TY - JOUR
T1 - Subgrouping children and adolescents with disruptive behaviors
T2 - symptom profiles and the role of callous–unemotional traits
AU - Rosa-Justicia, Mireia
AU - Saam, Melanie C.
AU - Flamarique, Itziar
AU - Borràs, Roger
AU - Naaijen, Jilly
AU - Dietrich, Andrea
AU - Hoekstra, Pieter J.
AU - Banaschewski, Tobias
AU - Aggensteiner, Pascal
AU - Craig, Michael C.
AU - Sethi, Arjun
AU - Santosh, Paramala
AU - Sagar-Ouriaghli, Ilyas
AU - Arango, Celso
AU - Penzol, María José
AU - Brandeis, Daniel
AU - Werhahn, Julia E.
AU - Glennon, Jeffrey C.
AU - Franke, Barbara
AU - Zwiers, Marcel P.
AU - Buitelaar, Jan K.
AU - Schulze, Ulrike M.E.
AU - Castro-Fornieles, Josefina
PY - 2020
Y1 - 2020
N2 - Disruptive behavior during childhood and adolescence is heterogeneous and associated with several psychiatric disorders. The identification of more homogeneous subgroups might help identify different underlying pathways and tailor treatment strategies. Children and adolescents (aged 8–18) with disruptive behaviors (N = 121) and healthy controls (N = 100) were included in a European multi-center cognition and brain imaging study. They were assessed via a battery of standardized semi-structured interviews and questionnaires. K-means cluster-model analysis was carried out to identify subgroups within the group with disruptive behaviors, based on clinical symptom profiles, callous–unemotional (CU) traits, and proactive and reactive aggression. The resulting subgroups were then compared to healthy controls with regard to these clinical variables. Three distinct subgroups were found within the group with disruptive behaviors. The High CU Traits subgroup presented elevated scores for CU traits, proactive aggression and conduct disorder (CD) symptoms, as well as a higher proportion of comorbidities (CD + oppositional defiant disorder + attention deficit hyperactivity disorder (ADHD). The ADHD and Affective Dysregulation subgroup showed elevated scores for internalizing and ADHD symptoms, as well as a higher proportion of females. The Low Severity subgroup had relatively low levels of psychopathology and aggressive behavior compared to the other two subgroups. The High CU Traits subgroup displayed more antisocial behaviors than the Low Severity subgroup, but did not differ when compared to the ADHD and Affective Dysregulation subgroup. All three subgroups differed significantly from the healthy controls in all the variables analyzed. The present study extends previous findings on subgrouping children and adolescents with disruptive behaviors using a multidimensional approach and describes levels of anxiety, affective problems, ADHD, proactive aggression and CU traits as key factors that differentiate conclusively between subgroups.
AB - Disruptive behavior during childhood and adolescence is heterogeneous and associated with several psychiatric disorders. The identification of more homogeneous subgroups might help identify different underlying pathways and tailor treatment strategies. Children and adolescents (aged 8–18) with disruptive behaviors (N = 121) and healthy controls (N = 100) were included in a European multi-center cognition and brain imaging study. They were assessed via a battery of standardized semi-structured interviews and questionnaires. K-means cluster-model analysis was carried out to identify subgroups within the group with disruptive behaviors, based on clinical symptom profiles, callous–unemotional (CU) traits, and proactive and reactive aggression. The resulting subgroups were then compared to healthy controls with regard to these clinical variables. Three distinct subgroups were found within the group with disruptive behaviors. The High CU Traits subgroup presented elevated scores for CU traits, proactive aggression and conduct disorder (CD) symptoms, as well as a higher proportion of comorbidities (CD + oppositional defiant disorder + attention deficit hyperactivity disorder (ADHD). The ADHD and Affective Dysregulation subgroup showed elevated scores for internalizing and ADHD symptoms, as well as a higher proportion of females. The Low Severity subgroup had relatively low levels of psychopathology and aggressive behavior compared to the other two subgroups. The High CU Traits subgroup displayed more antisocial behaviors than the Low Severity subgroup, but did not differ when compared to the ADHD and Affective Dysregulation subgroup. All three subgroups differed significantly from the healthy controls in all the variables analyzed. The present study extends previous findings on subgrouping children and adolescents with disruptive behaviors using a multidimensional approach and describes levels of anxiety, affective problems, ADHD, proactive aggression and CU traits as key factors that differentiate conclusively between subgroups.
KW - Aggression
KW - Callous–unemotional traits
KW - Conduct disorder
KW - Oppositional defiant disorder
KW - Psychopathology
KW - Subtyping
UR - http://www.scopus.com/inward/record.url?scp=85095413894&partnerID=8YFLogxK
U2 - 10.1007/s00787-020-01662-w
DO - 10.1007/s00787-020-01662-w
M3 - Article
AN - SCOPUS:85095413894
SN - 1018-8827
JO - European Child and Adolescent Psychiatry
JF - European Child and Adolescent Psychiatry
ER -
