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Continuity
Between Behavioral/Emotional Problems at
Ages 2-3 and Externalizing Disorders at Ages 5-6
Using
a sample of 235 low SES children, Shaw, Owens, Giovannelli, &
Winslow (2001) tested the relations between parent-rated problems
on the CBCL/2-3 administered when the children were 24 and 42
months of age and DSM-IV disruptive behavior disorder (DBD) diagnoses
based on K-SADS-E maternal interviews when the children were 5½.
Children with no DBD at 5½ had obtained significantly lower CBCL
Aggressive and Destructive syndrome scores at 24 and 42 months
than children with ADHD+ODD or CD at 5½. Children with ODD or
CD at 5½ scored higher than non-diagnosed children on the CBCL
Destructive syndrome at 24 and 42 months, whereas children with
CD at 5½ scored higher than non-diagnosed or ODD children on the
Aggressive syndrome at 42 months. A four-item "attention problems"
scale the researchers derived from the CBCL at 24 months also
discriminated the non-diagnosed 5½-year-olds from the ODD and
ADHD+ODD or CD groups. Children with ADHD at 5½ were only different
from the non-diagnosed group on the CBCL Aggressive syndrome at
42 months. The researchers also formed ADHD, ODD, CD, and ADHD+ODD
or CD diagnostic groups from the TRF administered at age 6. They
did this by constructing scales of TRF items that they considered
to correspond to DSM-IV criteria for the DBD diagnoses. These
diagnostic groupings manifested fewer significant relationships
with preschool measures. However, children identified as ODD by
the TRF at age 6 had significantly higher scores on the CBCL Destructive
syndrome at 24 months than non-diagnosed children. Additional
results indicated that children in the ADHD+ODD or CD group were
more temperamentally difficult as toddlers, had mothers with more
depressive and aggressive symptoms and lower social support, experienced
more rejecting parenting, and lived in more dangerous neighborhoods
than non-diagnosed children. Children with ODD and CD also had
many of these same risk factors, whereas the ADHD children were
similar to the non-diagnosed children on these risk factors. Results
of the study suggest strong continuity between behavior problems
identified at ages 2-3 and the presence of DBD at ages 5-6, as
well as significant associations between DBD in young children
and maternal, familial, and environmental risk factors.
Reference: Shaw, D.S., Owens, E.B., Giovannelli,
J., & Winslow, E.B. (2001). Infant and toddler pathways leading
to early externalizing disorders. Journal of American Academy
of Child and Adolescent Psychiatry, 40, 36-43.
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