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Disentangling Heterogeneity of Childhood Disruptive Behavior Problems Into Dimensions and Subgroups
Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands.
University of Notre Dame, Notre Dame, IN, United States; Vrije Universiteit, Amsterdam, Netherlands.
Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands.
Vrije Universiteit, Amsterdam, Netherlands.
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2017 (English)In: Journal of the American Academy of Child and Adolescent Psychiatry, ISSN 0890-8567, E-ISSN 1527-5418, Vol. 56, no 8, p. 678-686Article in journal (Refereed) Published
Abstract [en]

Objective: Irritable and oppositional behaviors are increasingly considered as distinct dimensions of oppositional defiant disorder. However, few studies have explored this multidimensionality across the broader spectrum of disruptive behavior problems (DBPs). This study examined the presence of dimensions and distinct subgroups of childhood DBPs, and the cross-sectional and longitudinal associations between these dimensions.

Method: Using factor mixture models (FMMs), the presence of dimensions and subgroups of DBPs was assessed in the Generation R Study at ages 6 (n = 6,209) and 10 (n = 4,724) years. Replications were performed in two population-based cohorts (Netherlands Twin Registry, n = 4,402, and Swedish Twin Study of Child and Adolescent Development, n = 1,089) and a clinical sample (n = 1,933). We used cross-lagged modeling in the Generation R Study to assess cross-sectional and longitudinal associations between dimensions. DBPs were assessed using mother-reported responses to the Child Behavior Checklist.

Results: Empirically obtained dimensions of DBPs were oppositional behavior (age 6 years), disobedient behavior, rule-breaking behavior (age 10 years), physical aggression, and irritability (both ages). FMMs suggested that one-class solutions had the best model fit for all dimensions in all three population-based cohorts. Similar results were obtained in the clinical sample. All three dimensions, including irritability, predicted subsequent physical aggression (range, 0.08-0.16).

Conclusion: This study showed that childhood DBPs should be regarded as a multidimensional phenotype rather than comprising distinct subgroups. Incorporating multidimensionality will improve diagnostic accuracy and refine treatment. Future studies need to address the biological validity of the DBP dimensions observed in this study; herein lies an important opportunity for neuro-imaging and genetic measures.

Place, publisher, year, edition, pages
Elsevier, 2017. Vol. 56, no 8, p. 678-686
Keywords [en]
disruptive behavior disorder, classification, DSM-5, irritable mood, factor mixture model
National Category
Psychology Psychiatry Pediatrics
Identifiers
URN: urn:nbn:se:oru:diva-59294DOI: 10.1016/j.jaac.2017.05.019ISI: 000406895100009PubMedID: 28735697Scopus ID: 2-s2.0-85021368426OAI: oai:DiVA.org:oru-59294DiVA, id: diva2:1136787
Funder
Forte, Swedish Research Council for Health, Working Life and WelfareSwedish Research Council
Note

Funding Agencies:

European Union Seventh Framework Program (FP7): ACTION: Aggression in Children: Unravelling gene-environment interplay to inform Treatment and InterventiON strategies  602768 

Erasmus Medical Centre, Rotterdam  

Erasmus University Rotterdam  

Netherlands Organization for Health Research and Development (ZonMw)  

Netherlands Organisation for Scientific Research  NWO 480-04-004  ZonMw 9121 0020  NWO 480-15001 

Netherlands Organization for Scientific Research: NWO-grant  016.VICI.170.200

Available from: 2017-08-29 Created: 2017-08-29 Last updated: 2017-10-16Bibliographically approved

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