ABSTRACT
OBJECTIVE: To examine sex differences in the rate and symptoms of posttraumatic stress disorder (PTSD), trauma exposure, and onset patterns in youth with conduct disorder (CD). METHOD: Youth admitted to a clinical facility for severe behaviour problems completed the Diagnostic Interview for Children and Adolescents--Revised (DICA-R) to assess the presence of CD and PTSD. RESULTS: Over one-half of CD youth reported exposure to trauma, yet only 17% met criteria for PTSD. PTSD was more frequent in CD girls (28%) than in boys (10%), and girls experienced greater symptom intensity and anhedonia, difficulty feeling love or affection, and disturbance of sleep and concentration. Girls more frequently reported sexual assault, while boys were more likely to report accidents, physical assaults, and witnessing the death of a loved one. Retrospective reports indicated that PTSD tended to develop subsequent to CD. CONCLUSIONS: Exposure to trauma is common among CD youth; however, diagnostic procedures should be adapted for increased sensitivity to PTSD. The development of CD may increase the risk for PTSD, particularly in girls, by exposing youth to situations in which they are traumatized. The role of trauma in CD should be routinely examined by clinicians and warrants further research.
Subject(s)
Conduct Disorder/complications , Conduct Disorder/epidemiology , Stress Disorders, Post-Traumatic/complications , Stress Disorders, Post-Traumatic/epidemiology , Adolescent , Age of Onset , Comorbidity , Conduct Disorder/diagnosis , Female , Humans , Life Change Events , Male , Psychiatric Status Rating Scales , Severity of Illness Index , Sex Factors , Stress Disorders, Post-Traumatic/diagnosisABSTRACT
This study investigated the relationship between attachment patterns and suicidal ideation in a clinical sample of adolescents. Participants (n = 116) were assessed on level of current ideation through self-report questionnaires. Lethality of methods contemplated was also rated on a subset of the sample (n = 16) who, in addition to endorsing current suicidal ideation, presented a plan on a diagnostic interview. Quality of attachment to care-givers based on a semi-structured clinical interview was assessed using Bartholomew's two-dimensional, four-category model of attachment. Categorical analyses indicated that youth with predominantly fearful or preoccupied attachment were more likely to endorse suicidal ideation than were predominantly secure or dismissing youth. Severity of suicidal ideation was positively correlated with ratings of fearfulness and negatively correlated with ratings on the secure and dismissing patterns. Greater lethality in methods of contemplated suicide was positively correlated with preoccupied tendencies. The importance of attachment theory for understanding the factors underlying suicidal ideation in troubled youth is discussed and implications for therapeutic intervention are presented.
Subject(s)
Mental Disorders/psychology , Object Attachment , Suicide, Attempted/psychology , Suicide/psychology , Adolescent , British Columbia , Child Behavior Disorders/diagnosis , Child Behavior Disorders/psychology , Comorbidity , Defense Mechanisms , Female , Humans , Male , Mental Disorders/diagnosis , Personality Inventory/statistics & numerical data , Psychometrics , Suicide, Attempted/prevention & control , Suicide PreventionABSTRACT
OBJECTIVE: To examine the rate of comorbidity between conduct disorder and substance use disorder in a clinical sample using the Diagnostic Interview for Children and Adolescents--Revised. METHOD: Examined the pattern of conduct disorder symptoms, including type, number, and severity, in conduct-disordered youth diagnosed with, and without a comorbid substance use disorder. RESULTS: The examination revealed no significant differences in the incidence of comorbidity between younger (aged 10 to 13) and older (above age 13) youth. Among youth who met criteria for conduct disorder, 52% also met criteria for a substance use disorder. Odds ratios indicated that the probability of comorbidity of conduct and substance use disorders was higher in the younger group. CONCLUSION: Substance abuse and dependence tend to develop rapidly following first use, suggesting that a slim window of opportunity exists to prevent substance disorders once drug use has begun.