Page 88 - Age of onset of disruptive behavior of residentially treated adolescents -Sjoukje de Boer

14.87, p=.001). The model as a whole explained 10.1% (Nagelkerke R-square) of the variance, and correctly identified 64.1% of cases.
Withdrawal versus pushout
About half of 77 participants of the dropout group were expelled from treatment (n=37; 16.5% of the total sample) because of incidents or complete lack of commitment. Many of them were transferred to a more restrictive residential facility (judicial institution or adult mental healthcare institution: 37.8%) and a quarter of the pushouts (24.3%) ended up in a crisis centre, wandered around or had a unknown residence. The other half of the dropouts (n=40; 17.8% of the total sample) withdrew from treatment. They ran away, did not return from leave or decided unilaterally and against the advice of the therapist to terminate the treatment. The dropout groups were compared on all pre-treatment client and disruptive behaviour characteristics listed in Tables 2 and 3. None of the pre-treatment client and disruptive behaviour characteristics differed, except the YSR Externalising score, which was higher for the pushouts (M=60.2, SD=9.9 versus M=55.9, SD=11.8, p=.05).
Discussion
Although not all clients benefit from psychiatric treatment or interventions aimed at reducing behavioural problems, treatment increases the likelihood that psychiatric and behavioural problems get resolved (e.g., Kazdin et al., 1994; M. Shaw et al., 2012). Hence, when clients drop out, their disorders might persist or even worsen later in life, because children with untreated behavioural problems are more likely to leave school without a qualification, tend to engage in delinquent activities more often, have high incidence of drug and alcohol abuse, and are likely to become unemployed as adults (De Haan et al., 2013; Moffitt et al., 2002). Therefore, preventing dropout and its negative consequences carries clinical relevance, with advantages for both the individual and the society as a whole. Especially among samples with a high incidence of disruptive behaviour, the stakes are high, because if left untreated, these individuals tend to cause substantial social turmoil.
In the meta-analysis on dropout among non-residential child and adolescent outpatients of De Haan et al. (2013), dropout percentages of 28-75% were shown.
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