Psychopathological and neuropsychological endophenotypes of children with disruptive behaviour

Childhood Disruptive Behaviors (DBs) are a robust predictor of delinquency, academic failure, social difficulties, and persistent mental health disorders and one of the most frequent reasons for referral to children's mental health services. Although high prevalence and referral rates and negative outcomes signal great need, current treatment approaches are inadequate with recent data estimating that approximately 25–40% of children continue to experience clinically-significant symptoms following treatment completion. Current research points to heterogeneity as one factor limiting treatment effectiveness, and the present study aimed to distill some of this heterogeneity by identifying data driven subgroups based on key dimensions of psychopathology and neuropsychological abilities. First, data from children 6–12 years (n=143) referred to a clinic for youth with DBs were analyzed using Latent class analysis (LCA) to determine classes (i.e., subgroups) based on measures of children's callous-unemotional (CU) traits, emotion regulation, and objective executive function (EF) task performance. Second, identified classes were compared on three parent- and teacher-rated outcome variables: level of functional impairment, social functioning, and conduct problems. Four classes emerged with varying relative levels of psychopathology and EF task performance. Classes with elevated levels of CU traits and poor selective attention had the greatest levels of conduct problems and overall impairment. Findings may inform more refined assessment processes, the discovery of novel treatment targets, and future treatment innovation for children with DBs and their families.