Predictors of adult outcomes in clinically- and legally-ascertained youth with externalizing problems

PLoS One. 2018 Nov 1;13(11):e0206442. doi: 10.1371/journal.pone.0206442. eCollection 2018.

Abstract

Externalizing problems (EP), including rule-breaking, aggression, and criminal involvement, are highly prevalent during adolescence, but the adult outcomes of adolescents exhibiting EP are characterized by heterogeneity. Although many youths' EP subside after adolescence, others' persists into adulthood. Characterizing the development of severe EP is essential to prevention and intervention efforts. Multiple predictors of adult antisocial personality disorder (ASPD) and legal outcomes of a large sample (N = 1205) of clinically- or legally-ascertained adolescents (ages 12-19 years) with severe EP were examined. Many psychosocial predictors hypothesized to predict persistence of EP demonstrated zero-order associations with adult outcomes, but accounted for little unique variation after accounting for baseline conduct disorder symptoms (CD) and demographic factors. Baseline measures of intelligence, which explained independent variation in legal outcomes, provided the only consistent exception to this pattern, though future work is needed to parse these effects from those of socioeconomic factors. CD severity during adolescence is a parsimonious index of liability for persistence of EP into adulthood that explains outcome variance above and beyond all other demographic and psychosocial predictors in this sample.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adolescent Behavior / physiology*
  • Adolescent Behavior / psychology
  • Adult
  • Age of Onset
  • Antisocial Personality Disorder / complications
  • Antisocial Personality Disorder / diagnosis*
  • Antisocial Personality Disorder / epidemiology
  • Antisocial Personality Disorder / psychology
  • Conduct Disorder / complications
  • Conduct Disorder / diagnosis*
  • Conduct Disorder / epidemiology
  • Conduct Disorder / psychology
  • Criminal Behavior* / physiology
  • Dangerous Behavior
  • Disease Progression
  • Expressed Emotion*
  • Female
  • Humans
  • Juvenile Delinquency* / legislation & jurisprudence
  • Juvenile Delinquency* / psychology
  • Juvenile Delinquency* / statistics & numerical data
  • Longitudinal Studies
  • Male
  • Prognosis
  • Substance-Related Disorders / complications
  • Substance-Related Disorders / diagnosis
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / psychology
  • Young Adult