Journal of Abnormal Child Psychology

, Volume 44, Issue 4, pp 677–690 | Cite as

Comorbid Development of Disruptive Behaviors from age 1½ to 5 Years in a Population Birth-Cohort and Association with School Adjustment in First Grade

  • Rene CarbonneauEmail author
  • Michel Boivin
  • Mara Brendgen
  • Daniel Nagin
  • Richard E. Tremblay


Comorbidity is frequent among disruptive behaviors (DB) and leads to mental health problems during adolescence and adulthood. However, the early developmental origins of this comorbidity have so far received little attention. This study investigated the developmental comorbidity of three DB categories during early childhood: hyperactivity-impulsivity, non-compliance, and physical aggression. Joint developmental trajectories of DB were identified based on annual mother interviews from age 1½ to 5 years, in a population-representative birth-cohort (N = 2045). A significant proportion of children (13 % to 21 %, depending on the type of DB) consistently displayed high levels of hyperactivity-impulsivity, non-compliance, or physical aggression from age 1½ to 5 years. Developmental comorbidity was frequent, especially for boys: 10 % of boys and 3.7 % of girls were on a stable trajectory with high levels of symptoms for the three categories of DB. Significant associations were observed between preschool joint-trajectories of DB and indicators of DB and school adjustment assessed by teachers in first grade. Preschoolers who maintained high levels of hyperactivity-impulsivity, non-compliance, and physical aggression, displayed the highest number of DB symptoms in first grade for all categories according to their teacher. They were also among the most disadvantaged of their class for school adjustment indicators. Thus, DB manifestations and developmental comorbidity of DB are highly prevalent in infancy. Early childhood appears to be a critical period to prevent persistent and comorbid DB that leads to impairment at the very beginning of school attendance and to long-term serious health and social adjustment problems.


Disruptive behaviors Trajectories Comorbidity Preschool years School entry 



We thank the Quebec Government Ministry of Health, the Fond Quebecois de la Recherche sur la Societe et la Culture, Canada’s Social Science and Humanities Research Council, the Canadian Institutes of Health Research St.-Justine Hospital’s Research Center, and the University of Montreal for financial support. Michel Boivin is supported by the Canada Research Chair Program.

We thank the families and teachers of the Quebec Longitudinal Study of Child Development (QLSCD) for their collaboration to this project; for data collection and management; Xuecheng Liu, Ph.D., for statistical expertise; as well as the Quebec Institute of Statistics, Mireille Jetté, and the staff of the Research Unit on Children’s Psychosocial Maladjustment for data collection and management.

Integrity of Research and Reporting

Informed consent has been appropriately obtained and Institutional Review Board of the University of Montreal provided ethical approval. Therefore this study has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Conflict of Interest

The authors declare that they have no conflict of interest.


