Title from PDF of title page. / Document formatted into pages; contains 124 pages. / Thesis (Ed.S.)--University of South Florida, 2003. / Includes bibliographical references. / Text (Electronic thesis) in PDF format. / ABSTRACT: This research study compared perceptions of family functioning among preadolescent children with behavior difficulties and their primary caregivers. Participants consisted of 29 caregiver-child dyads as well as each child's classroom teacher. Eligibility for the study was based on the child's placement within a self-contained Emotionally Handicapped (EH) or Severely Emotionally Disturbed (SED) classroom in one of three elementary schools within two west coast Florida counties. Data collection included teacher rating scales pertaining to the severity of each child's behavior and the presence of Callus Unemotional (CU) traits in addition to caregiver and child interviews tapping perceptions of family functioning. Results indicated that caregivers consistently viewed their families as more adaptive and cohesive than did children with a disruptive behavior disorder. / ABSTRACT: These findings are consistent with previous research showing a similar pattern among older adolescents with a disruptive behavior disorder. No relationship was not found between the child's perception of family functioning and CU traits, although it was noted that there was considerable restriction of range on CU traits. Overall, the results of this study contributes to the existing literature by demonstrating that preadolescents, like their older counterparts, also view their families as less adaptive and cohesive than do their caregivers. Limitations and directions for future research are discussed. / System requirements: World Wide Web browser and PDF reader. / Mode of access: World Wide Web.

Although anxiety disorders and conduct problems often co-occur in children and adolescents, literature describing the effects of such co-occurrence is mixed. There is evidence that symptoms of anxiety disorders may mitigate symptoms of conduct problems (buffering hypothesis) or may exacerbate symptoms of conduct problems (multiple problem hypothesis). A dual-pathway model has been proposed that suggests several possible etiological or risk processes that may differentiate these pathways (i.e., the buffering hypothesis or the multiple problem hypothesis) (Drabick, Ollendick, & Bubier, 2010). Executive functioning is one factor that has been identified that may differentially confer risk to the proposed pathways; however, little research has been done investigating its role. The purpose of the present study was to evaluate the dual-pathway model by determining whether executive functioning abilities contribute to differentiating those youth for whom anxiety exacerbates conduct problems from those for whom anxiety mitigates conduct problems. Specifically, the study sought to examine if executive functioning moderated the effect of anxiety symptom severity on conduct problems. Latent variable structural equation modeling (SEM) was used to analyze the data of 221 youth aged 9 to 16 in a residential treatment center who completed a full neuropsychological evaluation. Results of the study failed to support the hypothesis that executive functioning moderates the effect of anxiety on conduct problems. Furthermore, a structural equation model without an interaction between executive functioning and anxiety was found to fit the data better than a model with an interaction between those variables. Overall, the study found that executive functioning abilities could not distinguish youth for whom anxiety exacerbates conduct problems from youth for whom anxiety mitigates conduct problems. Recommendations for future research in light of the limitations of the current study, as well as remaining gaps in the literature, are discussed. / text

The academic underachievement of children and adolescents diagnosed with conduct disorder is well established in the literature. However, no study to date has explored the contributions of personal and contextual variables to specific areas of academic functioning in this population. In this study measures of basic reading, reading comprehension, mathematics reasoning, and numerical operations were assessed using the Wechsler Individual Achievement Test (WIAT) in 63 participants with childhood onset (CO) conduct disorder and 27 participants with adolescent onset (AO) conduct disorder. Participants were enrolled in a residential treatment facility between 1998 and 2002 at the time of evaluation. A series of ANCOVAs were conducted to evaluate how verbal IQ, onset subtype, comorbid ADHD, and residence location (urban versus nonurban) influenced each academic area. Only verbal IQ was significantly related to all academic areas. After adjusting for the variance explained by verbal IQ, comorbid ADHD did not significantly influence academic scores. After controlling for verbal IQ, participants with either CO or an urban residence were found to have significantly weaker scores in basic reading. Urban residents with CO had significantly weaker performance in mathematical reasoning. Numerical operations scores were the weakest among the four academic areas for both onset groups, and verbal IQ explained a relatively small portion of the variance. Overall, a larger portion of the variance in academic scores was explained among the AO group than the CO group, suggesting subtler complexities among the CO population that are yet unknown. This study highlights the heterogeneity among the conduct disorder population and variation in academic risk by demographic markers. If these results replicate across studies, they may represent a more parsimonious organization of patterns of characteristics that will provide treatment utility for clinical work and educational intervention beyond what is currently used.

