Abuse in childhood and adolescence linked to higher likelihood of conduct problems

A team of researchers at the Universities of Bath and Bristol examined data on 13,793 children and adolescents (51.6% boys), who were followed from ages four to 17 years, included in the Avon Longitudinal Study of Parents and Children, a cohort of children born in South-West England in the early 1990s.

Andreas Bauer, the lead author said: "Conduct problems refer to antisocial behaviors in childhood and/or adolescence, such as fighting, bullying, lying or stealing. They are associated with various negative outcomes, including mental and physical health problems, and it is important to understand their possible causes and to develop effective prevention and intervention programs. Although we know that child abuse is an important factor linked to conduct problems in children, much less is known about when child abuse is most harmful and how it relates to the development of serious behaviour problems over time."

From the children included in this study, the authors identified three groups who developed elevated levels of conduct problems. There was an early-onset persistent group who developed conduct problems in childhood which continued into adolescence (4.8% of the sample), an adolescence-onset group who developed conduct problems in adolescence (4.5%) and a childhood-limited group who developed conduct problems in childhood only (15.4%). The majority of children (75.3%) did not develop serious conduct problems.

Andreas Bauer said: "We assessed whether abuse was more common in the backgrounds of these three groups than in those who did not develop conduct problems. Our findings showed that abuse was more common in the early-onset persistent group who showed conduct problems in childhood and adolescence, and also in the adolescence-onset group who developed conduct problems in adolescence."

The authors also looked at the timing of child abuse, comparing those who were exposed to abuse only in childhood or only in adolescence with those exposed to abuse in childhood and adolescence. They found that children exposed to abuse in both childhood and adolescence were 10 times more likely to be in the early-onset persistent conduct problems group and 8 times more likely to be in the adolescence-onset conduct problems group. Abuse in childhood was associated with a 4- to 6-fold increase in risk for showing early-onset persistent or adolescence-onset conduct problems. In contrast, abuse in adolescence only was not linked to an increased risk of showing severe conduct problems.

Conduct problems were measured at ages 4, 7, 8, 10, 12, 13, and 17, by asking parents to rate their child's behavior over the last six months. At age 22, individuals were asked to report physical, psychological, or sexual abuse experienced in childhood (before age 11 years) and adolescence (between ages 11-17 years). Complete data for conduct problems as reported by parents and children, and physical, psychological, and sexual abuse as reported by children was available for 3,127 participants. Out of those, one in five (19.6%) participants reported experiencing some form of abuse, with 11.3%, 8.9%, and 8.1% of participants reporting physical, psychological, and sexual abuse, respectively.

A limitation of the study is that experiences of abuse in childhood and adolescence were measured when the participants were aged 22 years, so there may be issues with recall biases and issues surrounding disclosure of earlier abuse. Relying on parent-reported conduct problems in adolescence may have underestimated the level of behavioral problems, as parents may not be aware of their child's behavior outside the home.

Andreas Bauer said: "Our results suggest that abuse is more common in the backgrounds of young people with conduct problems and that conduct problems starting in adolescence may be linked to adverse experiences in childhood, rather than being an exaggerated form of teenage rebellion or due to peer pressure. Preventing child abuse may also help protect children from developing serious behaviour problems. However, it is important to note that many young people who experience abuse do not develop conduct problems, and conduct problems can also occur in the absence of child abuse."