  1. Achenbach, T. M. (1992). Manual for the Child Behavior Checklist/2–3 and 1992 Profile. Burlington:University of Vermont, Department of Psychiatry.Google Scholar
  2. Alatupa, S., Pulkki-Råback, L., Hintsanen, M., Mullola, S., Lipsanen, J., & Keltikangas-Järvinen, L. (2011). Childhood disruptive behaviour and school performance across comprehensive school: a prospective cohort study. Psychology, 2, 542–551.CrossRefGoogle Scholar
  3. Baillargeon, R. H., Keenan, K., & Cao, G. (2012a). The development of opposition-defiance during toddlerhood: a population-based cohort study. Journal of Developmental and Behavioral Pediatrics, 33, 608–617.CrossRefPubMedGoogle Scholar
  4. Baillargeon, R. H., Morisset, A., Keenan, K., Normand, C., Séguin, J. R., Japel, C., & Cao, G. (2012b). Development of disruptive behaviors in young children: a prospective population-based cohort study. Infant Mental Health Journal, 33, 633–650.CrossRefGoogle Scholar
  5. Baillargeon, R. H., Normand, C. L., Séguin, J. R., Zoccolillo, M., Japel, C., Pérusse, D., et al. (2007). The evolution of problem and social competence behaviors during toddlerhood: a prospective population-based cohort survey. Infant Mental Health Journal, 28, 12–38.CrossRefGoogle Scholar
  6. Basten, M., Tiemeier, H., Althoff, R. R., Van de Schoot, R., Jaddoe, V. W. V., Hofman, A., et al. (2015). The stability of problem behavior across the preschool years: an empirical approach in the general population. Journal of Abnormal Child Psychology. Advance Online publication. doi:. doi: 10.1007/s10802-015-9993-y.Google Scholar
  7. Bendiksen, B., Aase, H., Svensson, E., Friis, S., Myhre, A. M., Reichborn-Kjennerud, T., et al. (2014). Impairment in young preschool children with symptoms of attention-deficit/hyperactivity disorder and co-occurring oppositional defiant disorder and conduct disorder. Scandinavian Journal of Child and Adolescent Psychiatry and Psychology, 2, 95–105.Google Scholar
  8. Brennan, L.M., Shaw, D.S., Dishion, T.J., & Wilson, M.N. (2015). The predictive utility of early childhood disruptive behaviors for school-age social functioning. Journal of Abnormal Child Psychology, 43, 1187–1199.CrossRefPubMedPubMedCentralGoogle Scholar
  9. Brown, J. D. (1996). Testing in language programs. Upper Saddle River, NJ:Prentice Hall.Google Scholar
  10. Bufferd, S. J., Dougherty, L., Carlson, G., Rose, S., & Klein, D. (2012). Psychiatric disorders in preschoolers: continuity from ages 3 to 6. American Journal of Psychiatry, 169, 1157–1164.CrossRefPubMedPubMedCentralGoogle Scholar
  11. Bunte, T. L., Schoemaker, K., Hessen, D. J., van der Heijden, P. G. M., & Matthys, W. (2014). Stability and change of ODD, CD and ADHD diagnosis in referred preschool children. Journal of Abnormal Child Psychology, 42, 1213–1224.CrossRefPubMedGoogle Scholar
  12. Callender, J., & Osburn, H. (1979). An empirical comparison of coeficient alpha, guttman’s lambda2 and msplit maximized split-half reliability estimates. Journal of Educational Measurement, 16, 89–99.CrossRefGoogle Scholar
  13. Campbell, S. B., Spieker, S., Burchinal, M. R., Poe, M. D., & The, N. I. C. H. D. E. C. C. R. N. (2006). Trajectories of aggression from toddlerhood to age 9 predict academic and social functioning through age 12. Journal of Child Psychology and Psychiatry, 47, 791–800.CrossRefPubMedGoogle Scholar
  14. Campbell, S. B., Shaw, D. S., & Gilliom, M. (2000). Early externalizing behavior problems: toddlers and preschoolers at risk for later maladjustment. Development and Psychopathology, 12, 467–488.CrossRefPubMedGoogle Scholar
  15. Cherkasova, M., Sulla, E. M., Dalena, K. L., Pondé, M. P., & Hechtman, L. (2013). Developmental course of attention deficit hyperactivity disorder and its predictors. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 22, 47–54.CrossRefPubMedPubMedCentralGoogle Scholar