Individuals afflicted with childhood and adolescent mental disorders have an increased risk for poor outcome in adulthood. The progression of psychopathology from childhood to adult life may be influenced by a multitude of interacting variables, both biological and psychosocial. There is limited information on the relationships between child psychopathology and adult personality and personality disorders. The main aim of this thesis was therefore to gain better knowledge concerning adult personality outcome in patients with early onset of mental disorders. Former child psychiatric patients as compared to controls had a significantly higher prevalence of all DSM-IV personality disorders (38.0 vs. 10.9 percent, p<0.001) and also a considerably higher personality disorder co-morbidity. They also had more psychosocial and environmental problems. This was exaggerated in those diagnosed with a personality disorder. Major depression, disruptive disorders and substance use disorders at a young age were strong predictors for adult personality disorder. Patients with an early onset major depression had more personality disorders and more deviant personality traits than those with a late onset. Forensic psychiatric male patients diagnosed with a previous conduct disorder as compared to those without had more cluster B personality disorders, and more repeated violent criminality and mixed abuse. They also exhibited more deviant personality traits and higher psychopathy scores. The instrument "Child and Adolescent Psychiatric Screening Inventory-Retrospect" had acceptable sensitivity and specificity for assessment of child psychiatric disorders. Subscales demonstrated good internal reliability (Crohnbach´s alpha = 0.76-0.93). The results suggest that adult personality disturbances are prevalent in individuals affected with mental problems at young ages. A better understanding of the transition of psychopathology from childhood to adulthood and a better identification of those at risk will be of help in attempts to prevent permanent impact on the adult personality.

Este estudo, intitulado Adolescente infrator: A mediação prevista na nova Lei do Sistema Nacional de Atendimento Socioeducativo (SINASE) na cidade do Rio de Janeiro trata da mediação na vertente transformativa, com o objetivo de permitir nova ótica sobre a conduta infratora e as consequências dos atos no mundo social. Esta forma de atuação, dentre outros benefícios, pode evitar o desgaste jurisdicional, na medida em que os casos selecionados a partir de suas características passam a ser operados por especialistas em composição pacífica de conflitos, com a perspectiva de seres humanos que necessitam da inter-relação no convívio social. Os mediadores trabalham com os adolescentes em conflito com a lei, seus pais e as vítimas. Destarte, verificando as circunstâncias favoráveis à mediação, passa-se ao diálogo para alcançar um acordo, mantendo-se o centro da intervenção no conflito e na relação dos conflitantes, incentivando a capacitação para a negociação a partir do reconhecimento do direito do outro, produzindo a transformação interna dos litigantes que causará, como efeito desejado, a dissolução do conflito. A princípio os mediadores devem atuar apenas em fatos de menor potencial ofensivo, como agressões leves e outros conflitos entre adolescentes. Com o passar do tempo e o aperfeiçoamento da prática, é possível abarcar outras classes de prática infracional, a exemplo de pequenos furtos. Para tanto, na fase de pesquisa, tentando-se explicar a mediação transformadora a partir das referências teóricas publicadas em livros ou obras congêneres, utilizou-se a técnica bibliográfica; na fase da redação, ordenou-se o material coletado, segundo a lógica necessária à elaboração de um trabalho científico. O método a presidir este estudo foi o dedutivo, na medida em que parte da análise geral das crianças e dos adolescentes, em especial aqueles em conflito com a lei, para depois apresentar a teoria geral da mediação e em seguida, numa