B235 - Adolescent onset conduct problems a biopsychosocial model of risk - 01/04/2005
Rates of conduct problems rise sharply in the teens. Though less noxious than childhood onset
disruptiveness, adolescent conduct problems - affecting a much wider segment of the population -
nonetheless compromise later life-chances, impair relationships, and impact on both physical and mental
health. Most worrying, our research suggests that levels of adolescent conduct problems have been rising
in the UK across the last quarter of the 20th century, but that their implications for later adjustment remained
unchanged.
Much is now known about risks for early childhood conduct problems. By contrast, risks for adolescent
onset difficulties are less well understood. This proposal is designed to fill that gap, capitalizing on two key
UK data sources:
First, it will build on the rich developmental data already collected in the Avon Longitudinal Study of Parents
and Children (ALSPAC). Beginning in pregnancy, ALSPAC has amassed extensive developmental,
behavioural, psychological, biological and social data on a cohort of some 14,000 children. Born in 1991
and 92, the ALSPAC cohort are now entering the key risk period for adolescent onset conduct problems.
We propose new data collection at ages 15-16 which, in conjunction with existing measures, we will use (i)
to characterize trajectories of conduct problems across childhood and adolescence; (ii) to clarify risks for
adolescent onset conduct problems; and (iii) to differentiate risk profiles of early onset disruptive behaviours
that do and do not persist.
Second, we will use publically available data from the first four waves of the Edinburgh Study of Youth
Transitions and Crime (ESYTC) to complement and replicate findings on adolescent sources of risk.
Beginning in early adolescence, ESYTC has tracked a cohort of some 4300 young people annually from age
12, assessing individual, family and social influences on adolescent antisocial behaviour using measures
closely compatible with those available and planned for use in ALSPAC.
Taken together, these two complementary data sources offer valuable opportunities to advance
understanding of adolescent conduct problems and the factors most central to risk.
--------------------------------------------------------------------------------------------------------------
Summary of Health and Wealth Implications:
Child and adolescent conduct problems impose heavy burdens on individuals, their families and the wider
society. Follow-up studies consistently point to increased risks of educational and occupational
underachievement; failed relationships, family breakdown and poor parenting; and high rates of problems in
both physical and mental health. At the societal level, health economic studies highlight the financial costs
involved. Childhood conduct disorder is associated with a ten-fold increase in costs; less severe difficulties
still elevate costs by more than a factor of 3. Most worrying, our research suggests that levels of adolescent
conduct problems rose steadily in the UK across the last quarter of the 20th century, but that their impact on
later adjustment remained unchanged. Effective techniques are now available for intervention in early onset
conduct problems; much less success has been achieved with treatments beginning in the teens. Clearer
identification of risks for adolescent conduct problems promises important benefits.