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

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.

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References

  1. 1.

    Cicchetti D, Natsuaki MN, Granic I (2014) The role of anxiety in the development, maintenance, and treatment of childhood aggression. Dev Psychopathol 26(4pt2):1515–1530. https://doi.org/10.1017/S0954579414001175

    Article  Google Scholar 

  2. 2.

    Erskine HE, Ferrari AJ, Polanczyk GV, Moffitt TE, Murray CJL, Vos T, Scott JG (2014) The global burden of conduct disorder and attention-deficit/hyperactivity disorder in 2010. J Child Psychol Psychiatry 55(4):328–336. https://doi.org/10.1111/jcpp.12186

    Article  PubMed  Google Scholar 

  3. 3.

    Shivram R, Bankart J, Meltzer H, Ford T, Vostanis P, Goodman R (2009) Service utilization by children with conduct disorders: findings from the 2004 Great Britain child mental health survey. Eur Child Adolesc Psychiatry 18(9):555–563. https://doi.org/10.1007/s00787-009-0012-0

    Article  PubMed  Google Scholar 

  4. 4.

    Breslau J, Saito N, Tancredi DJ, Nock M, Gilman SE (2012) Classes of conduct disorder symptoms and their life course correlates in a US national sample. Psychol Med 42(5):1081–1089. https://doi.org/10.1017/S003329171100198X

    Article  CAS  PubMed  Google Scholar 

  5. 5.

    Broidy LM, Nagin DS, Tremblay RE, Bates JE, Brame B, Dodge KA, Vitaro F (2003) Developmental trajectories of childhood disruptive behaviors and adolescent delinquency: a six-site, cross-national study. Dev Psychol 39(2):222–245. https://doi.org/10.1037/0012-1649.39.2.222

    Article  PubMed  PubMed Central  Google Scholar 

  6. 6.

    Fergusson DM, Boden JM, Horwood LJ (2009) Situational and generalized conduct problems and later life outcomes: evidence from a New Zealand birth cohort. J Child Psychol Psychiatry 50(9):1084–1092. https://doi.org/10.1111/j.1469-7610.2009.02070.x

    Article  PubMed  Google Scholar 

  7. 7.

    Odgers CL, Caspi A, Broadbent JM, Dickson N, Hancox RJ, Harrington H, Moffitt TE (2007) Prediction of differential adult health burden by conduct problem subtypes in males. Arch Gen Psychiatry 64(4):476–484. https://doi.org/10.1001/archpsyc.64.4.476

    Article  PubMed  Google Scholar 

  8. 8.

    Temcheff C, Serbin L, Martin-Storey A, Stack D, Ledingham J, Schwartzman A (2011) Predicting adult physical health outcomes from childhood aggression, social withdrawal and likeability: a 30-year prospective, longitudinal study. Int J Behav Med 18(1):5–12. https://doi.org/10.1007/s12529-010-9082-0

    Article  PubMed  Google Scholar 

  9. 9.

    Trentacosta CJ, Shaw DS (2009) Emotional self-regulation, peer rejection, and antisocial behavior: developmental associations from early childhood to early adolescence. J Appl Dev Psychol 30(3):356–365. https://doi.org/10.1016/j.appdev.2008.12.016

    Article  PubMed  PubMed Central  Google Scholar 

  10. 10.

    Wildeboer A, Thijssen S, Van Ijzendoorn MH, Van Der Ende J, Jaddoe VWV, Verhulst FC, Bakermans-Kranenburg MJ (2015) Early childhood aggression trajectories: associations with teacher-reported problem behaviour. Int J Behav Dev 39(3):221–234. https://doi.org/10.1177/0165025414562239

    Article  Google Scholar 

  11. 11.

    Serbin LA, Temcheff CE, Cooperman JM, Stack DM, Ledingham J, Schwartzman AE (2011) Predicting family poverty and other disadvantaged conditions for child rearing from childhood aggression and social withdrawal: a 30-year longitudinal study. Int J Behav Med 35(2):97–106. https://doi.org/10.1177/0165025410372008

    Article  Google Scholar 

  12. 12.

