Sex Differences in the Classification of Conduct Problems: Implications for Treatment

Abstract

Purpose: Conduct problem behaviors are highly heterogeneous symptom clusters, creating many challenges in investigating etiology and planning treatment. The aim of this study was to first identify distinct subgroups of males and females with conduct problems using a data driven approach and, secondly, to investigate whether these subgroups differed in treatment outcome after an evidence-based crime prevention program. Methods: We used a latent class analysis (LCA) in Mplus` to classify 517 males and 354 females (age 6–11) into classes based on the presence of conduct disorder or oppositional defiance disorder items from the Child Behavior Checklist. All children were then enlisted into the 13-week group core component (children and parent groups) of the program Stop Now And Plan (SNAP®), a cognitive-behavioral, trauma-informed, and gender-specific program that teaches children (and their caregivers) emotion-regulation, self-control, and problem-solving skills. Results: The LCA revealed four classes for males, which separated into (1) “rule-breaking,” (2) “aggressive,” (3) “mild,” and (4) “severe” conduct problems. While all four groups showed a significant improvement following the SNAP program, they differed in the type and magnitude of their improvements. For females, we observed two classes of conduct problems that were largely distinguishable based on severity of conduct problems. Participants in both female groups significantly improved with treatment, but did not differ in the type or magnitude of improvement. Conclusion: This study presents novel findings of sex differences in clustering of conduct problems and adds to the discussion of how to target treatment for individuals presenting with a variety of different problem behaviors.