Page 73 - Age of onset of disruptive behavior of residentially treated adolescents -Sjoukje de Boer

AO disruptive behavior that persists into adulthood, as described by Odgers (Odgers et al., 2008). The fact that a proportion of both groups did improve during treatment, might be because of the intensive, highly specialized, tailored treatment that was provided.
Another potentially important factor is the manner in which the constructs
were operationalized. Collins and Vermeiren (2013), for instance, indicated that EO 4 and AO can be operationalized in different ways and that outcomes may vary depending on whichever operationalization is applied. Inherent limitations in the operationalization of the (retrospective) EO and AO reporting and the (prospective)
LCP and AL group differentiation may have influenced our ability to confirm the hypotheses. It cannot be ruled out that some AO group members were actually members of the EO group. For instance, some AO group members might have committed crimes for which they were not prosecuted because they had not yet reached the age of criminal responsibility (Van Domburgh, Vermeiren, et al., 2009).
When these crimes and their onset were also not reported during the study, the actual
age of onset of the disruptive behavior may have been earlier than reported.
However, some children who have committed a single offence do not exhibit concurrent or persistent disruptive behavior. It has, for instance, been found that many childhood first-time arrestees did not re-offend (within 2 years) and about two third of them were not diagnosed with an externalizing disorder (Moffitt et al., 2002; Van Domburgh, Loeber, Bezemer, Stallings, & Stouthamer-Loeber, 2009). It is thus possible that some of the patients in our study have committed a single offense at a young age, while actually starting worrisome disruptive behavior from adolescence on. Also, recall bias cannot entirely be ruled out, leading to an overestimation of early disruptive behavior.
Limitations
Findings of this study need to be considered in light of some limitations. First, because the EO and AO groups had additional and often multiple psychiatric problems, they must be considered as a specific subsample of the groups described by Moffitt (Moffitt, 1993; Moffitt et al., 2008). It is very likely that the psychiatric disorders and disruptive behavior interact with each other, and because there was a variety of
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