Sex Differences in the Classification of Conduct Problems: Implications for Treatment

Abstract

Purpose Conduct problem behaviors are highly heterogeneous symptom clusters, creating many challenges in investigating etiology and planning treatment. The aim of this study was to first identify distinct subgroups of males and females with conduct problems using a data driven approach and, secondly, to investigate whether these subgroups differed in treatment outcome after an evidence-based crime prevention program. Methods We used a latent class analysis (LCA) in Mplus`to classify 517 males and 354 females (age 6-11) into classes based on the presence of conduct disorder or oppositional defiance disorder items from the Child Behavior Checklist. All children were then enlisted into the 13-week group core component (children and parent groups) of the program Stop Now And Plan (SNAP®), a cognitive-behavioral, trauma-informed, and gender-specific program that teaches children (and their caregivers) emotion-regulation, self-control, and problem-solving skills. Results The LCA revealed four classes for males, which separated into (1) "rulebreaking," (2) "aggressive," (3) "mild," and (4) "severe" conduct problems. While all four groups showed a significant improvement following the SNAP program, they differed in the type and magnitude of their improvements. For females, we observed two classes of conduct problems that were largely distinguishable based on severity of conduct problems. Participants in both female groups significantly improved with treatment, but did not differ in the type or magnitude of improvement. Conclusion This study presents novel findings of sex differences in clustering of conduct problems and adds to the discussion of how to target treatment for individuals presenting with a variety of different problem behaviors.

Profiles of Mental Health Problems Among Adolescents

“…Males tend to be dominant in peer and conduct problems, while females tend to be prevalent in emotional and peer problems. In the male version, the manifestation of conduct problems is shown by inappropriate behavior, such as rule-breaking and aggressive behavior, that harms individuals, families, and communities and is a severe public health concern [37,38]. Thus, CD is a serious mental health concern associated with a substantial risk of both current and future impairments.…”

Conduct Disorder: An Update

“…At this point, the importance of psychosocial interventions in the treatment of conduct disorders is emphasized in the literature, the importance of interventions to be made according to child and adolescent age groups is emphasized, and it is stated that the onset of these behaviors in the most aggressive young people who are likely to exhibit antisocial behaviors in adulthood dates back to childhood (Sagar et al 2019). In addition, interventions for behavioral problems are more effective when initiated in the middle childhood period (6-11 years) and are cognitive-behavior based (Smaragdi et al 2020). In children with conduct disorder before the age of ten, treatment includes child-, school-, and family-oriented studies, wheares in the treatment of adolescence-onset conduct disorder, communitybased practices, and partial hospitalization programs are added to the methods used in childhood-onset conduct disorder.…”

Psychosocial Intervention for Youth With High Externalizing Behaviors and Aggression Is Associated With Improvement in Impulsivity and Brain Gray Matter Volume Changes

“…In fact, boys who displayed the most diverse behavioral difficulties evidenced the most improvement ( 12 ). SNAP model programs also show evidence for reducing offending ( 12 ), reducing conduct problems in boys with high levels of conduct problems ( 13 ), and decreasing financial costs of chronic delinquency to society ( 14 ). For example, a cost benefit analysis found that every $1 spent on SNAP yielded an estimated savings between $2.05 and $3.75 ( 14 ).…”