Michèle Déry

Cognitive and familial contributions to conduct disorder in children.

Although young children with conduct disorder (CD) are suspected of having verbal and executive function deficits, most studies that investigated this hypothesis did not control for attention deficit hyperactivity disorder (ADHD). Furthermore, relatively little is known about the interaction between cognitive deficits and familial factors in explaining the onset and persistence of CD in children. The participants in this study were 57 children with CD and 35 controls aged 7 to 12 years. At 1-year follow-up, 41 of the participants with CD were reassessed. Children with CD were found to be significantly impaired in four of five executive function measures after ADHD symptoms and socioeconomic status (SES) were controlled. Executive function test performance, number of ADHD symptoms, and familial characteristics (SES, parental punishment) together correctly classified 90% of the participants. Only the number of ADHD symptoms was found to significantly improve prediction of CD 1 year later beyond that afforded by number of CD symptoms a year earlier. Findings indicate that children with CD and ADHD symptoms are especially at risk for persistent antisocial behaviour. Results also highlight the importance of treatment programs that cover both cognitive and familial aspects associated with CD.

Neuropsychological characteristics of adolescents with conduct disorder: association with attention-deficit-hyperactivity and aggression.

The purpose of this study was to determine whether an association exists between neuropsychological deficits and conduct disorder (CD) with and without concurrent attention-deficit–hyperactivity disorder (ADHD). In addition, we explored the differential neuropsychological performance of aggressive and nonaggressive CD adolescents and the combined effect of this behavioral status and ADHD on performance. Fifty-nine adolescents (mean age of 15.4 years) who met the criteria for CD were compared with 29 controls comparable in age, gender, and socioeconomic status. A neuropsychological battery of current tests measuring executive functions and a battery of language tests were used in the study. Multivariate analyses showed that, compared with controls, CD adolescents had significantly lower verbal skills but did not differ on executive function measures. However, the lower verbal performance of CD adolescents is not explained by the existence of a CD subgroup with concomitant ADHD or aggressiveness. The study confirms with a sample of CD adolescents the association between verbal deficits and antisocial behavior when socioeconomic status is controlled. Our results also demonstrate that CD per se can be a sufficient condition for such deficits.

Frequency of Mental Health Disorders in a Sample of Elementary School Students Receiving Special Educational Services for Behavioural Difficulties

Objective: Despite being essential for defining and planning special educational services, very few data are available in Quebec regarding the nature and extent of behavioural difficulties presented by children who receive special educational services at school. This study provides a picture of the frequency of disruptive behaviour disorders (that is, attention-deficit hyperactivity disorder [ADHD], oppositional defiant disorder [ODD], and conduct disorder [CD]) and internalized disorders (including generalized anxiety disorder [GAD] and major depressive episode [MDE]) in a sample of elementary school students receiving special educational services for behavioural difficulties (n = 324). Method: In this descriptive study, we established the presence of mental health disorders according to teacher-, parent-, and child-reported data that were obtained using structured diagnostic interviews based on DSM-IV criteria. We also examined prevalence rates by sex and age group. Results: Three-quarters of the students met the criteria for ADHD, one-half for ODD, and one-third for CD. About 14% of the students presented with a GAD or met the criteria for an MDE in the past year. Only 2% of the students presented with an internalized disorder without a comorbid disruptive behaviour disorder. Conclusions: Our results suggest that among students receiving special educational services for behavioural difficulties, a large proportion may have difficulties severe enough to meet the criteria for at least one DSM-IV disruptive behaviour disorder. Such findings may underscore the need to develop more collaboration between the mental health and education sectors in rehabilitating these children.

Participation in Organized Activities and Conduct Problems in Elementary School: The Mediating Effect of Social Skills.

The goal of this study was to test a mediation model in which social skills mediate the relationship between participation in organized activities and conduct problems among elementary school children. Two moderators of these associations were also examined, namely, gender and reception of special education services. A total of 563 children (45% girls; Mage = 8.44) were surveyed. The findings revealed that, after controlling for important covariates, more frequent activity participation predicted better social skills, which, in turn, predicted fewer subsequent conduct problems among children. These associations were not moderated by gender or reception of special education services. These findings suggest that organized activities may provide a positive developmental context for children with conduct problems.

Precocious Initiation into Smoking, Alcohol Use, and Gambling among Children with Conduct Problems

Objective: Adolescent participation in risky and addictive behaviours, such as smoking, substance use, and gambling has the potential to lead to many serious problems. The presence of conduct problems (CPs) and early initiation into risky and addictive behaviours have been independently shown to be associated with adolescent and young adult smoking, drinking, and gambling. Nevertheless, the relation between early initiation into risky and addictive behaviours and CPs remains to be explored among pre-adolescents. Our study aims to examine the prospective relation between CPs in early primary school and pre-adolescent initiation into smoking, alcohol use, and gambling. Method: Our study used data from participants in an ongoing prospective, longitudinal study at the Université de Sherbrooke to examine cigarette, alcohol, and gambling initiation among primary school-aged boys and girls with CPs. Children were recruited between the ages of 6 and 9 years from several low socioeconomic status public schools in diverse geographical regions of Quebec. Initiation into cigarettes, alcohol, and gambling was measured 1 year later. Results: Children with CPs were found to be at greater risk for early initiation into smoking, alcohol, and gambling. These effects remained even once other known risk factors, such as poor parental supervision and child effortful control, were controlled for. Conclusions: These results suggest that CPs present in early elementary school can predict early initiation in to potentially addictive behaviours among boys and girls. Implications for targeted preventive intervention are discussed.

