David Quinton

The outcome of childhood conduct disorder: implications for defining adult personality disorder and conduct disorder

The effect of conduct disorder on adult social functioning in the areas of work, sexual/love relationships, social relationships and criminality was studied in a sample of young adults who spent much of their childhoods in group-cottage childrens homes and an inner-city comparison group. Most subjects with conduct disorder had pervasive (but not necessarily severe) social difficulties compared to peers without conduct disorder. Less than half of this group met DSM-III adult criteria for antisocial personality disorder and just over half were given a diagnosis of personality disorder on interviewer clinical ratings. A latent class model that used both the retrospective and contemporaneous indicators of conduct disorder confirmed the very high continuity with adult social difficulties. Current diagnoses did not adequately describe this group and conduct disorder appeared to be an almost necessary condition for multiple social disability in adults in these samples.

Partners, Peers and Pathways: assortative pairing and continuities in conduct disorder

The role of assortative pairing for conduct problems in the continuity of such problems with pervasive social maladaptation in early adulthood was examined in a general population inner-city sample and a high-risk group (young people raised in childrens homes). Previous findings showing a switch out of conduct disorder for those in the high-risk group who had supportive cohabiting relationships in early adulthood were replicated in the general population sample, using a latent class analysis. Conduct-disordered individuals, however, were much less likely to attain supportive relationships. The reasons for this lay in a chain of environmental linkages through which conduct-disordered individuals paired assortatively with those who provided less support. This process involved unsatisfactory parenting environments, a lack of planful competence, and the membership of a deviant peer group. Protection afforded by a stable family life, a nondeviant peer group, and planful behavior reduced the risks of assortative pairing. The linking processes appeared to be the same for the general population and the high-risk samples, although having been in the childrens homes related to an increased risk of a lack of support, even when the linking processes were taken into account.

Institutional rearing, parenting difficulties and marital support

A prospective follow-up study was undertaken of two groups of women first studied in the mid 1960s when they were children: 94 girls reared in institutions to which they had been admitted because of a breakdown in parenting, and 51 girls in a general population comparison group. Both groups were interviewed in detail when aged 21-27 years and home observations were undertaken for those with young children. The institution-reared women showed a markedly increased rate of poor psychosocial functioning and of severe parenting difficulties in adult life. However, the support of a non-deviant spouse and of good living conditions in adult life provided a powerful protective effect.

An evaluation of an interview assessment of marriage.

An interview assessment of marriage relationships is described. It is shown to have good inter-rater reliability, high consistency across the accounts of both marriage partners and to be resistant to methodologic bias. A four-year follow-up study demonstrated high predictive validity to later marriage breakdown. The marriage measure also showed a strong association with behavioural deviance in the children. The intercorrelations between individual measures of various aspects of the marriage and the summary are given. A shortened version of the interview is described and preliminary findings are given on its validity.

Contact between Children Placed Away from Home and their Birth Parents: Research Issues and Evidence

The importance of maintaining contact between children temporarily or permanently looked after away from their birth parents is now believed to be so important to their psychosocial development as to be written into the Children Act. This position has been argued both on the basis of the rights of children and birth parents and on the claimed strength of the research evidence concerning the positive effects of contact and the negative consequences of its absence. The quality of the research evidence is reviewed. It is concluded that evidence on either the beneficial or adverse effects of contact is not strong and that the design and/or analysis of existing studies contain a number of weaknesses that preclude clear research-based guidance to practitioners.

Parenting Late-Placed Children: The Development of New Relationships and the Challenge of Behavioural Problems

This article reports on the development of new relationships and the presence of behavioural and emotional problems in a study of 61 five- to nine-year-old children placed from care with the intention of permanence in new, unrelated families during middle childhood. When interviewed, new parents reported that 73% of the children had formed an attached relationship with one or both parents by the end of their first year in placement. The children who were not regarded as attached showed more behavioural and emotional problems and overactive/restless behaviour, and were also more likely to have been actively rejected by their birth parents. More detailed aspects of possible difficulties in the new parent/child relationships were investigated by means of a parent-completed questionnaire which explored the children’s expression of feelings. The non-attached children had many more difficulties in communicating their feelings and in specific interactions with their new parents by the end of the first year of placement. The new parents of these children tended to find it difficult to relate to them in a warm, responsive manner early in the placement and this worsened by the end of the year. There was considerable overlap between behavioural and relationship problems, suggesting the need to promote the quality of the relationship between children and their new parents as well as to reduce the level of behavioural problems in the children. Implications for post-placement support and intervention are discussed.

