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Background Contextual variation in child disruptive behavior is well documented but remains poorly understood. We first examine how variation in observed disruptive behavior across interactional contexts is associated with maternal reports of contextual variation in oppositional-defiant behavior and functional impairment. Second, we test whether child inhibitory control explains the magnitude of contextual variation in observed disruptive behavior. Methods Participants are 497 young children (mean age = 4 years, 11 months) from a subsample of the MAPS, a sociodemographically diverse pediatric sample, enriched for risk of disruptive behavior. Observed anger modulation and behavioral regulation problems were coded on the Disruptive Behavior Diagnostic Observation Schedule ( DB- DOS) during interactions with parent and examiner. Oppositional-defiant behavior, and impairment in relationships, with parents and nonparental adults, were measured with the Preschool Age Psychiatric Assessment ( PAPA) interview with the mother. Functional impairment in the home and out-and-about was assessed with the Family Life Impairment Scale ( FLIS), and expulsion from child care/school was measured with the baseline survey and FLIS. Results Observed disruptive behavior on the DB- DOS Parent Context was associated with oppositional-defiant behavior with parents, and with impairment at home and out-and-about. Observed disruptive behavior with the Examiner was associated with oppositional-defiant behavior with both parents and nonparental adults, impairment in relationships with nonparental adults, and child care/school expulsion. Differences in observed disruptive behavior in the Parent versus Examiner Contexts was related to the differences in maternal reports of oppositional-defiant behavior with parents versus nonparental adults. Children with larger decreases in disruptive behavior from Parent to Examiner Context had better inhibitory control and fewer attention-deficit/hyperactivity disorder symptoms. Conclusions The DB- DOS showed clinical utility in a community sample for identifying contextual variation that maps onto reported oppositional-defiant behavior and functioning across contexts. Elucidating the implications of contextual variation for early identification and targeted prevention is an important area for future research. [ABSTRACT FROM AUTHOR]

Background: Disregard for rules, an important dimension of oppositional defiant and conduct disorders, is frequent during early childhood, but the development of its chronic form has not been studied during this key socialization period. This study aimed to describe the developmental trajectories of disregard for rules during early childhood and identify prenatal and postnatal predictors for a high trajectory. Methods: Participants were involved in a longitudinal study of a birth cohort followed yearly from 5 to 74 months of age ( N = 1,942). Prenatal and postnatal predictors were measured by parental report at the beginning of the study, and parents reported child disregard for rules at five time points from 29 to 74 months of age. Results: Four groups of children followed distinct and stable trajectories of mother-rated disregard for rules: Very Low (approximately 9.1%), Low (56.9%), Moderate (29.7%) and Chronic (4.3%). As expected, male sex was a significant predictor of the chronic trajectory (OR = 1.76, CI = 1.09–2.83). Mothers’ history of antisocial behavior (OR = 1.72, CI = 1.02–2.91), and postnatal depressive symptoms experienced by the mother (OR = 1.71, CI = 1.03–2.84) and the father (OR = 2.02, CI = 1.10–3.71) were also important independent predictors. However, contrary to expectations, children’s difficult temperament and parenting at 5 months did not predict chronic disregard for rules beyond other risk factors. Conclusions: High disregard for rules is fairly stable during early childhood and is associated with risk factors identifiable before and shortly after birth which may be used for targeted prevention. [ABSTRACT FROM AUTHOR]

Objective: To review preventive studies of disruptive behaviour disorders (DBDs) in light of recent empirical knowledge on their development. Method: We draw on the results of longitudinal studies of children starting in infancy to examine the onset, development, and risk factors for DBD symptoms. We review randomized controlled trials of preventive interventions provided to families before the child is aged 3 years, with reported outcome measures of DBD symptoms at follow-up. Results: Children who present high levels of DBD symptoms start to do so in the first 2 years of life and have risk factors that can be identified in the mother during pregnancy or even earlier, and shortly after the child's birth. Most preventive experiments have started relatively late after birth and have targeted parenting, with weak effects on children's DBDs. Preventive experiments that have provided intensive intervention to at-risk mothers starting during pregnancy have shown important effects in reducing key risk factors and some of the most severe consequences of DBDs. However, even those experiments have not succeeded in preventing childhood DBDs in the home and school contexts. Conclusions: We suggest adopting a sequential, multitarget, intergenerational, experimental approach both to increase our knowledge about causal mechanisms and to increase our effectiveness in curbing DBDs and their serious lifelong consequences. [ABSTRACT FROM AUTHOR]

Irritability is a substrate of more than one dozen clinical syndromes. Thus, identifying when it is atypical and interfering with functioning is crucial to the prevention of mental disorder in the earliest phase of the clinical sequence. Advances in developmentally based measurement of irritability have enabled differentiation of normative irritable mood and tantrums from indicators of concern, beginning in infancy. However, developmentally sensitive assessments of irritability-related impairment are lacking. We introduce the Early Childhood Irritability-Related Impairment Interview (E-CRI), which assesses impairment associated with irritable mood and tantrums across contexts. Reliability and validity are established across two independent samples varied by developmental period: the Emotional Growth preschool sample (EmoGrow; N = 151, M = 4.82 years) and the When to Worry infant/toddler sample (W2W; N = 330, M = 14 months). We generated a well-fitting two-factor E-CRI model, with tantrum- and irritable mood-related impairment factors. The E-CRI exhibited good interrater, test-retest, and longitudinal reliability. Construct and clinical validity were also demonstrated. In both samples, E-CRI factors showed association to internalizing and externalizing problems, and to caregiver-reported concern in W2W. Tantrum-related impairment demonstrated stronger and more consistent explanatory value across outcomes, while mood-related impairment added explanatory utility for internalizing problems. The E-CRI also showed incremental utility beyond variance explained by the Family Life Impairment Scale (FLIS) survey indicator of developmental impairment. The E-CRI holds promise as an indicator of impairment to inform identification of typical versus atypical patterns reflecting early emerging irritability-related syndromes in the initial phase of the clinical sequence. [ABSTRACT FROM AUTHOR]

This study examined the frequent clinical observation that toddlers with less expressive language have more severe temper tantrums. A representative sample of 2001 mothers reported on their toddler's expressive vocabulary and frequency of different temper tantrum behaviors, a prominent feature of irritability and an emergent marker of mental health risk. Results revealed that 12- to 38-month-olds with fewer spoken words demonstrated more severe (frequent and dysregulated) temper tantrums. Toddlers who were late talkers at 24–30 months also had more severe tantrums; their relative risk of having severe tantrums was 1.96 times greater than peers with typical language. These results are the first to show that language and temper tantrums are related, and that this relation is present in the second year of life. These findings point to the importance of assessing both language and mental health risk in order to promote earlier identification and intervention for early childhood disorders. • Expressive language is associated with temper tantrums in 12–38-month-olds. • Late talkers, i.e., children with language delay, have more severe temper tantrums. • Relative risk for severe tantrums is nearly 2x greater for late talkers. • A relation between emergent language and mental health risk is evident. [ABSTRACT FROM AUTHOR]