Page 60 - Age of onset of disruptive behavior of residentially treated adolescents -Sjoukje de Boer

To date, not much is known about the effectiveness of treatment of adolescents with specifically LCP and AL disruptive behavior. Existing knowledge on the effectiveness of interventions targeting childhood onset disruptive behavior in clinical practice is predominantly based on studies with a younger population (e.g., Beauchaine et al., 2005; Hawes, Dadds, Brennan, Rhodes, & Cauchi, 2013). Although both the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) and the International Classification of Diseases 10th revision (ICD-10; World Health Organization, 2010) Conduct Disorder classifications included specifiers based on the distinction between childhood and adolescent onset, this has seldom been applied to treatment of adolescents. This is unfortunate, since differentiation in subgroups may result in more individualized and appropriate intervention and, consequently, better treatment results (Vermeiren, 2003).
The aim of the present study is thus to examine the treatment outcomes of adolescent inpatients with early-onset (EO) versus adolescent-onset (AO) disruptive behavior, who received residential treatment in a specialized facility for youths with severe behavioral problems. It was hypothesized that the outcome of treatment for individuals with EO disruptive behavior would be less satisfactory because their problems are enduring and have higher likelihood of being persistent. Interestingly, the assumption that individuals with EO disruptive behavior have worse prospects or may even be “therapy-resistant” has never been tested in clinical practice. The terms EO and AO were used because the course of the adolescent inpatients’ future disruptive behavior is as yet unknown. Adolescents diagnosed with severe disruptive behavior who also displayed this behavior during childhood, were labeled as EO. We expect that these adolescents are at increased risk of becoming LCP group members. Thus, although EO and LCP are not equivalent, EO is a risk factor for LCP. The inpatients with severe disruptive behavior who did not display disruptive behavior during childhood, were labeled as AO. Adolescents in this group will presumably develop as those in the AL group, even though it is not guaranteed that AO is equivalent to AL.
58