A Long-Term Look at “Early Starters”: Predicting Adult Psychosocial Outcomes from Childhood Conduct Problem Trajectories

Introduction: Moffitt’s (1993) developmental taxonomy proposed that youth with conduct problems (CP) could be categorized into two subgroups: life course-persistent (i.e., CP emerges in childhood, persists through adulthood) and adolescence-limited (i.e., CP emerges and desists during adolescence). However, evidence suggests that a third, unpredicted subgroup may also exist: a childhood-limited pathway, characterized by early-onset CP that steadily declines before adolescence (Fairchild et al., 2013). While the term ‘childhood-limited’ implies recovery from childhood CP, there is a lack of consensus in the literature on the long-term outcomes of this pathway. Thus, using a disproportionately high-risk sample, the present study investigated the adult psychosocial outcomes associated with different childhood CP trajectories.

Methods: Data were drawn from the Fast Track Project – a multisite, longitudinal investigation of the development and prevention of serious CP. Participants included children from the high-risk control and normative groups (n = 754; 58% boys, 50% Caucasian). Parents rated children’s CP using the Child Behavior Checklist in kindergarten and grades 1, 2, 4, 5, and 7. At age 25, a combination of self-report, peer-report, and official records was used to assess psychosocial outcomes across five domains (i.e., psychopathology, substance use, risky sexual behavior, antisocial behavior, and adaptive outcomes). Latent class growth analysis was used to identify childhood conduct problem trajectories. Associations between trajectory group membership and adult outcomes were examined using ANCOVAs and logistic regression.

Results: Four childhood CP trajectories were identified: low-decreasing (LD; 35.5%), moderate-decreasing (MD; 38.8%), high-stable (HS; 22.0%), and extremely-high-increasing (EHI; 3.7%). Overall, the EHI and HS groups had the poorest psychosocial outcomes at age 25. The LD group, in contrast, was the most positively adjusted. Although individuals in the MD group showed relatively positive adjustment on some outcomes, they displayed more psychopathology and risky sexual behavior, and lower well-being in adulthood than the LD group.

Conclusions: In this sample, a ‘hierarchy of risk’ was identified, with the EHI and HS groups being at the highest risk for maladjustment, followed by the MD group, and the LD group. These findings demonstrate the long-term costs associated with different pathways of early-starting conduct problems. Indeed, the results suggest that all “early starters” may be in need of some form of intervention, even if they present with relatively moderate CP that appears to decline over the course of childhood.