abordagem mais particular, enfrentar as questões envolvendo a mediação no Sistema Nacional de Atendimento Socioeducativo (SINASE) para, ao final, defender que é preciso desvendar o marco normativo que autoriza a prática da mediação como instrumento de resolução de questões relacionadas com o adolescente em conflito com a lei, para identificar a natureza jurídica desse modelo de mediação e, ao final, a título de sugestão, desenhar seu procedimento não estabelecido pela lei material que a prevê, qual seja, a Lei n 12.594, de 18 de janeiro de 2012. O grande desafio é establecer a metodologia adequada para que a autocomposição de conflito seja restaurativa ao adolescente infrator e aos integrantes desse conflito instaurado. O resgate do meio social abalado com a prática infracional é tão importante quanto a conscientização do adolescente. A pretensão é sugerir um marco normativo que posicione o procedimento da mediação como instrumento de ligação do indivíduo adolescente infrator, com o ambiente social onde está inserido, e com o formalismo processual que vem afastando o Poder Judiciário de sua função social de dizer o direito e fazer justiça. / This paper entitled Young Offender: from the island of exclusion to the bridge of social re-integration based on the concept of mediation found in the new Act SINASE focuses on transformative mediation with a view to shedding new light on the conduct disorder and its consequences to society. This form of action, among some other benefits, may avoid taking such cases to Court, as they may be dealt with according to their features by experts in conflicts aiming at guiding the human beings in need of establishing bonds in social life. The mediators work with young offenders who are in conflict with the law, their parents and their victims. Having checked the circumstances favourable to the mediation, the mediator establishes a clear conversation with all of them, focusing primarily on the conflict itself and the relationship among them. The mediator encourages negotiation taking into account their different views, which provides appropriate conditions for the internal transformation of the litigants and hopefully produces the dissolution of the major conflict. The mediators should initially deal with only less serious cases, such as assaults and other minor conflicts among adolescents. As the mediators get more experienced, they may also focus on some other types of law infractions like petty thefts, for instance. In order to achieve satisfactory results, the mediation has been initially explained according to the Literature in this area and in a second phase the necessary data to write a piece of scientific work was collected. A deductive methodology has been adopted and to start with there is an overall analysis of children and adolescents, particularly those in conflict with the law. The general theory of mediation is then addressed followed by a particular approach on the issues concerning mediation in SINASE. Finally it is argued that it is necessary to unravel the regulatory framework which authorizes the practice of mediation as a tool for addressing issues related to adolescents in conflict with the law. The main objective is to identify the legal nature of this type of mediation and establish its use which has not been addressed in Law No. 12594 of January 18, 2002 which originally makes reference to it. The greatest challenge is to find the appropriate methodology and to guarantee that the way to conduct the conflict becomes restorative for both the young offender and the other members involved in it. The attempt to rescue the social environment affected by the law infraction is as important as the effort to raise the adolescent‟s awareness of the issue. It is intended to suggest a regulatory framework that sets the procedure of mediation as a tool to connect the young offender, the social environment and the procedural rules that have prevented the judicial system to perform its main duty which is to do justice to society.