    Copeland WE, Miller-Johnson S, Keeler G, Angold A, Costello EJ (2007) Childhood psychiatric disorders and young adult crime: a prospective, population-based study. Am J Psychiatry 164(11):1668

    Article  PubMed  Google Scholar 

  13. 13.

    Erskine HE, Norman RE, Ferrari AJ, Chan GCK, Copeland WE, Whiteford HA, Scott JG (2016) Long-term outcomes of attention-deficit/hyperactivity disorder and conduct disorder: a systematic review and meta-analysis. J Am Acad Child Psychiatry 55(10):841–850. https://doi.org/10.1016/j.jaac.2016.06.016

    Article  Google Scholar 

  14. 14.

    Silberg J, Moore AA, Rutter M (2015) Age of onset and the subclassification of conduct/dissocial disorder. J Child Psychol Psychiatry 56(7):826–833. https://doi.org/10.1111/jcpp.12353

    Article  PubMed  Google Scholar 

  15. 15.

    Moffitt TE (1993) A developmental taxonomy. Psychol Rev 100(4):674–701

    Article  CAS  PubMed  Google Scholar 

  16. 16.

    Schoorl J, Van Rijn S, De Wied M, Van Goozen S, Swaab H (2016) Emotion regulation difficulties in boys with oppositional defiant disorder/conduct disorder and the relation with comorbid autism traits and attention deficit traits. PLoS One 11(7):e0159323. https://doi.org/10.1371/journal.pone.0159323

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. 17.

    American Psychiatric Association: DSM-5 Task Force (2013) Diagnostic and statistical manual of mental disorders: DSM-5, 5th edn. American Psychiatric Association, Washington

    Google Scholar 

  18. 18.

    World Health Organization (1992) The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. World Health Organization, Geneva

    Google Scholar 

  19. 19.

    Rowe R, Costello EJ, Angold A, Copeland WE, Maughan B (2010) Developmental pathways in oppositional defiant disorder and conduct disorder. J Abnorm Psychol 119(4):726–738. https://doi.org/10.1037/a0020798

    Article  PubMed  PubMed Central  Google Scholar 

  20. 20.

    Röll J, Koglin U, Petermann F (2012) Emotion regulation and childhood aggression: longitudinal associations. Child Psychiatry Hum Dev 43(6):909–923

    Article  PubMed  Google Scholar 

  21. 21.

    Loeber R, Burke J, Pardini DA (2009) Perspectives on oppositional defiant disorder, conduct disorder, and psychopathic features. J Child Psychol Psychiatry 50:133–142. https://doi.org/10.1111/j.1469-7610.2008.02011.x

    Article  PubMed  Google Scholar 

  22. 22.

    Ettekal I, Ladd GW (2015) Developmental pathways from childhood aggression: disruptiveness, chronic peer rejection, and deviant friendships to early-adolescent rule breaking. Child Dev 86(2):614–631

    Article  PubMed  Google Scholar 

  23. 23.

    Walters GD, Ronen T, Rosenbaum M (2010) The latent structure of childhood aggression: a taxometric analysis of self-reported and teacher-rated aggression in Israeli schoolchildren. Psychol Assess 22(3):628

    Article  PubMed  Google Scholar 

  24. 24.

    Kerig PK, Stellwagen KK (2009) Roles of callous-unemotional traits, narcissism, and machiavellianism in childhood aggression. J Psychopathol Behav 32:343–352

    Article  Google Scholar 

  25. 25.

    Johnson DR, Foster SL (2005) The relationship between relational aggression in kindergarten children and friendship stability, mutuality, and peer liking. Early Educ Dev 16:141–160

    Article  Google Scholar 

  26. 26.

    Nelson DA, Crick NR (2002) Parental psychological control: implications for childhood physical and relational aggression. In: Barber BK (ed) Intrusive parenting: how psychological control affects children and adolescents. American Psychological Association, Washington, pp 161–189

    Google Scholar 

  27. 27.

