Page 19 - Age of onset of disruptive behavior of residentially treated adolescents -Sjoukje de Boer

number of diagnoses, referral source, and lower social functioning. These 1 characteristics prevail among the youngsters of the orthopsychiatric institute.
To our knowledge, not much is known about characteristics associated with dropout within youth treated for disruptive behavior. The aforementioned distinction in LCP and AL antisocial behavior may play a role with regard to dropout, as was suggested by Moffitt (2008) stating that “Clinical trials are needed to identify whether potential CD (Conduct Disorder) diagnostic criteria can predict treatment compliance or treatment response (p.31)”. Among youth treated for severe disruptive behavior, it may be of relevance to distinguish by types of dropout (see Van den Reijen et al., 2013), i.e., withdrawal and expulsion. This distinction based on how treatment was terminated is in line with the dropout definition of De Haan and colleagues (De Haan et al., 2013). In regular psychiatric settings, most dropouts will be withdrawals (i.e., those who terminate treatment against the advice of the therapist). Although this will also hold for many individuals dropping out of orthopsychiatric treatment, it is to be expected that a number of them will be expelled because they continue to display unremitting disruptive behavior. Differentiating between types of dropout may be important in predicting, addressing and preventing dropout and may particularly be relevant to all settings working with conduct disordered youths and other samples with a high incidence of disruptive behavior. It may for instance also be that individuals with EO disruptive behavior have higher chance at expulsion.
Substance Use
Substance use is common among adolescents. At the time this study, in The Netherlands about half of all youngsters age 17 or 18 had used cannabis (Verdurmen et al., 2011). Especially among groups of troubled youth (i.e., loitering youth, homeless youth, truants, and youths under the supervision of youth welfare or judicial institution) the prevalence is substantial. Among adolescents admitted to judicial youth institutions for instance, percentages of 70% were found (Van Laar et al., 2014). There is a strong relation between substance use and antisocial behavioral (conduct disorder) (Disney, Elkins, McGue, & Iacono, 1999; Grant et al., 2015; Kendler, Prescott, Myers, & Neale, 2003) and it has even been found that early-onset conduct problems are a strong risk factor for adolescent problem cannabis use (Heron et al., 2013). With
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