Disruptive Behavior Disorders as Predictors of Adult Criminality
Disruptive behavior disorders are characterized by high rates of defiant, hostile, and non-compliant behaviors, which usually include hyperactivity and aggressiveness (Fonagy, Target, Cottrell, Phillips & Kurtz, 2005). According to DSM-IV, these behaviors can be categorized under the following headings: attention-deficit/hyperactivity disorders (ADHD), conduct disorder (CD), and oppositional defiant disorder (ODD) (Fonagy et al., 2005).
Conduct disturbance covers a broad range of behaviors that manifest in somewhat different ways at various ages of the same child across various settings. The symptoms of disturbances of conduct are often subjective as they can range from merely annoying behaviors such as temper tantrums, whining, and yelling to more terrorizing and frightening behaviors such as interpersonal aggression, physical destructiveness, and even murder (Fonagy et al., 2005). Despite this conflict in the definition of disruptive behavior, epidemiological evidence shows that the annoying oppositional behaviors of a young child – such as argumentativeness and non-compliance – “are developmental precursors of more serious forms of antisocial behavior in adolescence” (Fonagy et al., 2005, p. 107).
According to DSM-IV, ODD must include a repetitive pattern of disobedience and defiance and a hostile and negative attitude toward figures of authority, which lasts for a duration of six months (Fonagy et al., 2005). Four of the following behaviors must be present in order to identify someone as having ODD: vindictiveness or spite; frequent resentment and anger; being touchy and easily irritated by others; blaming others for one’s own wrongdoings; being deliberately annoying; non-compliance with or defiance of adult requests and rules; arguments with adults; and loss of temper.
CD, on the other hand, “entails the violations of the basic rights of others or of age-appropriate societal norms or rules” (Fonagy et al., 2005, p. 107). To be identified as having CD, one must exhibit three of following fifteen behaviors over the previous year, with one behavior being present over the last six months: serious rule violations (running away from home, being a truant before the age of 13, or staying out at night); theft or deceptiveness (stealing without confronting the victim, lying for personal gain, breaking and entering); property destruction (fire setting and other destructions of property); and aggressiveness to animals and people (forced sexual activity, stealing with confrontation of the victim, physical cruelty to animals, physical cruelty to people, using a weapon, fighting, bullying).
There are two types of CD based on the age at onset. In the childhood-onset type, at least one of the fifteen behaviors must manifest before the age of ten. The childhood-onset type appears to be associated with a high level of aggressivity, the male gender, and is comorbid with ADHD. In the adolescent-onset type, none of the aforementioned behaviors manifest before the age of ten. This type is also rarely accompanied by aggression when the onset is later than ten years old. After the age of ten, the gender balance also somewhat shifts to girls, as well as to fewer family histories of anti-social behavior. In a study conducted by Bartusch and colleagues (1997), results showed that from the age of five, there would be a significant association between childhood anti-social behavior and convictions for violence at the age of eighteen whereas adolescent anti-social behavior had a stronger association with convictions for non-violent offenses. Likewise, a study by Tremblay and colleagues (1994) showed that impulsivity in the kindergarten period results in the highest risk of stable delinquent behavior later in life.
There are also two bipolar dimensions with four groups of CD subtypes. The first dimension distinguishes between overt and covert problems while the second dimension distinguishes destructive from non-destructive behaviors. Destructive-overt problems are often aggressive in nature, with examples including blaming others, cruelty, and assault. On the other hand, destructive-covert acts mostly consist of property violations such as fire setting, vandalism, and stealing. Overt-nondestructive acts reflect an oppositional pattern such as defiance, touchiness, stubbornness, and anger while covert-non destructiveness is more serious as it reflects the status-violation aspect of CD. Examples include substance abuse, truancy, and running away.
Experts have also suggested that covert and overt conduct problems can represent “distinct pathways to CD and delinquency” (Fonagy et al., 2005, p. 108). In particular, stealing indicates a considerable risk for adolescent delinquency, especially when it is combined with social aggression. There is also a high degree of correlation between stealing and lying, but this association manifests earlier and grows stronger with age. As well, lying has a correlation with some overt disturbance of conduct, specifically when it is also combined with stealing.
Studies show that disturbance of conduct is more prevalent on low socio-economic status groups and that there is an ongoing increase in the incidence of disruptive behavior disorders (Fonagy, et al., 2005). Disturbance of conduct makes up majority of the clinic caseloads and is also the main reason for referring young kids to mental health services (Fonagy et al.. 2005).
In addition, school-based disturbance of conduct such as bullying is very prevalent. Studies show that 10 to 23 percent of children may be either bullies or victims of bullies in any single year. Similarly, as much as 35 percent of childhood psychiatric in-patients and 3 to 10 percent in epidemiological samples are involved in childhood fire setting (Fonagy et al., 2005). As well, instances of the adolescent onset disturbance of conduct are more prevalent than instances of the childhood-onset disturbance of conduct (Fonagy et al., 2005).
According to criminological statistics, young people below the age of 18 make up more than thirty percent of all arrests in the U.S. for index offenses. This includes 35 percent of arrests for property crimes and 19 percent of arrests for violent crimes (Fonagy et al., 2005). Similarly, the U.K. Home Office statistics showed that in 1994, young men and boys between the ages of ten and twenty committed 2 percent of all indictable offenses (Fonagy et al., 2005). Furthermore, young men who commit 50 percent of violent crimes make up 8 percent of the total population (Fonagy et al., 2005). Moreover, some studies indicate that the rate of murders that 14 to 17-year olds commit has increased by 165 percent from 1985 to 1993 (Fonagy et al., 2005).