<b>Introduction:</b> Children's social, emotional, and behavioural difficulties are associated with reduced academic performance, stressed teacher-child relationships, and other negative academic and life outcomes. The Incredible Years Teacher Classroom Management (IY TCM) programme is one intervention developed to address problematic behaviours via training teachers to use positive and proactive management strategies. The overall aim of this DPhil is to use the Incredible Years Teacher Classroom Management programme as a case study for applying mixed methods at the systematic review level to ascertain what is known about both the programme's effectiveness and how people experience the course, and subsequently to use the systematic review's findings as a springboard (rather than as an end goal) for more exploratory research into 'for whom' the programme might work. <b>Method:</b> Study One is a mixed methods systematic review of IY TCM. It applied multilevel meta-analysis to RCT outcome data and grounded theory meta-synthesis to interview and focus group data on stakeholders' experiences of IY TCM. Quantitative and qualitative findings were cross-synthesised and mapped using an integrative grid. Study Two moves the field forward by filling a gap in the evidence base, as identified in Study One. Semi-structured telephone interviews were conducted with special educational needs coordinators (SENCos) across Devon, exploring the acceptability and appropriateness of expanding IY TCM to the subgroup of children with special educational needs (SEN) in mainstream schools. Data were analysed thematically and mapped onto IY TCM content. <b>Results:</b> In Study One, nine studies reported across 14 papers met inclusion criteria for either quantitative or qualitative strands of this systematic review. Multilevel meta-analysis of RCTs (n=4) indicated that the programme produced teacher- and child-level results in the desired directions. Clear trends across all measured outcomes favoured the intervention group over the treatment-as-usual comparison. Qualitative meta-synthesis (n=5) illuminated a cyclical learning process and broader conceptualisation of teacher and child outcomes than was evident in the quantitative evidence. Notably, RCT data on teacher outcomes were limited to self-reported or observed behaviours, while teachers described other benefits from IY TCM including increased knowledge and emotional well-being. Cross-synthesis of findings from the two review strands highlighted harmony across the RCT and qualitative evidence but also a number of areas in which constructs that were prioritised by one type of research were not integrated into the other. Study Two generated classroom management strategies from SENCos, which aligned closely with strategies taught in IY TCM, indicating that IY TCM would be both acceptable and applicable (if not sufficient) for use when working with children identified with SEN and behavioural difficulties in schools. <b>Discussion:</b> Based on the positive effects of implementing IY TCM despite very few studies to power analyses, the programme appears to offer tangible benefits to both teachers and children. It is possible that results are underestimated due to limited types of outcomes measured and absence of experiential data from additional stakeholders (e.g., parents). Depending on current provision of special educational needs services, schools operating inclusion models are likely to find these strategies beneficial for children identified with SEN, and this subgroup should be explicitly examined in future IY TCM studies.

Objetivos: O transtorno de déficit de atenção/hiperatividade (TDAH), o transtorno de conduta (TC) e o transtorno opositor desafiante (TOD) frequentemente ocorrem juntos na infância. No entanto, a existência e importância destes transtornos na vida adulta ainda é motivo de discussão. Este estudo tem como objetivo avaliar a extensão do impacto da história de TOD e TC na saúde mental global de indivíduos com TDAH persistente. Visa também avaliar a relação desses achados com o modelo de desinibição comportamental, considerando os perfis de desenvolvimento neurológico, personalidade e comorbidades. Métodos: Os pacientes foram selecionados consecutivamente a partir de uma amostra de conveniência no ambulatório de pesquisa do TDAH em adultos do Hospital de Clínicas de Porto Alegre (n=458). O grupo controle foi composto de voluntários doadores de sangue no Hemocentro do mesmo hospital (n=121). Os