Contact between Children Placed Away from Home and their Birth Parents: Ryburn’s ‘Reanalysis’ Analysed:

Ryburn has critically reviewed our article on the research issues in the study of contact between children placed away from home and their birth parents (Quinton, Rushton, Dance, & Mayes, 1997). We argue that Ryburn seriously misrepresented our position. He also presented a ‘reanalysis’ of the studies we discussed, supplemented with references to other studies that we did not quote, which aimed to show that our conclusions were wrong. In this article we respond to Ryburn’s critique and raise questions concerning his interpretation of data and methods of reviewing that suggest that his conclusions from the research are unreliable.

Stability, Permanence, Outcomes and Support: Foster Care and Adoption Compared:

There are large numbers of children in the care system who are unable to return home and who need a stable permanent placement. Julie Selwyn and David Quinton report some of the findings of a Department of Health-funded study, which followed a complete sample of 130 older children, all of whom had had a best interest decision in favour of adoption as the chosen placement. In the event, not all the children were adopted, making it possible to compare the outcomes of children who were adopted with those who went into long-term foster placements. There were many similarities in the experience of offering an adoptive or foster home to the young people but some key differences were in the stability of placements, the amount of autonomy the adoptive parents/carers had and their views of how close they were to the child and their assessment of the childs closeness to them.

Findings from a UK Based Study of Late Permanent Placements

ABSTRACT This prospective, UK based adoption study examined the first year of placement of 61 boys and girls who joined permanent unrelated families during middle childhood. Most of the children had experienced abuse, neglect and discontinuity in their lives prior to this placement. The psycho-social functioning of the children and the development of family relationships were assessed by means of in-depth interviews with the new parents. High levels of behaviour problems were found in the children initially. About a third of the children showed a diminution of problems after placement, the remainder showed little change or a deterioration. At the end of the first year, 72% of the surviving placements were considered stable. An active rejection by birth parents stood out as a particular risk to placement stability, especially when accompanied by over active behaviour and where new parents had difficulty in maintaining warmth and sensitivity in their responses to the child in the early months of placement.

Coercion and punishment in long-term perspectives: Parental hostility, childhood behavior, and adult social functioning

Introduction Harsh and coercive parenting, even when it falls short of overt abuse, can have serious negative effects. To date, links with childhood conduct problems and delinquency have been most extensively explored (Loeber & Stouthamer-Loeber, 1986). Patterson (this volume) elegantly demonstrates how parental coercion feeds into the development of antisocial behaviors in childhood, and Cohen and Brook (this volume) trace the reciprocal patterning of these effects over time. Even in families where children are exposed to a range of problematic behavior from parents – where, for example, one or the other parent is psychiatrically ill – parental hostility appears to be among the most important risks (Rutter & Quinton, 1984). There is mounting evidence that these processes have long-term effects. Early classic studies (McCord, 1979; Robins, 1966) demonstrated the impact of childhood family atmosphere on criminality in adulthood, and more recent reports suggest that long-term vulnerabilities may extend more widely. Holmes and Robins (1987), interviewing adults selected from the Epidemiological Catchment Area (ECA) samples, found that two very different types of adult psychiatric disorder – depression and alcohol problems – were both strongly associated with reports of unfair, harsh, and inconsistent discipline in childhood. In a similar way, Andrews, Brown, and Creasey (1990) found that adverse parenting (in this case abuse and neglect) showed strong links with disorder in the second generation more powerful than those from the parental disorder itself.