Children With Early-Onset Disruptive Behavior: Parental Mental Disorders Predict Poor Psychosocial Functioning in Adolescence

J Am Acad Child Adolesc Psychiatry. 2019 Aug;58(8):806-817. doi: 10.1016/j.jaac.2018.10.017. Epub 2019 Mar 12.

Abstract

Objective: Parental mental disorders (MD) and child early-onset disruptive behavior (DB) are well-established risk factors for poor outcomes in adolescence. However, it is not clear whether parental MD increases risk of future maladjustment among children who already display DB.

Method: Parents of 9-year-old children reported on child DB, whereas a patient registry was used to determine parental MD. At follow-ups at ages 15 (n = 6,319) and 18 (n = 3,068) years, information about various problems were collected via registries, parent-, and self-reports.

Results: In the total sample, child DB was related to all outcomes (mean odds ratio [OR] = 1.18; range = 1.07-1.51; p values < .01), paternal MD to criminality, aggression, truancy, poor school performance, and a cumulative risk index of poor functioning, and maternal MD to peer problems, rule breaking, and truancy (mean OR = 1.67; range = 1.19-2.71; p values < .05). In the subsample of children with DB, paternal MD predicted criminality, consequences of antisocial behavior, truancy, poor school performance, and cumulative risk, whereas maternal MD predicted peer problems (mean OR = 1.94; range = 1.30-2.40; p values < .05).

Conclusion: This study provides novel evidence that parental MD places 9-year-olds with DB at risk for negative outcomes in adolescence. In addition, paternal MD is a better predictor than maternal MD, regardless of child DB at age 9, suggesting that fathers should be given increased attention in future research. Treatment-as-usual of children with DB could be augmented with additional screening and, if necessary, treatment of mental health problems in their parents.

Keywords: aggression; child of impaired parents; conduct disorder; longitudinal studies; oppositional defiant disorder.

Publication types

  • Research Support, Non-U.S. Gov't
  • Twin Study

MeSH terms

  • Adolescent
  • Age of Onset
  • Child
  • Child of Impaired Parents / psychology*
  • Conduct Disorder / epidemiology*
  • Female
  • Humans
  • Logistic Models
  • Male
  • Parent-Child Relations*
  • Parents / psychology*
  • Problem Behavior*
  • Psychiatric Status Rating Scales
  • Registries
  • Sweden / epidemiology