  16. Cohen, J. (1977). Statistical power analysis for behavioral sciences (revised ed., ). New York:Academic Press.Google Scholar
  17. Connor, D. F., Edwards, G., Fletcher, K. E., Baird, J., Barkley, R. A., & Steingard, R. J. (2003). Correlates of comorbid psychopathology in children with ADHD. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 193–200.CrossRefPubMedGoogle Scholar
  18. Costello, J. E., Egger, H., & Angold, A. (2005). 10-year research update review: the epidemiology of child and adolescent psychiatric disorders: I. Methods and Public health Burden. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 972–986.CrossRefPubMedGoogle Scholar
  19. Curchack-Lichtin, J. T., Chacko, A., & Halperin, J. M. (2014). Changes in ADHD symptom endorsement: preschool to school age. Journal of Abnormal Child Psychology, 42, 993–1004.CrossRefPubMedPubMedCentralGoogle Scholar
  20. Dougherty, L. R., Smith, V. C., Bufferd, S. J., Stringaris, A., Leibenluft, E., Carlson, G. A., & Klein, D. N. (2013). Preschool irritability: longitudinal associations with psychiatric disorders at age 6 and parental psychopathology. Journal of the American Academy of Child and Adolescent Psychiatry, 52, 1304–1313.CrossRefPubMedGoogle Scholar
  21. Egger, H. L., & Angold, A. (2006). Common emotional and behavioural disorders in preschool children: presentation, nosology, and epidemiology. Journal of Child Psychology and Psychiatry, 47, 313–337.CrossRefPubMedGoogle Scholar
  22. Ezpeleta, L., Granero, R., de la Osa, N., Penelo, E., & Domenech, J. M. (2012). Dimensions of oppositional defiant disorder in 3-year-old preschoolers. Journal of Child Psychology and Psychiatry, 53, 1128–1138.CrossRefPubMedGoogle Scholar
  23. Feldt, L. S., & Charter, R. A. (2003). Estimating the reliability of a test split into two parts of equal or unequal length. Psychological Methods, 8, 102–109.CrossRefPubMedGoogle Scholar
  24. Gadow, K. D., & Nolan, E. E. (2002). Differences between preschool children with ODD, ADHD, and ODD + ADHD symptoms. Journal of Child Psychology and Psychiatry, 43, 191–201.CrossRefPubMedGoogle Scholar
  25. Hamshere, M. L., Langley, K., Martin, J., et al (2013). High loading of polygenic risk for ADHD in children with comorbid aggression. American Journal of Psychiatry, 170, 909–916.CrossRefPubMedPubMedCentralGoogle Scholar
  26. Janus, M., & Offord, D. R. (2007). Development and psychometric properties of the early development instrument (EDI): a measure of children’s school readiness. Canadian Journal of Behavioral Science, 39, 1–22.CrossRefGoogle Scholar
  27. Jetté, M., & Des Groseillers, L. (2000a). Survey Description and Methodology. In: Longitudinal Study of Child Development in Quebec (ELDEQ 1998-2002) (Vol. 1, No. 1). Quebec City, Quebec, Canada: Institut de la statistique du Québec.Google Scholar
  28. Jetté, M.,& Des Groseillers, L. (2000b). Family, Child care, and Neighbourhood Characteristics. In: Longitudinal Study of Child Development in Quebec (ELDEQ 1998-2002) (Vol. 1, No. 2). Quebec City, Quebec, Canada: Institut de la statistique du Québec.Google Scholar
  29. Jones, B. L., Nagin, D. S., & Roeder, K. (2001). A SAS procedure based on mixture models for estimating developmental trajectories. Sociological Methods & Research, 29, 374–393.CrossRefGoogle Scholar
  30. Keenan, K., Boeldt, D., Chen, D., Coyne, C., Donald, R., Duax, J., et al (2011). Predictive validity of DSM-IV oppositional defiant and conduct disorders in clinically referred preschoolers. Journal of Child Psychology and Psychiatry, 52, 47–55.CrossRefPubMedPubMedCentralGoogle Scholar
  31. Keenan, K., & Shaw, D. S. (1997). Developmental and social influences on young girls' early problem behavior. Psychological Bulletin, 121, 95–113.CrossRefPubMedGoogle Scholar
