Page 80 - Age of onset of disruptive behavior of residentially treated adolescents -Sjoukje de Boer

behaviour differ and it is argued that the LCP behaviour is more tenacious (Moffitt, 1993, 2003; Moffitt et al., 2008; Moffitt et al., 2002). Therefore, one could argue that attrition rates may be different for both groups. This was already implied by Moffitt et al. (2008), as she stated that “Clinical trials are needed to identify whether potential CD (Conduct Disorder) diagnostic criteria can predict treatment compliance or treatment response (p.31)”.
Dropout
Particularly in youths with disruptive behaviour, early termination of residential treatment may not only be initiated by the client but also by the therapist (Van den Reijen et al., 2013). A client may for instance be pushed out by the therapist because of incidents, or lack of commitment which in turn may lead to transferal to another, more restrictive facility (e.g., prison). In most studies, dropout is simply defined as premature termination of treatment (De Haan et al., 2013), without differentiation. However, significant differences may be expected between youths who drop out on their own initiative (i.e., withdrawal), compared to those dropping out on their therapists initiative (i.e., pushout) (Boon & Colijn, 2001). For this reason, in the present study, a distinction was made within the dropout group between withdrawal and pushout.
The aim of the present study was to examine treatment adherence in a sample of adolescent psychiatric inpatients with severe disruptive behaviour. It was expected that a substantial part of the sample would drop out of treatment, and can be characterized by pre-treatment characteristics previously associated with dropout (De Haan et al., 2013). Because disruptive behaviour comprises all kinds of behaviour (e.g., oppositional defiant behaviour, delinquent behaviour, and aggressive or violent behaviour), besides early-onset disruptive behaviour, we also looked into the specific types of disruptive behaviour and their relation to dropout. Also, a distinction was made between withdrawal and pushout, because of the assumed differences between these concepts.
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