Impact of early intervention on psychopathology, crime, and well-being at age 25

Kenneth A Dodge, Karen L Bierman, John D Coie, Mark T Greenberg, John E Lochman, Robert J McMahon, Ellen E Pinderhughes, Conduct Problems Prevention Research Group, Kenneth A Dodge, Karen L Bierman, John D Coie, Mark T Greenberg, John E Lochman, Robert J McMahon, Ellen E Pinderhughes, Conduct Problems Prevention Research Group

Abstract

Objective: This randomized controlled trial tested the efficacy of early intervention to prevent adult psychopathology and improve well-being in early-starting conduct-problem children.

Method: Kindergarteners (N=9,594) in three cohorts (1991-1993) at 55 schools in four communities were screened for conduct problems, yielding 979 early starters. A total of 891 (91%) consented (51% African American, 47% European American; 69% boys). Children were randomly assigned by school cluster to a 10-year intervention or control. The intervention goal was to develop social competencies in children that would carry them throughout life, through social skills training, parent behavior-management training with home visiting, peer coaching, reading tutoring, and classroom social-emotional curricula. Manualization and supervision ensured program fidelity. Ninety-eight percent participated during grade 1, and 80% continued through grade 10. At age 25, arrest records were reviewed (N=817, 92%), and condition-blinded adults psychiatrically interviewed participants (N=702; 81% of living participants) and a peer (N=535) knowledgeable about the participant.

Results: Intent-to-treat logistic regression analyses indicated that 69% of participants in the control arm displayed at least one externalizing, internalizing, or substance abuse psychiatric problem (based on self- or peer interview) at age 25, in contrast with 59% of those assigned to intervention (odds ratio=0.59, CI=0.43-0.81; number needed to treat=8). This pattern also held for self-interviews, peer interviews, scores using an "and" rule for self- and peer reports, and separate tests for externalizing problems, internalizing problems, and substance abuse problems, as well as for each of three cohorts, four sites, male participants, female participants, African Americans, European Americans, moderate-risk, and high-risk subgroups. Intervention participants also received lower severity-weighted violent (standardized estimate=-0.37) and drug (standardized estimate=-0.43) crime conviction scores, lower risky sexual behavior scores (standardized estimate=-0.24), and higher well-being scores (standardized estimate=0.19).

Conclusions: This study provides evidence for the efficacy of early intervention in preventing adult psychopathology among high-risk early-starting conduct-problem children.

Trial registration: ClinicalTrials.gov NCT01653535.

Figures

FIGURE 1
FIGURE 1
Rates of Clinical Problems at Age 25 for Intervention and Control Participants