  32. Keenan, K., & Wakschlag, L. S. (2002). Can a valid diagnosis of externalizing disorders be made in preschool children? American Journal of Psychiatry, 159, 351–358.CrossRefPubMedGoogle Scholar
  33. Keenan, K., & Wakschlag, L. S. (2004). Are oppositional defiant and conduct disorder symptoms normative behaviors in preschoolers? A comparison of referred and nonreferred children. American Journal of Psychiatry, 161, 356–358.CrossRefPubMedGoogle Scholar
  34. Kochanska, G., Murray, K., & Coy, K. C. (1997). Inhibitory control as a contributor to conscience in childhood: from toddler to early school age. Child Development, 68, 263–277.CrossRefPubMedGoogle Scholar
  35. Lahey, B. B., McBurnett, K., & Loeber, R. (2000). Are attention deficit hyperactivity disorder and oppositional defiant disorder developmental precursors to conduct disorder? In a. Sameroff, M. Lewis, & S. Miller (Eds.), Handbook of developmental psychopathology (pp. 431–446 (2nd ed., ). New York:Plenum.Google Scholar
  36. Lahey, B. B., Pelham, W. E., Loney, J., Lee, S. S., & Willcut, E. G. (2005). Instability of the DSM subtypes of ADHD from preschool to elementary school. Archives of General Psychiatry, 62, 896–902.CrossRefPubMedGoogle Scholar
  37. Lavigne, J. V., Cicchetti, C., Gibbons, R. D., Binns, H. J., Larsen, L., & DeVito, C. (2001). Oppositional defiant disorder with onset in preschool years: longitudinal stability and pathways to other disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 1393–1400.CrossRefPubMedGoogle Scholar
  38. Leblanc, N., Boivin, M., Dionne, G., Brendgen, M., Vitaro, F., Tremblay, R. E., et al. (2008). The development of hyperactive–impulsive behaviors during the preschool years: the predictive validity of parental assessments. Journal of Abnormal Child Psychology, 36, 977–987.CrossRefPubMedGoogle Scholar
  39. Lemelin, J. P., & Boivin, M. (2007). In Success starts in Grade 1: The importance of school readiness”. In: Quebec Longitudinal Study of Child Development (QLSCD 1998-2010) (vol. Vol. 4, Fascicle 2). Quebec: Institut de la statistique du Quebec.Google Scholar
  40. Mattanah, J. F., Pratt, M. W., Cowan, P. A., & Cowan, C. (2005). Authoritative parenting, parental scaffolding of long-division mathematics, and children’s academic competence in fourth grade. Journal of Applied Developmental Psychology, 26, 85–106.CrossRefGoogle Scholar
  41. Nagin, D. (1999). Analyzing developmental trajectories: a semi-parametric, group-based approach. Psychological Methods, 4, 139–177.CrossRefGoogle Scholar
  42. Nagin, D. (2005). Group-based modeling of development. Cambridge:Harvard University Press.CrossRefGoogle Scholar
  43. Nagin, D., & Tremblay, R. E. (2001). Parental and early childhood predictors of persistent physical aggression in boys from kindergarten to high school. Archives of General Psychiatry, 58, 389–394.CrossRefPubMedGoogle Scholar
  44. Early Child Care Research Network, N. I. C. H. D. (2004). Trajectories of physical aggression from toddlerhood to middle school. Monographs of the Society for Research in Child Development Serial No., 278.Google Scholar
  45. Nunnally, J. C. (1978). Psychometric theory (2nd ed., ). New York:McGraw-Hill.Google Scholar
  46. Odgers, C. L., Caspi, A., Broadbent, J. M., Dickson, N., Hancox, R. J., Harrington, H., et al. (2007). Prediction of differential adult health burden by conduct problem subtypes in males. Archives of General Psychiatry, 64, 476–484.CrossRefPubMedGoogle Scholar
  47. Petitclerc, A., Boivin, M., Dionne, G., Pérusse, D., & Tremblay, R. E. (2011). Genetic and environmental etiology of disregard for rules. Behavior Genetics, 41, 192–200.CrossRefPubMedGoogle Scholar
  48. Petitclerc, A., Boivin, M., Dionne, G., Zoccolillo, M., & Tremblay, R. E. (2009). Disregard for rules: the early development and predictors of a specific dimension of disruptive behavior disorders. Journal of Child Psychology and Psychiatry, 50, 1477–1484.CrossRefPubMedGoogle Scholar
  49. Rutter, M., Kim-Cohen, J., & Maughan, B. (2006). Continuities and discontinuities in psychopathology between childhood and adult life. Journal of Child Psychology and Psychiatry, 47, 276–295.CrossRefPubMedGoogle Scholar
  50. Shaw, D. S. (2013). Future directions for research on the development and prevention of early cconduct problems. Journal of Clinical Child & Adolescent Psychology, 42, 418–428..CrossRefGoogle Scholar
  51. Shaw, D. S., Bell, R. Q., & Gilliom, M. (2000). A truly early starter model of antisocial behavior revisited. Clinical Child and Family Psychology Review, 3, 155–172.CrossRefPubMedGoogle Scholar
  52. Shaw, D. S., Lacourse, E., & Nagin, D. (2005). Developmental trajectories of conduct problems and hyperactivity from ages 2 to 10. Journal of Child Psychology and Psychiatry, 46, 931–942.CrossRefPubMedGoogle Scholar
  53. Statistics Canada and Human Resources Development Canada. (1995). National Longitudinal Survey of Children and Youth: Survey Instruments for 1994–1995 Data Collection Cycle 1. Ottawa,: Statistics Canada and Human Resources Development Canada.Google Scholar
  54. Stringaris, A. (2011). Irritability in children and adolescents: a challenge for DSM-5. European Child & Adolescent Psychiatry, 20, 61–66.CrossRefGoogle Scholar
  55. Ten Berge, J., & Socan, G. (2004). The greatest lower bound to the reliability of a test and the hypothesis of unidimensionality. Psychometrika, 69, 613–625.CrossRefGoogle Scholar
  56. Tremblay, R. E. (2010). Developmental origins of disruptive behaviour problems: the ‘original sin’ hypothesis, epigenetics and their consequences for prevention. Journal of Child Psychology and Psychiatry, 51, 341–367.CrossRefPubMedGoogle Scholar
  57. Tremblay, R. E., Nagin, D. S., Séguin, J. R., Zoccolillo, M., Zelazo, P. D., Boivin, M., et al. (2004). Physical aggression during early childhood: trajectories and predictors. Pediatrics, 114, 43–50.CrossRefGoogle Scholar
  58. Wakschlag, L., Tolan, P., & Leventhal, B. (2010). “Ain’t misbehavin”: towards a developmentally-specified nosology for preschool disruptive behavior. Journal of Child Psychology and Psychiatry, 51, 3–22.CrossRefPubMedPubMedCentralGoogle Scholar
  59. Waschbusch, D. A. (2002). A meta-analytic examination of comorbid hyperactive–impulsive–attention problems and conduct problems. Psychological Bulletin, 28, 118–150.CrossRefGoogle Scholar
  60. Wichstrøm, L., Berg-Nielsen, T. S., Angold, A., Egger, H. L., Solheim, E., & Sveen, T. H. (2012). Prevalence of psychiatric disorders in preschoolers. Journal of Child Psychology and Psychiatry, 53, 695–705.CrossRefPubMedGoogle Scholar
  61. Wolf, F. M. (1986). Meta-analysis: Quantitative Methods for Research Synthesis. Beverly Hills, CA:Sage.Google Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Rene Carbonneau
    • 1
    • 2
    • 3
    Email author
  • Michel Boivin
    • 3
    • 4
    • 5
  • Mara Brendgen
    • 2
    • 3
    • 6
  • Daniel Nagin
    • 7
  • Richard E. Tremblay
    • 2
    • 3
    • 5
    • 8
  1. 1.Department of Pediatrics, Faculty of MedicineUniversity of MontrealMontréalCanada
  2. 2.Sainte-Justine Hospital Research CenterMontrealCanada
  3. 3.Research Unit on Children’s Psychosocial MaladjustmentUniversity of MontrealMontrealCanada
  4. 4.Department of PsychologyLaval UniversityQuebecCanada
  5. 5.Institute of Genetic, Neurobiological, and Social Foundations of Child Development, Tomsk State UniversityTomskRussian Federation
  6. 6.Department of PsychologyUniversity of Quebec in MontrealMontrealCanada
  7. 7.Department of Public Policy and StatisticsCarnegie Mellon UniversityPittsburghUSA
  8. 8.School of Public Health and Population SciencesUniversity College DublinDublinIreland

Personalised recommendations