Page 53 - Age of onset of disruptive behavior of residentially treated adolescents -Sjoukje de Boer

outside of the home. Odds ratios ranged from 1.14 (number of changes in the home environment) to 9.80 (impulsive behavior), with effect sizes ranging from .03 to
.26.The multivariate model showed three significant independent predictors of EO- membership: grade retention, impulsive behavior and physical abuse (Table 3). The 3 model was statistically significant (χ2 (7, N=98) = 29.72, p<.0001), indicating that the
model was able to distinguish the patients with EO from those with AO disruptive behavior. The model as a whole explained 36% (Nagelkerke R square) of the variance in onset, and correctly identified 75.5% of cases.
Discussion
In previous research, in our clinical sample of inpatient adolescents with disruptive behavior and psychiatric disorders, we were able to make the distinction in EO and AO based on retrospective data (De Boer et al., 2007).The main goal of this paper was to identify factors that diagnosticians can use to differentiate between the subtypes EO and AO disruptive behavior in a clinical setting. This was done to help clinicians identify characteristics relevant to the choice of treatment for each group. Because of this practical purpose, we looked for characteristics that may easily be available in routine clinical practice.
As expected, the EO group showed higher levels of risk in childhood, compared to the AO group, including characteristics indicating inherited or acquired neuropsychological deficits and environmental risk factors (i.e., mean age at grade retention, grade retention in primary school, and prevalence of impulsive behavior). Besides, the EO and AO groups differed significantly on many of the other childhood risk factors (the number of changes in home environment, parental divorce (before age 11 years), physical abuse, employment of the mother, and mean age at placement outside of the home). Logistic regression yielded grade retention in primary school, impulsive behavior and physical abuse to be significantly correlated to EO disruptive behavior.
Differences in IQ were not found, but youngsters with very low cognitive ability were not included in this study because they were not eligible for treatment at De Fjord. Furthermore, the EO and AO groups did not differ on single parent at birth,
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