diagnósticos foram realizados com base nos critérios do DSM-IV, sendo os sujeitos avaliados para o TDAH e o TOD através do K-SADS-E; para o TC e o transtorno de personalidade anti-social através do MINI; e através do SCID para as demais comorbidades. A gravidade do TDAH foi avaliada utilizando o SNAP, e a personalidade avaliada com o TCI (Cloninger). Na análise foram comparados os pacientes com TDAH e os controles. No caso das variáveis com diferenças significativas, comparamos três grupos: TDAH sem história de TC ou de TOD (n=178); TDAH com história de TOD (sem TC) (n=184) e TDAH com história de TC (com ou sem TOD) (n=96). Resultados: Pacientes com TDAH apresentaram um perfil mais grave na comparação com os controles em diversas variáveis, incluindo todas as comorbidades. Internamente ao grupo com TDAH, uma história positiva de TC (e, em grau menor, de TOD) associou-se a maior gravidade e a um perfil mais externalizador. Conclusão: Uma história positiva de TOD e TC na infância ou adolescência associa-se a um impacto negativo na saúde mental de sujeitos com TDAH persistente, reforçando o valor preditivo destes transtornos para a saúde mental do adulto. Estes achados sugerem uma ligação entre déficits do desenvolvimento, características de personalidade, e desdobramentos de psicopatologias, que é consistente com o conceito de cascada de desinibição comportamental. / Objective: Attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder (CD) are frequently co-occurring disorders in children and adolescents. However, their clinical status among adults is disputed. This study analyzes how the clinical presentation of persistent ADHD might be influenced by a childhood or adolescence history of CD and ODD, and how these findings fit in the behavioral disinhibition framework. Methods: Patients were ascertained in an ADHD outpatient clinic. Diagnoses were based on the DSM-IV criteria and all subjects were evaluated using the KSADS- E for ADHD and ODD, MINI for CD/ASPD, SCID-I for other comorbidities, SNAP-IV for ADHD severity and Cloninger’s Temperament and Character Inventory (TCI) for personality. We compared patients with ADHD (n= 458) with controls (n=121). For those variables with significant differences, we compared three groups of patients: ADHD without history of CD or ODD (n=178); ADHD + history of ODD (without CD) (n=184) and ADHD + history of CD (with or without ODD) (n=96). Results: Patients with ADHD presented a worse profile than controls in several variables, including a higher frequency of all comorbidities. Within the ADHD group, a history of CD (and to a lower extent ODD) is associated with a more severe and externalizing profile. Conclusion: A history of CD and ODD entail a significant negative mental health impact on persistent ADHD, reinforcing the predictive validity of these entities in adulthood mental health. These findings suggest a link among neurodevelopmental deficits, personality characteristics, and unfolding of psychopathology consistent with the behavioral disinhibition cascade.

Este estudo, intitulado Adolescente infrator: A mediação prevista na nova Lei do Sistema Nacional de Atendimento Socioeducativo (SINASE) na cidade do Rio de Janeiro trata da mediação na vertente transformativa, com o objetivo de permitir nova ótica sobre a conduta infratora e as consequências dos atos no mundo social. Esta forma de atuação, dentre outros benefícios, pode evitar o desgaste jurisdicional, na medida em que os casos selecionados a partir de suas características passam a ser operados por especialistas em composição pacífica de conflitos, com a perspectiva de seres humanos que necessitam da inter-relação no convívio social. Os mediadores trabalham com os adolescentes em conflito com a lei, seus pais e as vítimas. Destarte, verificando as circunstâncias favoráveis à mediação, passa-se ao diálogo para alcançar um acordo, mantendo-se o centro da intervenção no conflito e na relação dos conflitantes, incentivando a capacitação para a negociação a partir do reconhecimento do direito do outro, produzindo a transformação interna dos litigantes que causará, como efeito desejado, a dissolução do conflito. A princípio os mediadores devem atuar apenas em fatos de menor potencial ofensivo, como agressões leves e outros conflitos entre adolescentes. Com o passar do tempo e o aperfeiçoamento da prática, é possível abarcar outras classes de prática infracional, a exemplo de pequenos furtos. Para tanto, na fase de pesquisa, tentando-se explicar a mediação