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Teaching Parents Strategies for Difficult Teens
Difficult Teens continuing education counselor CEUs

Section 18
Risk Factors Associated with Disruptive Behavior Disorders

CEU Question 18 | CEU Answer Booklet | Table of Contents | Parenting
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Risk Factors Associated with Disruptive Behavior Disorders
The risk factors for disruptive behavior disorders in children can provide much insight into children's behavior. Risk factors can be societal, familial, or individual in nature. Risk factors may vary by sex (Kazdin, 1995). In addition, Moss, Mezzich, Yao, Gavaler, and Martin (1995) noted that low socioeconomic status (SES) is likely to be "the most reliable and robust correlate" (p. 197) associated with DSM disorders in general. Loeber, Green, Keenan, and Lahey (1995) found that low SES, particularly when accompanied by oppositional behavior and parental substance abuse, was a very good predictor of CD in boys. Information on girls was not provided in the study.

Parental behavior also seems to be a strong indicator of potential behavior disorders in children. Moss et al. (1995) found higher levels of aggressive behavior in sons of substance-abusing fathers than in sons of fathers in the control group. Frick, Lahey, Loeber, and Stouthamer-Loeber (1992) discussed the effects of parental antisocial personality disorder and substance abuse on children. Children with severe conduct problems and also ODD, in this particular study, were found to have parents with a high rate of both corresponding factors, that is, antisocial personality disorder and substance abuse. This finding was particularly true of biological fathers (Frick et al., 1992).

Depression in parents can also be a factor related to disruptive behavior disorders in children. Frick et al. (1992) cited studies that reported, among other things, the greater likelihood of parents with depression having children with emotional or behavioral problems. Webster-Stratton (1996) found gender differences in predictors of externalizing behaviors at treatment outcome. Depression in the mother, along with mother "negativity" and father "negativity" and life stress, "significantly predicted girls' externalizing problems" (Webster-Stratton, 1996, p. 550). The same factors did not indicate these behaviors in boys. It has been speculated that parental psychological status has more of an influence on girls than on boys because of girls' socialization in the family (Webster-Stratton, 1996).

Parent-child relationships may also determine disruptive behavior disorders in children. Speltz, DeKlyen, Greenberg, and Dryden (1995) discussed the use of attachment studies to identify at-risk children. Their work was based on Bowlby's (1969,1973) attachment and separation theories. Speltz et al. cited longitudinal studies concluding that attachment quality in a child's first 12 to 18 months "is predictive of the child's later emotional and social functioning" (p. 489). Infants with insecure attachments were more likely to have poor peer relations, depression, and aggression later in childhood. Attachment also seems to be an indicator of potential behavior problems later in life, making early detection and intervention all the more important. Parent-child interactions throughout childhood are critical. Lax and inconsistent discipline are also related to delinquency (Kazdin, 1995).

Other factors related to the child that may determine the onset of conduct problems are child temperament, neuropsychological deficits, and academic and intellectual performance. First, those "difficult" children who do not adapt easily to changes and new stimuli and who have a negative mood are more likely to be referred than are those without this temperament (Kazdin, 1995). Second, Kazdin pointed to evidence suggesting that neurological deficits and difficulties in early childhood "place a youth at risk for subsequent conduct problems and delinquency" (p. 52). The third child-related risk factor, academic and intellectual performance, is critical to child adjustment. Atkins et al. (1996) noted that, generally, children who were highly aggressive also had severe academic problems. This presents an interesting question: Does poor academic performance precede behavior problems or do behavior problem cause poor academic performance? The two variables are, of course, quite interdependent. Of related interest, students with behavior problems who were below average and received academic tutoring improved socially as well as academically (Atkins et al., 1996).

- Kann, R. T., & Hann, F. J. (2000). Disruptive Behavior Disorders in Children and Adolescents: How Do Girls Differ From Boys? Journal of Counseling & Development, 78(3), 267-274. doi:10.1002/j.1556-6676.2000.tb01907.x
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Risk and Protective Factors of Child Delinquency

- Wasserman, G. A., Keenan, K., Temblay, R. E., Cole, J. D., Herrenkohl, T. I., Loeber, R., & Petechuk, D. (2003). Risk and Protective Factors of Child Delinquency. U.S. Department of Justice.
The article above contains foundational information. Articles below contain optional updates.

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Personal Reflection Exercise #4
The preceding section contained information about risk factors associated with disruptive behavior disorders.  Write three case study examples regarding how you might use the content of this section in your practice.

Online Continuing Education QUESTION 18
What significantly predicted girls’ externalizing problems? Record the letter of the correct answer the CEU Answer Booklet.

 
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