Page 29 - Age of onset of disruptive behavior of residentially treated adolescents -Sjoukje de Boer
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Introduction
Epidemiological research (Moffitt, 1993, 2003) has shown that a relatively small
part of the population (6.2%) was engaged in antisocial behavior at a very young age 2 which persisted at every stage in their life. This group was labeled life-course- persistent (LCP). A larger group (23.6%) was found to be involved in antisocial behavior
during adolescence only and therefore their behavior was labeled adolescence-limited
(AL). Although during adolescence both groups did not differ in frequency and seriousness of offending, Moffitt (Moffitt, 1993, 2003; Moffitt & Caspi, 2001) argued
that they differed in etiology, developmental course, prognosis and classification of
their behavior as either pathological (LCP) or normative (AL). Extensive support for
these prototypes and their relevance for etiology, developmental processes, and prevention priorities was found (Odgers et al., 2008). By labeling children with early
onset of antisocial behavior as “life-course-persistent”, the epidemiological researchers implied that this group would hardly benefit from treatment or at least are
in need of more intensive treatment. However, thus far this consequence has barely
been tested in treatment research, nor have findings from epidemiological research
been put to practical use for inpatient or forensic settings.
Present study concerned adolescents with antisocial behavior that were treated in a residential orthopsychiatric treatment facility for severe disruptive behavior combined with psychiatric disorders. For prognostic purposes it would be relevant to know whether these inpatients belonged to the LCP or the AL group. Therefore the question arose whether it was possible to determine if the patients’ disruptive behaviors were present in early life based on retrospective data. At the moment of treatment, no reliable data about their disruptive behavior earlier in life nor about the age of onset of this behavior were available. Anamnestic information gathered at admission is often subjective and unreliable: patients themselves are no reliable source on their early history and the parents’ view on their child’s development is often biased by their child’s current condition. Therefore more objective sources of information on the child’s early behavior were required. For the present study the information about the childhood disruptive behavior was drawn from youth health care files to examine its use for diagnostic purposes. The information in these files was gathered at fixed points in the child’s life by youth health care professionals. In the
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