Predicting adult emotional and behavioral problems from externalizing problem trajectories in a 24-year longitudinal study

Abstract

The aim of this study was to examine the prediction of adult behavioral and emotional problems from developmental trajectories of externalizing behavior in a 24-years longitudinal population-based study of 2,076 children. The adult psychiatric outcome of these trajectories has not yet been examined. Trajectories of the four externalizing behavior types: aggression, opposition, property violations and status violations were determined separately through latent class growth analysis using data of five waves, covering ages 4-18 years. We used regression analyses to determine the associations between children's trajectories and adults' psychiatric problems based on the Adult Self-Report. The developmental trajectories of the four types of externalizing behavior mostly predicted intrusive, aggressive and rule-breaking behavior in adulthood. Non-destructive behaviors in childhood such as opposition and status violations predict adult problems to a larger extent than destructive behaviors such as aggression and property violations. In general, children who develop through high-level trajectories are likely to suffer from both internalizing and externalizing problem behavior in adulthood, regardless the direction of change (i.e. increasing/decreasing/persisting) of the high-level trajectory. We can conclude that the level rather than the developmental change of externalizing behavior problems has a larger impact on adult outcome.

Early childhood aggression trajectories

“…Emerging different trajectories may be predictive of distinct developmental outcomes. Several studies reported that higher levels and increasing patterns of childhood aggression were predictive of aggression and related behaviours at later ages (Kokko & Pulkkinen, 2005;Kokko, Pulkkinen, Huesmann, Dubow, & Boxer, 2009;Reef, Diamantopoulou, Van Meurs, Verhulst, & Van der Ende, 2010;Temcheff et al, 2008). For example, school-age children who followed a peer-rated trajectory with increasing levels of aggression had higher ratings of externalizing problem behaviour, poorer school performance, and were more often rejected by their peers as compared to children who showed a stable pattern of moderate or low aggression.…”

Neural Changes Associated with Treatment Outcome in Children with Externalizing Problems

“…Aggression in childhood, being a key characteristic of externalizing behaviour problems, is linked to severe psychosocial maladjustment across several domains including peer relations and academic functioning (Tremblay et al, 1992). Moreover, childhood aggression is predictive of later occupational instability, unemployment, marital problems (Caspi, 1987;Farrington, 1989;Loeber & Dishion, 1983;Patterson, Reid, & Dishion, 1992;Reef, Diamantopoulou, van Meurs, Verhulst, & van der Ende, 2010), depression, risky sexual behaviour, and substance abuse (Bongers, Koot, van der Ende, & Verhulst, 2008;Robins & Price, 1991;Timmermans, van Lier, & Koot, 2008;Tremblay, Pihl, Vitaro, & Dobkin, 1994).…”

To what extent can we predict the future?

“…When looking at developmental trajectories, it is important to know if these differ between twins and singletons [16]. The sequence of specific disorders should be analyzed longitudinally; Reef et al [14], for instance, have shown that symptoms of oppositional defiant disorder develop in parallel and are not precursors to those of conduct disorder. The value of children's as well as mothers' reports of children's aggression for predicting different types of serious antisocial behavior in adulthood has been supported [2] and serves as an example of research into the use of different informants for longitudinal studies.…”