How do childhood conduct problems, callousness and anxiety relate to later offending and adult mental disorder?

BACKGROUND: Various combinations of childhood conduct problems, callous traits and anxiety may confer increased risk of offending, psychopathic traits and mental disorders. Knowledge of these outcomes in adulthood is limited.

AIMS: To compare adult criminal convictions, psychopathy checklist scores and mental disorders between five groups of men, variously defined in childhood by: (1) callous traits, (2) conduct problems, (3) conduct problems and callous traits, (4) conduct problems and callous traits and anxiety or (5) developing typically.

METHOD: Teachers rated conduct problems, callous traits and anxiety at ages 6, 10 and 12 years. Criminal convictions from age 12 to 24 were extracted from official records. The Psychopathy Checklist-Revised (PCL-R) and diagnostic interviews were completed at age 33.

RESULTS: Relative to the typically developing group, the groups with conduct problems, with and without callous traits and anxiety, showed 5-fold elevations in risks of violent convictions and 3 to 4-fold elevations in risk for antisocial personality disorder, while the groups with conduct problems only and with conduct problems plus callous traits plus anxiety were at increased risk for borderline personality disorder. All risk groups obtained higher PCL-R total scores than the typically developing childhood group.

CONCLUSIONS AND IMPLICATIONS: It is widely accepted that childhood conduct problems in boys are associated with increased risks of criminal convictions and poorer mental health, but our findings suggest that teachers can identify different subgroups and these have different trajectories. As some subgroups were small, replication is recommended, but our findings offer preliminary support for trialling specific interventions for at risk boys.