APD (Antisocial Personality Disorder) or psychopathy may also have a relation with disturbance of conduct. In a study conducted by Simonoff, Elander, Holmshaw, Pickles, Murray & Rutter (2004), it was found that both conduct disorder and hyperactivity were strongly linked to early and later APD, as well as to criminality in early and mid-to-adult life. This implied that childhood disruptive behavior had significant long-term effects on adult antisocial outcomes, which continued to middle adulthood (Simonoff et al.,2004).
Among adolescent boys, those with a combination of impulsivity, hyperactivity, and attention conduct problems most closely resemble psychopathic adults. In a longitudinal study conducted by Babinski, Harsough & Lambert (1999), it was found that both early conduct problems and hyperactivity-impulsivity were either independently or jointly predictive of the increased likelihood of getting an arrest record. However, this applied only to males and not to females. This study further showed that symptoms of hyperactivity-impulsivity – and not inattention –contributed to the risk for criminal involvement beyond the risk associated solely with early conduct problems (Balinski, Harsough & Lambert, 1999). Similarly, in a study of 100 adult maximum-security inmates, it was found that 63 percent of them met the DSM-IV criteria for childhood CD while 41 percent were either assessed or treated for childhood ADHD (Vitelli, 1996). Significant comorbidity between childhood ADHD and CD was established, although CD was the only one significantly predictive of adult criminality (Vitelli, 1996).
Studies of school-age children have determined that disturbance of conduct is modestly correlated with a personality type that’s characterized by the lack of anxiety, the absence of guilt and concern, and superficial charm (Fonagy et al., 2005). Disturbance of conduct has a high degree of correlation with anxiety while psychopathy does not. “However, psychopathic features identify a group of children with quite serious disturbance of conduct and predict the increased likelihood of contact with police” (Fonagy, 2005, p. 110).
As well, disturbance of conduct is an important risk factor for substance use, although this does not mean that all young people who have problems with substance abuse have histories of disturbance of conduct as well. It appears that the onset of minor delinquency leads to alcohol use. There is a strong association between CD and later substance use disorder, and the early onset of substance use is predictive of later criminality (Fonagy et al., 2005).
In addition, other studies have shown that shy and withdrawn children who have disturbance of conduct end up having relatively poor life outcomes, as these behaviors represent a risk for delinquency (Fonagy et al., 2005). In particular, boys who appear to be disruptive and withdrawn are at the greatest risk for delinquency. Withdrawal without aggression is not stable and is not predictive of ongoing difficulties.
There also seems to be a high level of comorbidity between PTSD (posttraumatic stress disorder) and delinquency as a study found that 50 percent of eighty-five incarcerated boys had partial and active PTSD (Fonagy et al., 2005). As well, childhood aggression is a good predictor of CD and ODD problems, as well as of delinquency in adolescence. More than half of future recidivists can be predicted at the age of seven based on their aggressive behavior. In addition, there is a significant correlation between fighting and lying where lying is also predictive of stealing, especially among adolescents. Moreover, assaultive behavior in childhood and criminality in a biological parent are predictive of adult incarceration. However, CD alone is not completely predictive of adult criminality.
There is usually a shift in aggression from a highly uncontrolled and overt pattern that is easily observed in the early years to a more covert and sneaky type of aggression that developmentally increases rather than decreases and that becomes harder to detect. In general, longitudinal studies have shown the continuity of disturbance of conduct from early to later childhood, from childhood to adolescence, and from adolescence to adulthood (Fonagy et al., 2005). Although very little research has been done to determine the relationship between pre-school behavior and adult criminality, it was found by Stevenson & Goodman (2001) that there are also continuities in behavior among pre-schoolers where an association between pre-school ( particularly at the age of 3) behavior and adult criminality is established. In particular, externalizing behaviors such as management difficulties and temper tantrums were linked to adult convictions, particularly with non-violent offenses (Stevenson & Goodman, 2001).
Psychiatric disorders that result from CD include antisocial personality disorder, drug dependence, and alcoholism. On the other hand, the non-psychiatric antisocial behaviors that result from CD include group violence with vandalism, the carrying of illegal weapons, the use of illegal drugs, drunk driving, violence to property and people, and theft. In a study of 254 children who had clinically significant CD and who were followed up into adulthood, it was found that 75 percent of them exhibited persistent and pervasive social functioning, although most fell above the threshold for being diagnosed with a personality disorder (Fonagy et al., 2005).
In conclusion, it is evident from these studies that there is a relationship between disruptive behavior disorders in childhood and the risk of criminality in adulthood. In particular, associations are strongest for CD, hyperactivity, antisocial behavior, and impulsivity. As such, the need for proper parenting needs to be stressed even more, as well as for the proper implementation of interventions either through schools or through medical professionals. With so much adult violence stemming from childhood behavioral disorders, it would be much easier and more effective to correct these behaviors in childhood than to wait for these individuals to commit a crime before taking action. Since a lot of the crimes that now occur in our society stem from childhood problems, making sure that our children grow in healthy environments and with the proper guidance will eventually, hopefully provide us with a healthier and safer society.
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