transformadora a partir das referências teóricas publicadas em livros ou obras congêneres, utilizou-se a técnica bibliográfica; na fase da redação, ordenou-se o material coletado, segundo a lógica necessária à elaboração de um trabalho científico. O método a presidir este estudo foi o dedutivo, na medida em que parte da análise geral das crianças e dos adolescentes, em especial aqueles em conflito com a lei, para depois apresentar a teoria geral da mediação e em seguida, numa abordagem mais particular, enfrentar as questões envolvendo a mediação no Sistema Nacional de Atendimento Socioeducativo (SINASE) para, ao final, defender que é preciso desvendar o marco normativo que autoriza a prática da mediação como instrumento de resolução de questões relacionadas com o adolescente em conflito com a lei, para identificar a natureza jurídica desse modelo de mediação e, ao final, a título de sugestão, desenhar seu procedimento não estabelecido pela lei material que a prevê, qual seja, a Lei n 12.594, de 18 de janeiro de 2012. O grande desafio é establecer a metodologia adequada para que a autocomposição de conflito seja restaurativa ao adolescente infrator e aos integrantes desse conflito instaurado. O resgate do meio social abalado com a prática infracional é tão importante quanto a conscientização do adolescente. A pretensão é sugerir um marco normativo que posicione o procedimento da mediação como instrumento de ligação do indivíduo adolescente infrator, com o ambiente social onde está inserido, e com o formalismo processual que vem afastando o Poder Judiciário de sua função social de dizer o direito e fazer justiça. / This paper entitled Young Offender: from the island of exclusion to the bridge of social re-integration based on the concept of mediation found in the new Act SINASE focuses on transformative mediation with a view to shedding new light on the conduct disorder and its consequences to society. This form of action, among some other benefits, may avoid taking such cases to Court, as they may be dealt with according to their features by experts in conflicts aiming at guiding the human beings in need of establishing bonds in social life. The mediators work with young offenders who are in conflict with the law, their parents and their victims. Having checked the circumstances favourable to the mediation, the mediator establishes a clear conversation with all of them, focusing primarily on the conflict itself and the relationship among them. The mediator encourages negotiation taking into account their different views, which provides appropriate conditions for the internal transformation of the litigants and hopefully produces the dissolution of the major conflict. The mediators should initially deal with only less serious cases, such as assaults and other minor conflicts among adolescents. As the mediators get more experienced, they may also focus on some other types of law infractions like petty thefts, for instance. In order to achieve satisfactory results, the mediation has been initially explained according to the Literature in this area and in a second phase the necessary data to write a piece of scientific work was collected. A deductive methodology has been adopted and to start with there is an overall analysis of children and adolescents, particularly those in conflict with the law. The general theory of mediation is then addressed followed by a particular approach on the issues concerning mediation in SINASE. Finally it is argued that it is necessary to unravel the regulatory framework which authorizes the practice of mediation as a tool for addressing issues related to adolescents in conflict with the law. The main objective is to identify the legal nature of this type of mediation and establish its use which has not been addressed in Law No. 12594 of January 18, 2002 which originally makes reference to it. The greatest challenge is to find the appropriate methodology and to guarantee that the way to conduct the conflict becomes restorative for both the young offender and the other members involved in it. The attempt to rescue the social environment affected by the law infraction is as important as the effort to raise the adolescent&#8223;s awareness of the issue. It is intended to suggest a regulatory framework that sets the procedure of mediation as a tool to connect the young offender, the social environment and the procedural rules that have prevented the judicial system to perform its main duty which is to do justice to society.

