Page 72 - Age of onset of disruptive behavior of residentially treated adolescents -Sjoukje de Boer

the AO youths. It thus seems that the EO group is more problematic compared to the AO group in terms of treatment adherence.
In itself this is not a surprising finding; EO youngsters are probably more inclined to lack the necessary support from their social environment and may thus feel less supported to complete treatment. Moreover, most of the EO patients already had a long treatment history that so far had little success. This will certainly have had an impact on the expectations of the patients regarding their treatment. Future research should be conducted on the relationship between EO disruptive behavior and dropout.
Patients of the EO group who stayed in treatment improved to the same extent as patients with AO disruptive behavior. Thus, for this selective group, no support was found for the hypothesis. More than half of both onset groups reported improvement or recovery during treatment, which was for most confirmed by their parents. This conclusion should be treated with caution, because parents of the EO group had a lower response rate than those of the AO group. It is likely that this difference in response rate relates to the severity of the problems (and etiological differences) of the EO group.
The finding that there were no differences in treatment outcome between the onset groups may be caused by several factors. Possibly the AO group responded less well on treatment because they were negatively influenced by the EO group. Besides, both onset groups (and not just the EO group) were highly problematic, because in addition to disruptive behavior, they were also affected by psychiatric disorders. Undoubtedly, this had an effect on the treatment outcomes of both groups. Maybe the EO group responded better to the treatment than may be expected because the environmental risk was eliminated by the admission. However, being admitted in an institution likely exacerbates problems (e.g., there is a concentration of juvenile delinquents to learn from, causing more environmental risks to arise).
Furthermore, the EO group staying in treatment may be a selective group that is more susceptible to interventions, which in part may explain why no differences were found between the onset groups. Also, all patients had a history of previous (unsuccessful) treatment. Therefore, the AO group members could not be considered the “promising candidates for intervention programs” where Moffitt was referring to (Moffitt et al., 1996). Maybe some of them belonged to the subgroup of patients with
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