Treatment of antisocial behavior in children: Current status and future directions.

Abstract

Antisocial behavior in children represents a serious and pervasive clinical problem. To date, progress in identifying effective treatments has been relatively slow. The purpose of the present article is to characterize the current status of treatment for antisocial child behavior, to identify promising approaches based on contemporary outcome research, and to note limitations and emergent methodological issues. A central purpose is to identify alternative models of treatment application and evaluation, including the high-strength intervention, amenability-to-treatment, broad-based treatment, and chronic-disease models. These models are designed to integrate findings regarding characteristics and prognosis of antisocial behavior with outcome research and to accelerate the identification and development of effective treatments.Antisocial behaviors include a broad range of activities, such as aggressive acts, theft, vandalism, fire setting, lying, truancy, and running away. Many terms-including acting out, externalizing behaviors, conduct disorder or conduct problems, and delinquency-denote antisocial behaviors. Two of the terms are worth delineating at the outset. For present purposes, antisocial behavior is used to refer broadly to any behaviors that reflect social-rule violations or acts against others. In this usage, antisocial behavior refers to such acts as fighting, lying, and other behaviors whether or not they are necessarily severe. Such behaviors are evident in clinically referred youths, but they are also seen in varying degrees in most children over the course of normal development. The term conduct disorder is used to refer to instances when the children evince a pattern of antisocial behavior, when there is significant impairment in everyday functioning at home or school, or when the behaviors are regarded as unmanageable by significant others. Thus, conduct disorder is reserved here for antisocial behavior that is clinically significant and clearly beyond the realm of "normal" functioning.The significance of conduct disorder as a clinical and social problem can be punctuated by highlighting major characteristics.Prevalence. The prevalence of conduct disorder is difficult to estimate, given different denning criteria and variations in rates for children of different ages, sexes, socioeconomic classes, and geographical locales. Nevertheless, estimates of the rate of conduct disorder among children have ranged from approximately

Academic Performance of Students with Emotional and Behavioral Disorders Served in a Self-Contained Setting

“…Despite the limitations noted above, findings from this study confirm earlier works that report substandard performance in academic, social, and behavioral domains; with patterns that remain stable (Anderson et al 2001;Nelson et al 2004) or even worsen (e.g., math, Nelson et al 2004) over time (Kazdin 1987;Walker et al 2004). Although results, particularly the findings related to the predictive utility of school adjustment, should be considered tentative at best, these outcomes do offer important considerations for educational programming.…”

“…Namely, when students are unable to negotiate social demands and meet teachers' expectations for school success , school becomes a formidable task. In the absence of effective interventions, these behavior patterns become more firmly established and less amenable to intervention efforts (Kazdin 1987;Walker et al 2004).…”

Long-Term Safety and Efficacy of Risperidone for the Treatment of Disruptive Behavior Disorders in Children With Subaverage IQs

“…This longterm OL trial shows positive effects on behavior with minimal side effects compared with reports in the literature regarding the use of haloperidol, clonidine, and lithium. 16,24,[42][43][44][45][46][47][48] Based on various a posteriori subgroup analyses of the primary behavioral outcome variable, low-dose risperidone was equally effective for the treatment of symptoms of CD, ODD, and DBD-NOS, and in participants who had borderline intellectual function, or were mildly or moderately mentally retarded. Furthermore, the efficacy of risperidone was not diminished by the presence of somnolence or ADHD, or by the use of psychostimulants.…”

Initial impact of the fast track prevention trial for conduct problems: I. The high-risk sample.

“…The Fast Track program involves a developmentally based, long-term multicomponent, and multisite intervention, evaluated using a randomized design with a no-intervention control group and a comprehensive multimethod set of assessment strategies (Cicchetti, 1984;Kazdin, 1987). A model of the developmental pathways associated with early starting conduct problems provided the framework for the prevention design that is described later.…”

“…On this scale, parents used a 3-point scale to rate items describing the extent to which their child exhibited a series of oppositional, aggressive, and delinquent behaviors. Parents also completed the Parent Daily Report (PDR; 1987) on three occasions, indicating whether or not 30 different behavior problems occurred during the previous 24-hr period. A preliminary factor analysis of the PDR identified 15 behaviors that factored onto two scales, reflectin g 6 aggressive behaviors (e.g., fighting, hitting, and yelling; α = .83) and 9 oppositional behaviors (e.g., whining, talking back, and noncompliance; α = .81).…”