Objetivos: O transtorno de déficit de atenção/hiperatividade (TDAH), o transtorno de conduta (TC) e o transtorno opositor desafiante (TOD) frequentemente ocorrem juntos na infância. No entanto, a existência e importância destes transtornos na vida adulta ainda é motivo de discussão. Este estudo tem como objetivo avaliar a extensão do impacto da história de TOD e TC na saúde mental global de indivíduos com TDAH persistente. Visa também avaliar a relação desses achados com o modelo de desinibição comportamental, considerando os perfis de desenvolvimento neurológico, personalidade e comorbidades. Métodos: Os pacientes foram selecionados consecutivamente a partir de uma amostra de conveniência no ambulatório de pesquisa do TDAH em adultos do Hospital de Clínicas de Porto Alegre (n=458). O grupo controle foi composto de voluntários doadores de sangue no Hemocentro do mesmo hospital (n=121). Os diagnósticos foram realizados com base nos critérios do DSM-IV, sendo os sujeitos avaliados para o TDAH e o TOD através do K-SADS-E; para o TC e o transtorno de personalidade anti-social através do MINI; e através do SCID para as demais comorbidades. A gravidade do TDAH foi avaliada utilizando o SNAP, e a personalidade avaliada com o TCI (Cloninger). Na análise foram comparados os pacientes com TDAH e os controles. No caso das variáveis com diferenças significativas, comparamos três grupos: TDAH sem história de TC ou de TOD (n=178); TDAH com história de TOD (sem TC) (n=184) e TDAH com história de TC (com ou sem TOD) (n=96). Resultados: Pacientes com TDAH apresentaram um perfil mais grave na comparação com os controles em diversas variáveis, incluindo todas as comorbidades. Internamente ao grupo com TDAH, uma história positiva de TC (e, em grau menor, de TOD) associou-se a maior gravidade e a um perfil mais externalizador. Conclusão: Uma história positiva de TOD e TC na infância ou adolescência associa-se a um impacto negativo na saúde mental de sujeitos com TDAH persistente, reforçando o valor preditivo destes transtornos para a saúde mental do adulto. Estes achados sugerem uma ligação entre déficits do desenvolvimento, características de personalidade, e desdobramentos de psicopatologias, que é consistente com o conceito de cascada de desinibição comportamental. / Objective: Attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder (CD) are frequently co-occurring disorders in children and adolescents. However, their clinical status among adults is disputed. This study analyzes how the clinical presentation of persistent ADHD might be influenced by a childhood or adolescence history of CD and ODD, and how these findings fit in the behavioral disinhibition framework. Methods: Patients were ascertained in an ADHD outpatient clinic. Diagnoses were based on the DSM-IV criteria and all subjects were evaluated using the KSADS- E for ADHD and ODD, MINI for CD/ASPD, SCID-I for other comorbidities, SNAP-IV for ADHD severity and Cloninger’s Temperament and Character Inventory (TCI) for personality. We compared patients with ADHD (n= 458) with controls (n=121). For those variables with significant differences, we compared three groups of patients: ADHD without history of CD or ODD (n=178); ADHD + history of ODD (without CD) (n=184) and ADHD + history of CD (with or without ODD) (n=96). Results: Patients with ADHD presented a worse profile than controls in several variables, including a higher frequency of all comorbidities. Within the ADHD group, a history of CD (and to a lower extent ODD) is associated with a more severe and externalizing profile. Conclusion: A history of CD and ODD entail a significant negative mental health impact on persistent ADHD, reinforcing the predictive validity of these entities in adulthood mental health. These findings suggest a link among neurodevelopmental deficits, personality characteristics, and unfolding of psychopathology consistent with the behavioral disinhibition cascade.

Abstract Data from the National Longitudinal Survey of Children and Youth (NLSCY), and the Avon Longitudinal Study of Parents and Children (ALSPAC), both prospective cohorts, were used to explore the association between early life stressors, childhood protective factors, and early adolescent mental health outcomes (depression, anxiety, conduct disorder, and attention deficit hyperactivity disorder). Early life stressors were measured prenatally to the age of 3 within the ALSPAC analysis, while early life stressors were measured between the ages of 1-3 within the NLSCY analysis. Childhood protective factors, exclusively modifiable protective factors, (physical activity, extracurricular activities, positive parenting, and positive friendships) were measured between the ages of 6-11 within both ALSPAC and the NLSCY. Mental health outcomes were measured between the ages of 12-15 in both ALSPAC and the NLSCY. The associations between early life stressors and childhood protective factors on early adolescent mental health outcomes were computed using multivariate logistic regression modeling. It was found that the majority of early life stressors, including prenatal stressors and family dysfunction increased the odds of developing early adolescent mental health disorders although more statistically significant results were found within the NLSCY analysis. Contrarily, it was found that the majority of childhood protective factors reduced the likelihood of early adolescent mental health disorders with some exceptions found within the NLSCY analysis. No interaction terms between early life stressors and childhood protective factors were found to be statistically significant.