Christ MAG, Hart EL, Hanson K (1993) Oppositional defiant disorder and conduct disorder: a meta-analytic review of factor analyses and cross-validation in a clinic sample. Clin Psychol Rev 13:319–340CrossRefGoogle Scholar
  16. 16.
    Kim-Cohen J, Caspi A, Moffit TE, Harrington H, Milne BJ, Poulton R (2003) Prior Juvenile diagnoses in adults with mental disorder. Arch Gen Psychiatry 60:709–717CrossRefPubMedGoogle Scholar
  17. 17.
    Mannuzza S, Klein RG, Moulton JL 3rd (2008) Lifetime criminality among boys with attention deficit hyperactivity disorder: a prospective follow-up study into adulthood using official arrest records. Psychiatry Res 160:237–246CrossRefPubMedGoogle Scholar
  18. 18.
    Moffitt TE (1993) Adolescence-limited and life-course-persistent antisocial behavior: a developmental taxonomy. Psychol Rev 100:674–701CrossRefPubMedGoogle Scholar
  19. 19.
    Moffitt TE, Caspi A (2001) Childhood predictors differentiate life-course persistent and adolescence-limited antisocial pathways among males and females. Develop Psychopathol 13:355–375CrossRefGoogle Scholar
  20. 20.
    Moffitt TE, Caspi A, Harrington H, Milne BJ (2002) Males on the life-course-persistent and adolescence-limited antisocial pathways: follow-up at age 26 years. Develop Psychopathol 14:179–207CrossRefGoogle Scholar
  21. 21.
    Nagin DS (1999) Analyzing developmental trajectories: a semiparametric, group-based approach. Psychol Methods 4:139–157CrossRefGoogle Scholar
  22. 22.
    Nagin DS, Tremblay RE (1999) Trajectories of boys’ physical aggression, opposition, and hyperactivity on the path to physically violent and nonviolent juvenile delinquency. Child Dev 70:1181–1196CrossRefPubMedGoogle Scholar
  23. 23.
    Nock MK, Kazdin AE, Hiripi E, Kessler RC (2007) Lifetime prevalence, correlates, and persistence of oppositional defiant disorder: results from the National Comorbidity Survey Replication. J Child Psychol Psychiatry 48:703–713CrossRefPubMedGoogle Scholar
  24. 24.
    Odgers CL, Caspi A, Broadbent JM, Dickson N, Hancox RJ, Harrington H, Poulton R, Sears MR, Thomson WM, Moffitt TE (2007) Prediction of differential adult health burden by conduct problem subtypes in males. Arch Gen Psychiatry 64:476–484CrossRefPubMedGoogle Scholar
  25. 25.
    Odgers CL, Moffitt TE, Broadbent JM, Dickson N, Hancox RJ, Harrington H, Poulton R, Sears MR, Thomson WM, Caspi A (2008) Female and male antisocial trajectories: from childhood origins to adult outcomes. Develop Psychopathol 20:673–716CrossRefGoogle Scholar
  26. 26.
    Roisman GI, Aguilar B, Egeland B (2004) Antisocial behavior in the transition to adulthood: the independent and interactive roles of developmental history and emerging developmental tasks. Develop Psychopathol 16:857–871CrossRefGoogle Scholar
  27. 27.
    Simonoff E, Elander J, Holmshaw J, Pickles A, Murray R, Rutter M, Silberg J, O’Connor T, Meyer J, Maes H (2004) Predictors of antisocial personality: continuities from childhood to adult life. Br J Psychiatry 184:118–127CrossRefPubMedGoogle Scholar
  28. 28.
    Sourander A, Jensen P, Davies M, Niemela S, Elonheimo H, Ristkari T, Helenius H, Sillanmaki L, Piha J, Kumpulainen K, Tamminen T, Moilanen I, Almqvist F (2007) Who is at greatest risk of adverse long-term outcomes? The Finnish from a Boy to a Man study. J Am Acad Child Adolesc Psychiatry 46:1148–1161CrossRefPubMedGoogle Scholar
  29. 29.
    Stanger C, Achenbach TM, Verhulst FC (1997) Accelerated longitudinal comparisons of aggressive versus delinquent syndromes. Develop Psychopathol 9:43–58CrossRefGoogle Scholar
  30. 30.
    Timmermans M, van Lier PA, Koot HM (2008) Which forms of child/adolescent externalizing behaviors account for late adolescent risky sexual behavior and substance use? J Child Psychol Psychiatry 49:386–394CrossRefPubMedGoogle Scholar
  31. 31.
    Tremblay RE (2000) The development of aggressive behaviour during childhood: what have we learned in the past century? Int J Behav Develop 24:129–141CrossRefGoogle Scholar
  32. 32.
    Van Meurs I, Reef J, Verhulst F, van der Ende J (2008) Intergenerational transmission of child problem behaviors: a longitudinal, population-based study. J Am Acad Child Adolesc Psychiatry 48(2):138–145CrossRefGoogle Scholar
  33. 33.
    van Westerlaak JH, Kropman JA, Collaris JWM (1975) Beroepenklapper (Manual for occupational level). Instituut voor Sociologie, NijmegenGoogle Scholar
  34. 34.
    Vanheusden K, van der Ende J, Mulder CL, van Lenthe FJ, Verhulst FC, Mackenbach JP (2009) Beliefs about mental health problems and help-seeking behavior in Dutch young adults. Soc Psychiatry Psychiatr Epidemiol 44:239–246CrossRefPubMedGoogle Scholar
  35. 35.
    Verhulst FC, van der Ende J, Koot HM (1996) Handleiding voor de CBCL/4-18 (Manual for the CBCL/4-18). Erasmus University/Department of Child and Adolescent Psychiatry, Sophia Children’s Hospital, RotterdamGoogle Scholar
  36. 36.
    Vitaro F, Brendgen M, Tremblay R (2002) Reactively and proactively aggressive children: antecedent and subsequent characteristics. J Child Psychol Psychiatry 43:495–505CrossRefPubMedGoogle Scholar
  37. 37.
    Zoccolillo M (1992) Cooccurrence of conduct disorder and its adult outcomes with depressive and anxiety disorders—a review. J Am Acad Child Adolesc Psychiatry 31:547–556CrossRefPubMedGoogle Scholar
  38. 38.
    Zoccolillo M, Pickles A, Quinton D, Rutter M (1992) The outcome of childhood conduct disorder: implications for defining adult personality disorder and conduct disorder. Psychol Med 22:971–986CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Joni Reef
    • 1
    Email author
  • Sofia Diamantopoulou
    • 1
  • Inge van Meurs
    • 1
  • Frank Verhulst
    • 1
  • Jan van der Ende
    • 1
  1. 1.Department of Child and Adolescent PsychiatryErasmus Medical Center-Sophia Children’s HospitalRotterdamThe Netherlands

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