References

    1. Moffitt TE. Life-course persistent and adolescent-limited antisocial behavior: a developmental taxonomy. Psychol Rev. 1993;100:674–701.
    1. Achenbach TM. Manual for the Young Adult Self-Report and Young Adult Behavior Checklist. Burlington, Vt: Department of Psychiatry, University of Vermont; 1997.
    1. Blumstein A, Cohen J, Roth J, Visher C. Criminal careers and career criminals. Washington, DC: National Academy Press; 1986.
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Publishing; 1994.
    1. Hare RD, Neumann CS. Psychopathy as a clinical and empirical construct. Annu Rev Clin Psychol. 2008;4:217–246.
    1. Dilulio JJ. The coming of the super-predators. Wkly Stand. 1995;1:23–30.
    1. Dodge KA, Coie JD, Lynam D. In: Aggression and antisocial behavior in youth, in Handbook of Child Psychology, vol 3, Social, Emotional, and Personality Development. 6th ed. Damon W, editor; Eisenberg N, editor. New York: Wiley; 2006. pp. 719–788. (series ed), (vol ed)
    1. Cohen MA, Piquero AR. New evidence on the monetary value of saving a high risk youth. J Quant Criminol. 2009;25:25–49.
    1. Kazdin AE. Parent management training: treatment for oppositional, aggressive, and antisocial behavior in children and adolescents. New York: Oxford University Press; 2005.
    1. Wilson C. Indiana court upholds life sentence for teen killer. Associated Press; 2012. Aug 1,
    1. Benjamin G. Prevention funding: one step forward, two steps back. Health Affairs Blog.
    1. Conduct Problems Prevention Research Group. A developmental and clinical model for the prevention of conduct disorders: the FAST Track Program. Dev Psychopathol. 1992;4:509–527.
    1. Patterson GR, Yoerger K. In: A developmental model for early- and late-onset antisocial behavior, in Antisocial Behavior in Children and Adolescents: A Developmental Analysis and Model for Intervention. Reid JB, Snyder J, Patterson GR, editors. Washington, DC: American Psychological Association; 2002. pp. 147–172.
    1. Lochman JE, Wells KC. Effectiveness study of coping power and classroom intervention with aggressive children: outcomes at a one-year follow-up. Behav Ther. 2003;3:493–515.
    1. Oden S, Asher SR. Coaching children in social skills for friendship making. Child Dev. 1977;48:495–506.
    1. Coie JD, Krehbiel G. Effects of academic tutoring on the social status of low-achieving, socially-rejected children. Child Dev. 1978;55:1465–1478.
    1. Greenberg MT, Kusche CA, Cook ET, Quamma JP. Promoting emotional competence in school-aged children: the effects of the PATHS curriculum. Dev Psychopathol. 1995;7:117–136.
    1. Dodge KA, Greenberg MT, Malone PS Conduct Problems Prevention Research Group. Testing an idealized dynamic cascade model of the development of serious violence in adolescence. Child Dev. 2008;79:1907–1927.
    1. Conduct Problems Prevention Research Group. Initial impact of the Fast Track prevention trial for conduct problems, I: the high-risk sample. J Consult Clin Psychol. 1999;67:631–647.
    1. Conduct Problems Prevention Research Group. Evaluation of the first 3 years of the Fast Track prevention trial with children at high risk for adolescent conduct problems. J Abnorm Child Psychol. 2002;30:19–35.
    1. Bierman KL, Coie JD, Dodge KA, Foster EM, Greenberg MT, Lochman JE, McMahon RJ, Pinderhughes EE Conduct Problems Prevention Research Group. The effects of the Fast Track program on serious problem outcomes at the end of elementary school. J Clin Child Adolesc Psychol. 2004;33:650–661.
    1. Conduct Problems Prevention Research Group. Fast Track randomized controlled trial to prevent externalizing psychiatric disorders: findings from grades 3 to 9. J Am Acad Child Adolesc Psychiatry. 2007;46:1250–1262.
    1. Conduct Problems Prevention Research Group. Fast Track intervention effects on youth arrests and delinquency. J Exp Criminol. 2010;6:131–157.
    1. Conduct Problems Prevention Research Group. The difficulty of maintaining positive intervention effects: a look at disruptive behavior, deviant peer relations, and social skills during the middle school years. J Early Adolesc. 2010;30:593–624.
    1. Conduct Problems Prevention Research Group. The effects of the Fast Track preventive intervention on the development of conduct disorder across childhood. Child Dev. 2011;82:331–345.