Social, Psychological, and Neuropsychological Correlates of Conduct Disorder in Children and Adolescents

An important number of studies have obtained associations between social and familial factors and antisocial behaviors. Some researchers have distinguished between adversity factors, such as life stresses, monoparentality and parent’s mental health, and proximal factors such as parental education practices and family interactions. Studies have demonstrated that these factors remain significant even when socioeconomic status (SES) is statistically controlled (Frick, 1994).

Developmental Course of ADHD Symptoms Based on Multirater Report in Girls and Boys With or Without a Disruptive Behavior Disorder

The developmental course of attention-deficit/hyperactivity disorder (ADHD) symptoms (inattention, hyperactivity, impulsivity) from childhood to adolescence was described and compared based on parent and teacher report as a function of co-occurring conduct disorder/oppositional defiant disorder (CD/ODD) over 6 years. The moderating effect of gender was investigated. Participants were 291 children (6–13 years old; 79 girls) with ADHD: 91 with ADHD only and 200 with ADHD+CD/ODD. At study entry, boys and girls in the ADHD+CD/ODD group presented significantly more hyperactivity symptoms based on parent report and more impulsivity symptoms based on teacher report than did those in the ADHD-only group. ADHD symptoms, however, diminished on average over time in both groups, according to both parent and teacher report. However, as children in the ADHD+CD/ODD group, particularly girls, presented more symptoms at study entry, they tended to remain above the diagnostic threshold 6 years later. This suggests an association exists between co-occurring CD/ODD and ADHD persistence.

The Role of Academic Skills in the Evolution of Conduct Problems and Depressive Symptoms Among Children With and Without Early Clinically Significant Conduct Problems

Youth with conduct problems present frequently depressive symptoms. Academic skills are thought to be a mediating variable by which conduct problems could lead to depressive symptoms. No studies have longitudinally compared this model among school-aged boys and girls with different levels of conduct problems. Cascade models were tested to examine the relations between conduct problems, depressive symptoms, and academic skills over a 3-year period, and whether the severity of conduct problems and gender moderated these associations. Participants were 381 children presenting early clinically significant conduct problems (44.9% female) and 363 children with low levels of conduct problems (48.8% female). While results did not show any cascade or indirect associations, they revealed different direct links between conduct problems or depressive symptoms and academic skills in the four groups. These findings suggest that conduct problems severity and gender differences should be considered in treatment planning.

Trajectories of internalizing problems during the transition to adolescence in children with and without conduct problems

Children with conduct problems are at greater risk for internalizing problems. The objectives of this study were to (1) examine trajectories of internalizing problems among children with and without clinically significant conduct problems during the transition to adolescence; and (2) identify how academic achievement, peer rejection, parent socioeconomic status, maternal distress, parental warmth, child temperament, and receptive verbal functioning explained differences between the two groups. Children with conduct problems (N = 388, 45% girls) and a comparison sample without conduct problems (N = 299, 52% girls) were recruited from Quebec, Canada, when they were between the ages of 7 and 10 years, and were followed across 4 years. Mothers and teachers provided information on internalizing problems each year. Having clinically significant conduct problems was associated with higher initial levels of internalizing problems according to mothers and teachers, but not with changes in internalizing problems over time. With regards to teacher ratings, academic achievement, peer rejection, and negative emotionality partially explained differences in internalizing problems for youth with and without conduct problems. For mother ratings, maternal distress, negative emotionality, and peer rejection completely explained the association for girls, and partially explained the association for boys. Findings supported a multi-rater approach for understanding risk for internalizing problems among children with and without conduct problems. In particular, they highlight the importance of differences across context for understanding factors associated with vulnerability to internalizing problems.

Predictors of childhood trajectories of overt and indirect aggression: An interdisciplinary approach

The aim of this study was to advance our understanding of the development of aggression in boys and girls by testing a model combining insights from both evolutionary theory and developmental psychology. A sample of 744 children (348 girls) between six and 13 years old was recruited in schools with high deprivation indices. Half of the sample (N = 372; 40.1% girls) had received special educational services for behavioral and/or socio-emotional problems. Two trajectories for overt aggression and two trajectories for indirect aggression were identified and binomial logistic regressions were used to identify environmental predictors and sex-specific patterns of these trajectories. Results indicated that peer rejection predicted overt aggression and indirect aggression and that extraversion and male sex predicted overt aggression. The results also showed that interaction between parental practices and some child temperament traits predicted overt aggression (coercion and lack of supervision associated with extraversion or low effortful control) or indirect aggression (coercion and neglect associated with negative affect or low effortful control), and the absence of a father figure predicted high indirect aggression in girls.