    Neal JW, Cappella E (2012) An examination of network position and childhood relational aggression: integrating resource control and social exchange theories. Aggressive Behav 38:126–140. https://doi.org/10.1002/ab.21414

    Article  Google Scholar 

  28. 28.

    Baker SG, Kramer BS (2001) Good for women, good for men, bad for people: simpson’s paradox and the importance of sex-specific analysis in observational studies. J Women Health Gen B 10(9):867–872

    Article  CAS  Google Scholar 

  29. 29.

    Asparouhov T, Masyn K, Muthén BO (2006) Continuous time survival in latent variable models. In: Proceedings of the joint statistical meeting in Seattle (pp 180–187). Retrieved from http://www.statmodel2.com/download/SurvivalJSM3.pdf. Accessed June 14 2017

  30. 30.

    Chang Z, Lichtenstein P, D’Onofrio BM, Sjölander A, Larsson H (2014) Serious transport accidents in adults with attention-deficit/hyperactivity disorder and the effect of medication: a population-based study. JAMA Psychiatry 71(3):319–325. https://doi.org/10.1001/jamapsychiatry.2013.4174

    Article  PubMed  PubMed Central  Google Scholar 

  31. 31.

    Kendler KS, Ohlsson H, Mezuk B, Sundquist JO, Sundquist K (2016) Observed cognitive performance and deviation from familial cognitive aptitude at age 16 years and ages 18 to 20 years and risk for schizophrenia and bipolar illness in a Swedish national sample. JAMA Psychiatry 73(5):465–471. https://doi.org/10.1001/jamapsychiatry.2016.0053

    Article  PubMed  Google Scholar 

  32. 32.

    Lichtenstein P, Halldner L, Zetterqvist J, Sjölander A, Serlachius E, Fazel S, Larsson H (2012) Medication for attention deficit–hyperactivity disorder and criminality. N Engl J Med 367(21):2006–2014. https://doi.org/10.1056/NEJMoa1203241

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. 33.

    Molero Y, Lichtenstein P, Zetterqvist J, Gumpert CH, Fazel S (2015) Varenicline and risk of psychiatric conditions, suicidal behaviour, criminal offending, and transport accidents and offences: population based cohort study. BMJ 350(8011):13–19

    CAS  Google Scholar 

  34. 34.

    Bennett KJ, Offord DR (2001) Screening for conduct problems: does the predictive accuracy of conduct disorder symptoms improve with age? J Am Acad Child Psychiatry 40(12):1418–1425

    Article  CAS  Google Scholar 

  35. 35.

    Frick PJ, Nigg JT (2012) Current issues in the diagnosis of attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder. Annu Rev Clin Psychol 8:77–107. https://doi.org/10.1146/annurev-clinpsy-032511-143150

    Article  PubMed  Google Scholar 

  36. 36.

    Sariaslan A, Larsson H, D’Onofrio B, Långström N, Faxel S, Lichtenstein P (2014) Does population density and neighborhood deprivation predict schizophrenia? A nationwide Swedish family-based study of 2.4 million individuals. Schizophr Bull 41(2):494–502

    Article  PubMed  PubMed Central  Google Scholar 

  37. 37.

    Herpers P, Klip H, Rommelse N, Greven C, Buitelaar J (2016) Associations between high callous–unemotional traits and quality of life across youths with non-conduct disorder diagnoses. Eur Child Adolesc Psychiatry 25(5):547–555. https://doi.org/10.1007/s00787-015-0766-5

    Article  PubMed  Google Scholar 

  38. 38.

    Boylan K, Vaillancourt T, Boyle M, Szatmari P (2007) Comorbidity of internalizing disorders in children with oppositional defiant disorder. Eur Child Adolesc Psychiatry 16(8):484–494

    Article  PubMed  Google Scholar 

  39. 39.

    Lubke G, Campbell I (2016) Inference based on the best-fitting model can contribute to the replication crisis: assessing model selection uncertainty using a bootstrap approach. Struct Equ Model 23(4):479–490

    Article  Google Scholar 

  40. 40.