    1. Lochman JE Conduct Problems Prevention Research Group. Screening of child behavior problems for prevention programs at school entry. J Consult Clin Psychol. 1995;63:549–559.
    1. Werthamer-Larsson L, Kellam S, Wheeler L. Effect of first-grade classroom environment on shy behavior, aggressive behavior, and concentration problems. Am J Community Psychol. 1991;19:585–602.
    1. Achenbach TM. Manual for the Child Behavior Checklist and 1991 Profile. Burlington, Vt: University of Vermont Department of Psychiatry; 1991.
    1. Achenbach TM. Manual for the Teacher’s Report Form and 1991 Profile. Burlington, Vt: University of Vermont Department of Psychiatry; 1991.
    1. Bierman KL, Greenberg MT. Conduct Problems Prevention Research Group. In: Social skills training in the Fast Track program, in Preventing Childhood Disorders, Substance Abuse, and Delinquency. Peters RDev, McMahon RJ, editors. Thousand Oaks: Calif, Sage; 1996. pp. 65–89.
    1. McMahon RJ, Slough N. Conduct Problems Prevention Research Group. In: Family-based intervention in the Fast Track program, in Preventing Childhood Disorders, Substance Abuse, and Delinquency. Peters RDev, McMahon RJ, editors. Thousand Oaks: Calif, Sage; 1996. pp. 90–110.
    1. Greenberg MT, Kusche CA Conduct Problems Prevention Research Group. The PATHS (Promoting Alternative Thinking Strategies) Curriculum. Deerfield, Mass: Channing-Bete Co; 2014.
    1. Oyserman D. School-to-Jobs Facilitators Manual: After-School Program. Ann Arbor: University of Michigan; 2000.
    1. Conduct Problems Prevention Research Group. The implementation of the Fast Track program: an example of a large-scale prevention science efficacy trial. J Abnorm Child Psychol. 2002;30:1–17.
    1. Cernkovich SA, Giordano PC. Stability and change in antisocial behavior: the transition from adolescence to early adulthood. Criminology. 2001;39:371–410.
    1. Achenbach TM, Rescorla LA. Manual for the ASEBA Adult Forms and Profiles. Burlington, Vt: University of Vermont, Research Center or Children, Youth, and Families; 2003.
    1. Bureau of Labor Statistics, US Department of Labor. National Longitudinal Survey of Youth 1997 Cohort, 1997–2001 (produced by the National Opinion Research Center, the University of Chicago, and distributed by the Center for Human Resource Research) Washington, DC: US Department of Labor, Bureau of Labor Statistics; 2002.
    1. Robins LN, Helzer JE, Croughan J, Ratcliff KS. National Institute of Mental Health Diagnostic Interview Schedule: its history, characteristics, and validity. Arch Gen Psychiatry. 1981;38:381–389.
    1. Ware JE, Jr, Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36), I: conceptual framework and item selection. Med Care. 1992;30:473–483.
    1. Howe D, Frazis D. What researchers have learned from the National Longitudinal Surveys about Youth Unemployment (no 828) Washington, DC: US Department of Labor, Bureau of Labor Statistics; 1992.
    1. Capaldi DM, Stoolmiller M, Clark S, Owen LD. Heterosexual risk behaviors in at-risk young men from early adolescence to young adulthood: prevalence, prediction, and association with STD contraction. Dev Psychol. 2002;38:394–406.
    1. Holtzworth-Monroe A, Rehman U, Herron C. General and spouse specific anger and hostility in subtypes of maritally violent men and nonviolent men. Behav Ther. 2000;31:603–630.
    1. Straus M. Measuring intrafamily conflict and violence: the Conflict Tactics Scales. J March Fam. 1979;41:75–88.
    1. McQuay HJ, Moore RA. Using numerical results from systematic reviews in clinical practice. Ann Intern Med. 1997;126:712–720.
    1. Long JS, Freese J. Regression models for categorical and limited dependent variables with Stata. College Station, Tex: Stata Press; 2001.
    1. Masten AS, Roisman GI, Long JD, Burt KB, Obradovic J, Riley JR, Boelcke-Stennes K, Tellegen A. Developmental cascades: linking academic achievement and externalizing and internalizing symptoms over 20 years. Dev Psychol. 2005;41:733–746.
    1. Olds D, Henderson CR, Jr, Cole R, Eckenrode J, Kitzman H, Luckey D, Pettitt L, Sidora K, Morris P, Powers J. Long-term effects of nurse home visitation on children’s criminal and antisocial behavior: 15-year follow-up of a randomized controlled trial. JAMA. 1998;280:1238–1244.

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir