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The relation between the age at diagnosis of problem behaviors related to aggression and distal outcomes in Swedish children

  • Ian Campbell
  • Sebastian Lundstrom
  • Hendrik Larsson
  • Paul Lichtenstein
  • Gitta Lubke
Original Contribution
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Abstract

Severe childhood aggressive behaviors are known to predict negative outcomes later in life; however, little is known about the effect of when in childhood aggression problems are diagnosed. While an earlier first diagnosis of problematic aggressive behavior might be associated with increased severity and, thus, worse outcomes, it is also possible that an earlier diagnosis affords an earlier start of treatment programs or indicates that greater attention is being paid to behavioral problems, thus resulting in attenuation of the severity of childhood aggression’s impact on distal outcomes. The current study analyzed data from the population-based Swedish Data Registries, which include data on all children formally diagnosed by the Swedish medical system with a wide range of aggression problems between ages 8 and 18 (N = 5816) during the years 1987–2013, along with a matched control. Time-to-event analyses investigated whether the age at time of diagnosis affects later life outcomes while controlling for relevant confounders. Results show that for both boys and girls, those with a later diagnosis had lower average incomes (regression coefficient b = − 0.055, p < 0.005) and a higher probability of having a criminal record (odds ratio 1.126, p < 0.005) than children with earlier diagnoses. The effect on suicide attempts was not significant after correcting for multiple testing (odds ratio 1.264, p = 0.016). Grade score was not significantly affected. The results warrant further research concerning the potential advantage of earlier diagnoses, especially concerning generalizability beyond the Swedish population.

Keywords

Childhood aggression Conduct disorder Time-to-event analysis Swedish data registry 
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Notes

Acknowledgements

This work was supported in part by funding from the European Union Seventh Framework Program (FP7/2007–2013) under Grant agreement no 602768, and a Grant from the National Science Foundation (NSF) Graduate Research Fellowship Program under Grant no. DGE-1313583. The content is solely the responsibility of the authors and does not represent the official views of the EU or the NSF.

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Supplementary material

787_2018_1250_MOESM1_ESM.docx (128 kb)
Supplementary material 1 (DOCX 128 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Ian Campbell
    • 1
  • Sebastian Lundstrom
    • 2
  • Hendrik Larsson
    • 3
  • Paul Lichtenstein
    • 3
  • Gitta Lubke
    • 1
  1. 1.Department of PsychologyUniversity of Notre DameNotre DameUSA
  2. 2.Institute of Neuroscience and Physiology, Centre for Ethics Law and Mental Health, Gillberg Neuropsychiatry CentreUniversity of GothenburgGothenburgSweden
  3. 3.Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden

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