    Nyholt DR (2004) A simple correction for multiple testing for SNPs in linkage disequilibrium with each other. Am J Hum Genet 74(4):765–769. https://doi.org/10.1086/383251

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. 41.

    Cox DR (1972) Regression models and life-tables. J R Stat Soc B Methodol 34(2):187–220

    Google Scholar 

  42. 42.

    Muthén LK, Muthén BO (1998–2011) Mplus user’s guide, 6th edn. Muthén & Muthén, Los Angeles

  43. 43.

    R Core Team (2016) R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. https://www.R-project.org/. Accessed 29 Mar 2017

  44. 44.

    Conduct Problems Prevention Research Group (2011) The effects of the Fast Track preventive intervention on the development of conduct disorder across childhood. Child Dev 82(1):331–345

    Article  PubMed Central  Google Scholar 

  45. 45.

    Reynolds AJ, Temple JA, Robertson DL (2001) Long-term Effects of an early childhood intervention on educational achievement and juvenile arrest: a 15-year follow-up of low-income children in public schools. JAMA 285(18):2339–2346

    Article  CAS  PubMed  Google Scholar 

  46. 46.

    Redelmeier DA, Chan WK, Lu H (2010) Road trauma in teenage male youth with childhood disruptive behavior disorders: a population based analysis. PloS Med 7(11):1000369. https://doi.org/10.1371/journal.pmed.1000369

    Article  Google Scholar 

  47. 47.

    Idring S, Rai D, Dal H, Dalman C, Sturm H, Zander E, Lee BK, Serlachius E, Magnusson C (2012) Autism spectrum disorders in the Stockholm youth cohort: design, prevalence and validity. PloS One 7(7):e41280

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. 48.

    Ludvigsson JF, Andersson E, Ekbom A, Feychting M, Kim JL, Reuterwall C, Heurgren M, Olausson PO (2011) External review and validation of the Swedish national inpatient register. BMC Public Health 11(1):450

    Article  PubMed  PubMed Central  Google Scholar 

  49. 49.

    Rück C, Larsson KJ, Lind K, Perez-Vigil A, Isomura K, Sariaslan A, Lichtenstein P, Mataix-Cols D (2015) Validity and reliability of chronic tic disorder and obsessive-compulsive disorder diagnoses in the Swedish national patient register. BMJ Open 5(6):e007520

    Article  PubMed  PubMed Central  Google Scholar 

  50. 50.

    Jester JM, Nigg JT, Buu A, Puttler LI, Glass JM, Heitzeg MM, Fitzgerald HE, Zucker RA (2008) Trajectories of childhood aggression and inattention/hyperactivity: differential effects on substance abuse in adolescence. J Am Acad Child Psychiatry 47(10):1158–1165

    Article  Google Scholar 

  51. 51.

    Statistics Sweden (2018) Population and population changes 1749–2017. Retrieved from https://www.scb.se/en/finding-statistics/statistics-by-subject-area/population/population-composition/population-statistics/pong/tables-and-graphs/yearly-statistics–the-whole-country/population-and-population-changes/. Accessed 21 Feb 2018

  52. 52.

    Boomsma DI (2015) Aggression in children: unravelling the interplay of genes and environment through (epi)genetics and metabolomics. J Pediatr Neonatal Individ Med 4(2):e040251. https://doi.org/10.7363/040251

    Article  Google Scholar 

  53. 53.

    Mauri M (2015) DisseminACTION: Disseminating science in the information age (www.action-euproject.edu: a website for researchers and parents). J Pediatr Neonatal Individ Med 4(2):e040254. https://doi.org/10.7363/040254

    Article  Google Scholar 

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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.

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Campbell, I., Lundstrom, S., Larsson, H. et al. The relation between the age at diagnosis of problem behaviors related to aggression and distal outcomes in Swedish children. Eur Child Adolesc Psychiatry 28, 899–911 (2019). https://doi.org/10.1007/s00787-018-1250-9

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Keywords

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