Should relational aggression be included in DSM-V?

Relational aggression in romantic relationship: empirical evidence among young female adults in Malaysia

BACKGROUND

Aggressive behaviour in romantic relationship is a social problem of great concern. Studies related to the influence of psychosocial factors on relational aggression are still limited. Furthermore, these factors have not been widely studied in the local context, resulting in the issue of relational aggression among young female adults still not being addressed. This study aims to explore whether psychosocial factors such as big five personality traits, adult attachment style and loneliness could predict relational aggression in romantic relationships among young female adults in Malaysia. In addition, this study aims to identify the moderating effect of social support in the relationship between psychosocial factors and relational aggression in romantic relationship.

METHODS

A quantitative research approach was used with 424 young female adults in Malaysia aged between 18 and 30 years old (mean age = 24.18) were recruited through multistage sampling design by completing a questionnaire consisting of the Big Five Inventory (BFI), Experiences in Close Relationships Scale II (ECRS-II), Revised UCLA Loneliness Scale, Measure of Relational Aggression and Victimization (MRAV) and Multidimensional Scale of Perceived Social Support (MSPSS).

RESULTS

Multiple regression analysis predicted significant relationship between agreeableness personality, loneliness, avoidant attachment style and anxious attachment style with relational aggression in romantic relationships. Hierarchical regression analysis found a significant effect of social support as a moderator between loneliness with relational aggression in romantic relationships.

CONCLUSIONS

Thus, the results show that young female adults with low level of agreeableness, high level of loneliness, avoidant attachment style and anxious attachment style are at a higher risk of engaging in relational aggression in romantic relationships. The implication of this study can help in understanding the psychosocial factors that form the basis of relational aggression in romantic relationships. Hence, the gap in knowledge warrants further research.

Relational Aggression in Adolescents with Conduct Disorder: Sex Differences and Behavioral Correlates

As most research on conduct disorder (CD) has been conducted on male participants, it has been suggested that female-specific symptoms may be underestimated based on current DSM-5 criteria. In particular, relational aggression, i.e. the hurtful, often indirect, manipulation of relationships with the intention of damaging the other's social position, has been proposed as a characteristic of CD that is more common in females. In addition, sex-specific studies on correlates of relational aggressive behavior are lacking. Relational aggression may be strongly related to the correlates of proactive aggression, namely low affective empathy, and high levels of callous-unemotional (CU) traits and relational victimization. Thus, the present study investigated sex differences in relational aggression, and associations between relational aggression and correlates of proactive aggression in 662 adolescents with CD (403 females) and 849 typically-developing controls (568 females) aged 9-18 years (M = 14.74, SD = 2.34) from the European multi-site FemNAT-CD study. Females with CD showed significantly higher levels of relational aggression compared to males with CD, whereas no sex differences were seen in controls. Relational aggression was only partly related to correlates of proactive aggression in CD: Independent of sex, CU traits showed a positive association with relational aggression. In females only, cognitive, but not affective empathy, was negatively associated with relational aggression. Relational victimization was more strongly associated with relational aggression in males compared to females. Despite interesting sex specific correlates of relational aggression, effects are small and the potential clinical implications should be investigated in future studies.

The Use of Indirect Aggression among Boys and Girls with and without Conduct Problems: Trajectories from Childhood to Adolescence

Though conceptually distinct from other behavior problems, indirect aggression (IA) is correlated with physical aggression and is linked to oppositional defiant disorder and conduct disorder from childhood to adolescence. Thus, IA could be part of the clinical picture of children with identified conduct problems (CP). However, trajectories of IA have not been studied in children with CP. In the present study, we evaluated and compared the mean trajectory of IA from 7 to 14 years of age in children with (n = 328; 47.6% girls) and without (n = 320; 51.3% girls) early clinically significant CP using both parent and teacher ratings. We then examined if sub-groups of children distinguished themselves by their use of IA over time and tested for sex differences. Latent growth models showed that children with CP used IA at higher rates over time than children without CP. Regardless of this higher frequency, the use of IA in both groups of children was best described by down-turned curvilinear trajectories peaking at 10 years of age. Growth mixture models showed that children without CP, according to parent and teacher ratings, and children with CP, according to parent ratings, both followed two trajectories of IA over time, with, respectively, 10% to 14% of them following a high trajectory. As for sex differences, the use of IA of boys and girls without CP did not differ, but differences emerged for children with CP, with girls using IA more frequently. The clinical implications of the findings are discussed.

Relational Aggression and Narcissistic Traits: How Youth Personality Pathology Informs Aggressive Behavior

Low agreeableness features centrally in personality profiles of Cluster B personality disorder (PD) diagnoses, and it has been associated with relational aggression (RAgg; intentionally damaging others' social relationships). Researchers have hypothesized that RAgg may be a potential developmental precursor for Cluster B PDs. However, a dimensional approach to personality dysfunction is preferable to the categorical system found in the current diagnostic manual. To build a bridge between two disjointed literatures (categorical PDs and RAgg), the aim of this project is to detail how RAgg in youth is situated in the trait space represented by disagreeableness in a dimensional model of personality pathology. Caregivers of 911 youth (ages 6-18) reported on youth's RAgg and disagreeableness. We found that RAgg was most strongly related to three facets: Narcissistic traits, Hyperexpressive traits, and Dominance-Egocentrism traits. Overall, these findings provide support for RAgg as an early manifestation of personality pathology, particularly for narcissistic traits.

Relational Aggressiveness in Adolescence: Relations With Emotional Awareness and Self-Control

Involvement in relationally aggressive conduct is an important contributor to maladaptive functioning in both childhood and adulthood. Decreased emotional awareness and impairments of self-control are risk factors for relational aggressiveness, while emotional awareness can also be treated as an important prerequisite for proper self-control. The aim of the study was to examine the associations between dimensions of emotional awareness (attention to emotions and emotional clarity), self-control, and relational aggressiveness. Self-control was also examined as a mediating variable between emotional awareness and relational aggressiveness. Self-report measures of trait meta-mood, alexithymia, self-control, and relational aggressiveness were completed by 214 adolescents (129 females), aged 15–23. The confirmatory factor analysis confirmed two factors of emotional awareness: (1) inattention to emotions (reflecting low attention to emotions and externally oriented thinking) and (2) a lack of emotional clarity (reflecting difficulties in identifying emotion, difficulties in describing emotion, and low clarity of emotion). Self-control and mood repair ability inversely correlated with proactive and reactive relational aggressiveness, whereas the clarity component of the meta-mood trait only inversely predicted reactive relational aggressiveness. Structural equation modeling (SEM) showed that direct relationships between inattention to emotions and relational aggressiveness, as well as between lack of emotional clarity and relational aggressiveness were non-significant. Nevertheless, a lack of emotional clarity was indirectly and significantly associated with relational aggressiveness through decreased self-control.

Conduct disorder in adolescent females: current state of research and study design of the FemNAT-CD consortium

Conduct disorder (CD) is a common and highly impairing psychiatric disorder of childhood and adolescence that frequently leads to poor physical and mental health outcomes in adulthood. The prevalence of CD is substantially higher in males than females, and partly due to this, most research on this condition has used all-male or predominantly male samples. Although the number of females exhibiting CD has increased in recent decades, the majority of studies on neurobiological measures, neurocognitive phenotypes, and treatments for CD have focused on male subjects only, despite strong evidence for sex differences in the aetiology and neurobiology of CD. Here, we selectively review the existing literature on CD and related phenotypes in females, focusing in particular on sex differences in CD symptoms, patterns of psychiatric comorbidity, and callous-unemotional personality traits. We also consider studies investigating the neurobiology of CD in females, with a focus on studies using genetic, structural and functional neuroimaging, psychophysiological, and neuroendocrinological methods. We end the article by providing an overview of the study design of the FemNAT-CD consortium, an interdisciplinary, multi-level and multi-site study that explicitly focuses on CD in females, but which is also investigating sex differences in the causes, developmental course, and neurobiological correlates of CD.

The development of externalizing symptoms from late childhood through adolescence: A longitudinal study of Mexican-origin youth

Youth who exhibit externalizing problems during childhood and adolescence are at an increased risk for a wide range of detrimental life outcomes. Despite the profound consequences of externalizing problems for children, their families, and their communities, we know less about the precise trajectory of externalizing symptoms across late childhood and adolescence, because of the paucity of fine-grained longitudinal research. The present study examined the development of externalizing symptoms in a large sample (N = 674) of Mexican-origin youth, assessed annually from age 10 to 17. Specifically, we conducted analyses to better understand the trajectories of attention-deficit-hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) symptoms (and their codevelopment), as well as how gender and cultural factors influence symptom trajectories. On average, ADHD symptoms slowly declined from age 10 to 17; ODD symptoms increased until age 13 and then declined thereafter; and, CD symptoms slowly increased until age 15 and then leveled off. ADHD, ODD, and CD symptoms predicted change in each other, indicating youth may accumulate multiple forms of externalizing problems over time. Boys reported fewer externalizing problems than girls, contrary to expectations. Consistent with the Immigrant Paradox, we found that 2nd + generation youth, youth who endorsed fewer traditional Mexican cultural values (traditional gender roles, traditional family values, and religiosity), and youth who engaged in less Spanish/more English language use were at increased risk for exhibiting ADHD, ODD, and CD symptoms from childhood through adolescence. We discuss the theoretical and practical implications of these developmental patterns among Mexican-origin youth. (PsycINFO Database Record

Prospective associations between peer victimization and social-psychological adjustment problems in early childhood

The present short-term longitudinal study examined prospective associations between two forms of peer victimization (i.e., physical, relational) and both externalizing and internalizing problems in early childhood. The study assessed 97 children (42 girls; M age = 45.22 months, SD = 6.99) over the course of one school year with assessments occurring at the end of each semester (approximately 6 months apart). Multiple methods were used to collect data over the course of one school year to test theoretically driven hypotheses. Cross-lagged path analyses were conducted, revealing significant associations between relational victimization and increases in depressive symptoms. On the other hand, relational victimization was also significantly associated with decreases in externalizing problems (e.g., inattention, deception/lying) and increases in prosocial behavior. Physical aggression predicted increases in physical victimization, supporting hypotheses that children displaying physically aggressive behavior are likely to be reactive to negative peer interactions and endure future victimization.

The Co-Development of Relational Aggression and Disruptive Behavior Symptoms from Late Childhood through Adolescence

Researchers have debated whether relational aggression is a developmentally-normative behavior or a sign of some underlying psychopathology. However, due to the dearth of longitudinal studies, we know little about how relational aggression and more severe forms of disruptive behavior co-develop. The present study examined bidirectional associations between relational aggression and two psychiatric disorders, Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD), using data from a longitudinal study of 674 Mexican-origin youth followed from age 10 to 16. Results showed that individuals who engaged in relational aggression tended to increase over time in ODD and CD symptoms, and conversely, individuals exhibiting symptoms of ODD and CD tended to increase in relational aggression. These findings held for boys and girls, for youth born in Mexico and the U.S., and after controlling for physical aggression. Thus, relational aggression seems to be both a developmentally-normative behavior and a predictor of future mental health problems.

Interpersonal dysfunction in personality disorders: A meta-analytic review

Personality disorders are defined in the current psychiatric diagnostic system as pervasive, inflexible, and stable patterns of thinking, feeling, behaving, and interacting with others. Questions regarding the validity and reliability of the current personality disorder diagnoses prompted a reconceptualization of personality pathology in the most recent edition of the psychiatric diagnostic manual, in an appendix of emerging models for future study. To evaluate the construct and discriminant validity of the current personality disorder diagnoses, we conducted a quantitative synthesis of the existing empirical research on associations between personality disorders and interpersonal functioning, defined using the interpersonal circumplex model (comprising orthogonal dimensions of agency and communion), as well as functioning in specific relationship domains (parent-child, family, peer, romantic). A comprehensive literature search yielded 127 published and unpublished studies, comprising 2,579 effect sizes. Average effect sizes from 120 separate meta-analyses, corrected for sampling error and measurement unreliability, and aggregated using a random-effects model, indicated that each personality disorder showed a distinct profile of interpersonal style consistent with its characteristic pattern of symptomatic dysfunction; specific relationship domains affected and strength of associations varied for each personality disorder. Overall, results support the construct and discriminant validity of the personality disorders in the current diagnostic manual, as well as the proposed conceptualization that disturbances in self and interpersonal functioning constitute the core of personality pathology. Importantly, however, contradicting both the current and proposed conceptualizations, there was not evidence for pervasive dysfunction across interpersonal situations and relationships. (PsycINFO Database Record

Viewing relational aggression through multiple lenses: Temperament, personality, and personality pathology

Dispositional trait frameworks offer great potential to elucidate the nature and development of psychopathology, including the construct of relational aggression. The present study sought to explore the dispositional context of relational aggression across three dispositional frameworks: temperament, personality, and personality pathology. Participants comprised a large community sample of youth, aged 6 to 18 years (N= 1,188; 51.2% female). Ratings of children's relational aggression, temperament, personality, and personality pathology traits were obtained through parent report (86.3% mothers). Results showed convergence and divergence across these three dispositional frameworks. Like other antisocial behavior subtypes, relational aggression generally showed connections with traits reflecting negative emotionality and poor self-regulation. Relational aggression showed stronger connections with temperament traits than with personality traits, suggesting that temperament frameworks may capture more relationally aggressive content. Findings at the lower order trait level help differentiate relational aggression from other externalizing problems by providing a more nuanced perspective (e.g., both sociabilityandshyness positively predicted relational aggression). In addition, there was little evidence of moderation of these associations by gender, age, or age2, and findings remained robust even after controlling for physical aggression. Results are discussed in the broader context of conceptualizing relational aggression in an overarching personality-psychopathology framework.

I-DAQ: a new test to assess direct and indirect aggression free of response bias

Self-reports of aggression are deeply impacted by response bias, especially by social desirability, but there are no specific methods for controlling this bias. Furthermore, despite the importance of the subject few instruments have been designed to assess both direct and indirect forms of aggression. The aim of the present research was to develop a brief measure that comprises both forms of aggression and which makes it possible to obtain scores free of social desirability and acquiescence effects. The scales were created using recently developed methods for controlling response bias effects in a sample of 750 participants over a wide age range. The items were chosen by a panel of judges from among the best of the existing aggression measures. Confirmatory factor analysis showed the expected three factor structure (CFI = .98; AGFI = .97 and RSMEA = .078, 90% C.I. = .074 - .083) and the scales showed good psychometric properties in that they had good reliability (ranging from θxx = .77 to θxx = .83), and convergent and criterion validity.

Revisiting data related to the age of onset and developmental course of female conduct problems

Children who exhibit persistently elevated levels of conduct problems (CP) from early childhood, so-called early-starters, are known to be at increased risk for continued CP throughout middle childhood, adolescence, and adulthood. Theoretical and empirical work has focused on this subgroup of children characterized by similar risk factors, an early age of onset, and a persistent developmental course of CP. However, females were historically neglected from this literature. Although research on female CP has increased, conclusions drawn from limited prior work continue to predominate. The primary aim of this review was to evaluate the updated literature to determine the percentage of females who show the early-starter CP pattern relative to two other trajectories often theorized to be more characteristic of females: early-starting desisting and adolescent-onset CP. The findings suggest that a subgroup of females exhibits an early-starting and persistent CP pattern, while a separate group of females demonstrates an onset of CP in adolescence. In addition, although it has been argued that females with childhood CP are not likely to show CP into adolescence and adulthood, evidence for early-starting desisting CP was inconsistent. The results are discussed with respect to implications for developmental taxonomy theory and future basic research in the area of CP development, as well as intervention efforts.

Oppositional defiant- and conduct disorder-like problems: neurodevelopmental predictors and genetic background in boys and girls, in a nationwide twin study

Background. Previous research has supported gender-specific aetiological factors in oppositional defiant disorder (ODD) and conduct disorder (CD). The aims of this study were to identify gender-specific associations between the behavioural problems-ODD/CD-like problems-and the neurodevelopmental disorders-attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD)-and to investigate underlying genetic effects. Methods. 17,220 twins aged 9 or 12 were screened using the Autism-Tics, AD/HD and other Comorbidities inventory. The main covariates of ODD- and CD-like problems were investigated, and the relative importance of unique versus shared hereditary and environmental effects was estimated using twin model fitting. Results. Social interaction problems (one of the ASD subdomains) was the strongest neurodevelopmental covariate of the behavioural problems in both genders, while ADHD-related hyperactivity/impulsiveness in boys and inattention in girls stood out as important covariates of CD-like problems. Genetic effects accounted for 50%-62% of the variance in behavioural problems, except in CD-like problems in girls (26%). Genetic and environmental effects linked to ADHD and ASD also influenced ODD-like problems in both genders and, to a lesser extent, CD-like problems in boys, but not in girls. Conclusions. The gender-specific patterns should be considered in the assessment and treatment, especially of CD.

Relational aggression, victimization, and adjustment during middle childhood

A secondary analysis of the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development was conducted to test the mechanisms by which relational aggression in third grade was associated both directly and indirectly with relational victimization in sixth grade. A large sample (N = 1,035; 522 girls; M = 8.3 years old; SD = 0.23) and multiple informants (teacher, child, and parent report) and methods were used to test several theoretically driven hypotheses. Our path analysis model suggested evidence for both direct and indirect pathways consistent with the sequential social process model of peer harassment. Relational aggression was significantly associated with future relational victimization even after controlling for physical aggression and gender. Loneliness mediated the direct association between relational aggression and peer victimization. A second model testing the reverse direction of effect revealed that relational victimization in third grade predicted relational aggression in sixth grade and was associated with loneliness and depressive symptoms in fifth grade, but there was no evidence for any of the indirect pathways.

[Female conduct disorders]

The last few years have seen much research on girls with conduct disorder (CD). This article summarizes the gender-specific data regarding prevalence, differences with respect to symptomatology (e.g., subtypes of aggression, callous-unemotional (cu)-traits), and it presents data on the autonomic and neuroendocrine stress system as well as genetic, neurocognitive, and neuroimaging data. Differences in the impact of environmental factors on boys and girls for the development of CD are discussed. Taken together, the data indicate that there is great overlap in symptomatology, personality traits, and neurobiological aberrations in girls and boys with CD. Since fewer girls than boys exhibit CD symptomatology, further investigations on CD in girls might help to identify resilience factors that could improve future therapeutic interventions.

Relational aggression in middle childhood predicting adolescent social-psychological adjustment: the role of friendship quality

The present longitudinal study examined the indirect effect of 6th-grade negative friendship quality on the associations between 5th-grade relational aggression and age 15 social-psychological adjustment (i.e., depressive symptoms and risky behavior). The study consisted of a secondary analysis of the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development using 776 children (M = 10.42 years in 5th grade; 50.4% boys) from the original sample. Using teacher and self-report ratings, relational and physical aggression, friendship quality, depressive symptoms, and risky behavior were measured. Bootstrapping mediation analyses were conducted. Negative friendship quality was found to mediate the association between relational aggression and depressive symptoms as well as between relational aggression and risky behavior, when controlling for physical aggression, gender and age. This longitudinal study identifies possible developmental pathways by which relational aggression and future social psychological adjustment may be linked.

Mädchen mit Störungen des Sozialverhaltens

Unser Wissen zu Ursachen, Verlauf und Behandlungsoptionen von Patienten mit Störungen des Sozialverhaltens beschränkt sich überwiegend auf Studien an männlichen Patienten. In neueren Untersuchungen werden vermehrt weibliche Patientinnen berücksichtigt und geschlechtsassoziierte Unterschiede überprüft. Die vorliegende Arbeit gibt eine Übersicht über aktuelle Erkenntnisse zum psychopathologischen Erscheinungsbild und den neuropsychologischen Auffälligkeiten bei Mädchen mit Störungen des Sozialverhaltens. Es wird zudem die Frage berücksichtigt, ob auf der Basis der referierten Untersuchungsbefunde auf das Vorliegen geschlechtsspezifischer psychosozialer und neurobiologischer Risikofaktoren zu schließen ist. Implikationen für zukünftige Trends in der Forschung und Möglichkeiten für differentielle Behandlungsoptionen für Mädchen und Jungen werden diskutiert.

A longitudinal assessment of the associations among response access, attention problems, and aggression during childhood

Children with ADHD symptoms often display social competence deficits, yet mechanisms for their social difficulties remain unclear. Using data from the normative sample of non-intervention respondents (N = 387; 50 % male; 49 % non-European-American; age at initial assessment: M = 6.5 years, SD = 0.48) in the Fast Track project (Lochman and CPPRG Journal of Consulting and Clinical Psychology 63:549-59, 1995), the social-information processing ability of accessing responses for social situations was modeled across four time points from kindergarten to third grade. Teacher-rated aggression and ADHD symptoms were included as predictors of the intercept and slope. Low ADHD symptoms were associated with a decline in aggressive responses across childhood, whereas high ADHD symptoms were linked to an increase in aggressive responses that decelerated between second and third grade. Regarding competent responses, low ADHD symptoms predicted increases in competent responses, but this increase decelerated between second and third grade. High ADHD symptoms were also associated with a slight increase in competent responses into first grade, but competent responses decreased from first to third grade. Neither aggression nor the interaction of ADHD symptoms and aggression accounted for a significant amount of variance in aggressive or competent responses. Future research should identify if differences in response access associated with high and low ADHD symptoms link to difficulties making and keeping friendships.

Is relational aggression part of the externalizing spectrum? a bifactor model of youth antisocial behavior

The primary purpose of the present study was to examine support for the inclusion of relational aggression (RAgg) alongside physical aggression (Agg) and rule-breaking behaviors (RB) as a subfactor of antisocial behavior (ASB). Caregiver reports were collected for 1,087 youth (48.9% male) ages 6-18. Results indicated that all three subfactors of ASB demonstrated substantial loadings on a general ASB factor. Using a bifactor model approach, specific factors representing each ASB subfactor were simultaneously modeled, allowing for examination of common and specific correlates. At the scale level, results demonstrated consistently strong connections with high Neuroticism and low Agreeableness across all 3 ASB subfactors, a pattern which was replicated for the general ASB factor in the bifactor approach. Specific factors in the bifactor model demonstrated connections with personality and psychopathology correlates, primarily for Agg. These findings provide some support for an overall grouping of RAgg with other ASB subfactors in youth, and further distinguish Agg as potentially representing a more potent variant of youth ASB relative to both RB and RAgg.

Relational aggression in children with preschool-onset psychiatric disorders

OBJECTIVE

The role of preschool-onset (PO) psychiatric disorders as correlates and/or risk factors for relational aggression during kindergarten or first grade was tested in a sample of 146 preschool-age children (age 3 to 5.11 years).

METHOD

Axis-I diagnoses and symptom scores were derived using the Preschool Age Psychiatric Assessment. Children's roles in relational aggression as aggressor, victim, aggressive-victim, or nonaggressor/nonvictim were determined at preschool and again 24 months later at elementary school entry.

RESULTS

Preschoolers diagnosed with PO psychiatric disorders were three times as likely as the healthy preschoolers to be classified aggressors, victims, or aggressive-victims. Children diagnosed with PO disruptive, depressive, and/or anxiety disorders were at least six times as likely as children without PO psychiatric disorders to become aggressive-victims during elementary school after covarying for other key risk factors.

CONCLUSIONS

Findings suggested that PO psychiatric disorders differentiated preschool and school-age children's roles in relational aggression based on teacher report. Recommendations for future research and preventative intervention aimed at minimizing the development of relational aggression in early childhood by identifying and targeting PO psychiatric disorders are made.

Annual research review: phenotypic and causal structure of conduct disorder in the broader context of prevalent forms of psychopathology

BACKGROUND

A better understanding of the nature and etiology of conduct disorder (CD) can inform nosology and vice versa. We posit that any prevalent form of psychopathology, including CD, can be best understood if it is studied in the context of other correlated forms of child and adolescent psychopathology using formal models to guide inquiry.

METHODS

Review of both cross-sectional and longitudinal studies of the place of CD in the phenotypic and causal structure of prevalent psychopathology, with an emphasis on similarities and differences between CD and oppositional defiant disorder (ODD). Papers were located using Web of Science by topic searches with no restriction on year of publication.

RESULTS

Although some important nosologic questions remain unanswered, the dimensional phenotype of CD is well defined. CD differs from other disorders in its correlates, associated impairment, and course. Nonetheless, it is robustly correlated with many other prevalent dimensions of psychopathology both concurrently and predictively, including both other 'externalizing' disorders and some 'internalizing' disorders. Based on emerging evidence, we hypothesize that these concurrent and predictive correlations result primarily from widespread genetic pleiotropy, with some genetic factors nonspecifically influencing risk for multiple correlated dimensions of psychopathology. In contrast, environmental influences mostly act to differentiate dimensions of psychopathology from one another both concurrently and over time. CD and ODD share half of their genetic influences, but their genetic etiologies are distinct in other ways. Unlike most other dimensions of psychopathology, half of the genetic influences on CD appear to be unique to CD. In contrast, ODD broadly shares nearly all of its genetic influences with other disorders and has little unique genetic variance.

CONCLUSIONS

Conduct disorder is a relatively distinct syndrome at both phenotypic and etiologic levels, but much is revealed by studying CD in the context of its causal and phenotypic associations with other disorders over time. Advancing and refining formal causal models that specify the common and unique causes and biological mechanisms underlying each correlated dimension of psychopathology should facilitate research on the fundamental nature and nosology of CD.

Current issues in the diagnosis of attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder

This review evaluates the diagnostic criteria for three of the most common disorders for which children and adolescents are referred for mental health treatment: attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD). Although research supports the validity and clinical utility of these disorders, several issues are highlighted that could enhance the current diagnostic criteria. For ADHD, defining the core features of the disorder and its fit with other disorders, enhancing the validity of the criteria through the lifespan, considering alternative ways to form subtypes of the disorder, and modifying the age-of-onset criterion are discussed relative to the current diagnostic criteria. For ODD, eliminating the exclusionary criteria of CD, recognizing important symptom domains within the disorder, and using the cross-situational pervasiveness of the disorder as an index of severity are highlighted as important issues for improving classification. Finally, for CD, enhancing the current subtypes related to age of onset and integrating callous-unemotional traits into the diagnostic criteria are identified as key issues for improving classification.

Relational benefits of relational aggression: adaptive and maladaptive associations with adolescent friendship quality

Two longitudinal studies examined associations between relational aggression and friendship quality during adolescence. In Study 1, 62 adolescents in Grades 6 (25.8%), 7 (32.3%), and 8 (41.9%) completed assessments of friendship affiliations, relational and overt aggression, and friendship quality at 2 time points, 1 year apart. Results using actor partner interdependence modeling indicated that high levels of relational aggression predicted increases in self-reported positive friendship quality 1 year later. In Study 2, 56 adolescents in Grades 9 (66.7%) and 10 (33.3%) attended a laboratory session with a friend in which their conversations were videotaped and coded for relationally aggressive talk. Target adolescents completed measures of positive and negative friendship quality during the laboratory session and during a follow-up phone call 6 months later. Analyses revealed that high levels of relationally aggressive talk at Time 1 predicted increases in negative friendship quality 6 months later. In addition, among adolescents involved in a reciprocal best friendship, high levels of observed relationally aggressive talk predicted increases in positive friendship quality over time. Taken together, these studies provide support for the idea that relational aggression may be associated with adaptive as well as maladaptive outcomes within the dyadic context of adolescent friendship.

Building an evidence base for DSM-5 conceptualizations of oppositional defiant disorder and conduct disorder: introduction to the special section

The DSM-5 ADHD and Disruptive Behavior Disorders Work Group recently outlined a research agenda designed to support possible revisions to the diagnostic criteria for oppositional defiant disorder (ODD) and conduct disorder (CD). Some of the areas in need of further investigation include (a) examining the clinical utility of the current diagnostic system in girls, (b) further clarifying the developmental progression from ODD to CD, (c) determining whether facets of ODD symptoms can help explain heterotypic continuity and enhance predictive validity, (d) evaluating the clinical utility of a new subtyping scheme for CD on the basis of the presence of callous-unemotional traits, and (e) comparing the clinical utility of dimensional versus categorical conceptualizations of ODD and CD. This special section was organized in an attempt to provide data on these issues using a diverse array of longitudinal data sets consisting of both epidemiological and clinic-based samples that collectively cover a large developmental span ranging from childhood through early adulthood.

Age of onset, symptom threshold, and expansion of the nosology of conduct disorder for girls

The study of conduct disorder (CD) in girls is characterized by several nosologic controversies that center on the most common age of onset, the most valid symptom threshold, and the possible inclusion of other manifestations of antisocial behavior and dimensions of personality as part of the definition of CD. Data from a prospective, longitudinal study of a community sample of 2,451 racially diverse girls were used to empirically inform these issues. Results revealed that adolescent-onset CD is rare in girls. There was mixed support for the threshold at which symptoms are associated with impairment: Parent-reported impairment provided the clearest evidence of maintaining the current Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) threshold of 3 symptoms. The impact of callousness and relational aggression on impairment varied by informant, with small effects for parent- and youth-reported impairment and larger effects for teacher-rated impairment relative to the effects for CD. These results support arguments for revising the typical age of onset of CD for girls but for maintaining the current symptom threshold. The results also suggest the need to consider subtyping according to the presence or absence of callousness. Given its content validity, relational aggression requires further study in the context of oppositional defiant disorder and CD.

Dimensions of oppositional defiant disorder as predictors of depression and conduct disorder in preadolescent girls

OBJECTIVE

To examine whether oppositional defiant disorder (ODD) rather than conduct disorder (CD) may explain the comorbidity between behavioral disorders and depression; to test whether distinct affective and behavioral dimensions can be discerned within the symptoms of ODD; and to determine whether an affective dimension of ODD symptoms is specifically predictive of later depression.

METHOD

The dimensions of ODD and their prediction to later CD and depression were examined in a community sample of 2,451 girls between the ages of 5 and 8 years, followed up annually over a 5-year period, using parent, child, and teacher questionnaire ratings of the severity of symptoms of psychopathology.

RESULTS

Dimensions of negative affect, oppositional behavior, and antagonistic behavior were found within ODD symptoms. Negative affect predicted later depression. Oppositional and antagonistic behavior predicted CD overall, and for Caucasian girls, negative affect also predicted later CD. CD was not predictive of later depression, controlling for comorbid conditions.

CONCLUSIONS

ODD plays a key role in the early development of psychopathology. It is central in the comorbidity between internalizing and externalizing psychopathology, which may be caused by a dimension of negative affective symptoms within ODD. How this dimension relates to later CD appears to vary by race.

Proactive, reactive, and romantic relational aggression in adulthood: measurement, predictive validity, gender differences, and association with Intermittent Explosive Disorder

The psychometric properties of a recently introduced adult self-report of relational aggression are presented. Specifically, the predictive utility of proactive and reactive peer-directed relational aggression, as well as romantic relational aggression, are explored in a large (N=1387) study of adults. The measure had adequate reliability and validity and the subscales demonstrated unique predictive abilities for a number of dependent variables. In particular, reactive but not proactive relational aggression was uniquely associated with history of abuse, hostile attribution biases, and feelings of distress regarding relational provocation situations. Reactive relational aggression was also more strongly related to anger and hostility than proactive aggression. In addition, relational aggression in the context of romantic relationships was uniquely related to anger, hostility, impulsivity, history of abuse, hostile attribution biases, and emotional sensitivity to relational provocations, even when controlling for peer-directed relational aggression. Gender differences in overall levels of relational aggression were not observed; however, males were most likely to engage in peer-directed proactive and reactive relational aggression whereas females were most likely to engage in romantic relational aggression. In a second study (N=150), relational aggression was higher in a sample of adults with Intermittent Explosive Disorder than in a sample of healthy controls or psychiatric controls. The findings highlight the importance of assessing subtypes of relational aggression in adult samples. Ways in which this measure may extend research in psychology and psychiatry are discussed.

Developmental origins of disruptive behaviour problems: the 'original sin' hypothesis, epigenetics and their consequences for prevention

This paper reviews publications on developmental trajectories of disruptive behaviour (DB) problems (aggression, opposition-defiance, rule breaking, and stealing-vandalism) over the past decade. Prior to these studies two theoretical models had strongly influenced research on DB: social learning and disease onset. According to these developmental perspectives, children learn DB from their environment and onset of the disease is triggered by accumulated exposition to disruptive models in the environment, including the media. Most of the evidence came from studies of school age children and adolescents. Longitudinal studies tracing developmental trajectories of DB from early childhood onwards suggest an inversed developmental process. DB are universal during early childhood. With age, children learn socially acceptable behaviours from interactions with their environment. A 'disease' status is given to children who fail to learn the socially acceptable behaviours. The mechanisms that lead to deficits in using socially accepted behaviours are strongly intergenerational, based on complex genetic and environmental contributions, including epigenetic mechanisms. Prevention of these deficits requires early, intensive and long-term support to parents and child. Newly discovered epigenetic mechanisms suggest that intensive perinatal interventions will have impacts on numerous aspects of physical and mental health, including DB. This review also concludes that: a) subtypes of disruptive behaviours should not be aggregated because they have different developmental trajectories and require specific corrective interventions; b) the overt-covert and destructive-nondestructive dimensions appear the most useful to create DB subtypes; c) overt DB onset before covert DB because the latter require more brain maturation; d) DB subtype taxonomies are more useful for clinicians than developmental taxonomies because the latter are post mortem diagnoses and clinicians' retrospective information is unreliable; e) we need large-scale collaborative preventive experimental interventions starting during early pregnancy to advance knowledge on causes and prevention of DB problems.

Etiology and measurement of relational aggression: A multi-informant behavior genetic investigation

Although the study of relational aggression is gaining attention in the literature, little is known about the underlying causes of this behavior and the relative validity of various informants. These issues were addressed in a sample of 1,981 6- to 18-year-old twin pairs (36% female, 34% male, 30% opposite-sex). Relational aggression was assessed via maternal and self-report using a structured interview. Univariate models estimated genetic and environmental influences by informant and examined evidence for gender differences. A psychometric model combined data from both informants to estimate etiologic influences that were both common to the informants and informant specific. In both sexes, the latent variable reflecting the mother's and child's shared perception of the child's relational aggression was substantially influenced by both additive genetic (63%) and shared environmental (37%) influences, although this latent variable accounted for much greater variance in the maternal report (66%) than it did in the youth report (9%). In addition, informant-specific additive genetic and shared environmental influences were found only for the youth report, with all remaining variance in the mother's report attributed to nonshared environmental influences. Results are discussed in the context of measuring relational aggression and the importance of multiple informants.

Understanding the gender differences in pathways to social deviancy: relational aggression and emotion regulation

This study explored the associations among childhood emotion regulation, overt aggression, relational aggression, and adolescent deviant social behaviors. Data were drawn from the Family Health Project, a longitudinal study conducted over 4 years. The sample consisted of 111 children at Time 1 who ranged in age from 51/2 to 12 years at Time 1 and 8 to 14 years at Time 3. A significant finding was that, for girls, lower emotion regulation predicted later relational aggression (beta = -2.95, P < .05). Moreover, low prosocial skills coupled with relational aggression were associated with deviant social behaviors.

It’s “Mean,” But What Does It Mean to Adolescents? Relational Aggression Described by Victims, Aggressors, and Their Peers

Early adolescent girls and boys ( N = 33) with known histories of relational aggression and/or victimization gave detailed accounts of the nature, frequency, intensity, course, and impact of relational aggression among their peers. They also described reasons for, and forms of, aggression after being prompted by a series of hypothetical vignettes. Despite identifying many forms of aggression that were similar for girls and boys, some sex differences were found; girls were described as experiencing more victimization within close friendships than boys, with a focus on maintaining exclusivity. Boys described exclusion from larger groups with themes of masculinity, athletic skill, and/or perceived sexual identity. Girls’ and boys’ perceptions about the motivations for these different forms of relational aggression were quite similar. These included power, popularity, and wanting to fit in as well as the aggressors’ emotional states and the victims’ characteristics.

Continuity and change in social and physical aggression from middle childhood through early adolescence

For a sample followed from age 9-13 (N=281), this investigation examined developmental trajectories for social and physical aggression as measured by teacher ratings. Trajectories for both forms of aggression were estimated first separately, then jointly. Mean levels of both social and physical aggression decreased over time for the overall sample, but with high variability of individual trajectories. Subgroups followed high trajectories for both social and physical aggression. Joint estimation yielded six trajectories: low stable, low increasers, medium increasers, medium desisters, high desisters, and high increasers. Membership in the high increaser group was predicted by male gender, unmarried parents, African American ethnicity, and maternal authoritarian and permissive parenting. Permissive parenting also predicted membership in the medium increaser group. This is one of the first studies to examine social aggression longitudinally across this developmental period. Though the results challenge the claim that social aggression is at its peak in early adolescence, the findings emphasize the importance of considering different developmental trajectories in trying to understand origins and outcomes of aggression.

Impulsivity-hyperactivity and subtypes of aggression in early childhood: an observational and short-term longitudinal study

This short-term longitudinal study (N = 112) was conducted to explore the concurrent and prospective associations between teacher-reported impulsive-hyperactive behavior and observed relational and physical aggression during early childhood (M = 45.54 months old, SD = 9.07). Multiple informants and methods including observational methods (i.e., 160 min per child) were used to assess aggression and impulsivity-hyperactivity. All measures were found to be valid and reliable. Prospective hierarchical regression analyses revealed that impulsivity-hyperactivity was associated with increases in observed physical aggression across time, controlling for initial relational aggression and gender. These findings add to the growing developmental psychopathology literature that suggests that distinguishing between subtypes of aggression during early childhood may be important for understanding the course of impulsivity-hyperactivity in young children. Implications for practice are discussed.