Conduct problems, depressive symptomatology and their comorbid presentation: adjustment to early adolescence

Thesis (Ph. D.)--University of Washington, 2002Conduct problems and depression are both associated with negative outcomes in adolescents, including suicide, academic difficulties and social skills deficits. Youth with comorbid conduct problems and depression have even greater functional impairment in many of these areas than do youth with symptomatology in one domain. This current study aims to increase our understanding of comorbid depression and CP in youth. To that end, both continuous and categorical measures of CP and depression were created using multiple-reporter constructs. Continuous measures of CP and depression were used to examine the longitudinal relationship between the two sets of symptoms in the development of comorbidity in the transition from childhood to early adolescence. Categorical measures were used to predict the stability of CP, depression, and their comorbid presentation over time. The differential relationships between a variety of adjustment outcomes (e.g., academic achievement, social competence, antisocial peer relations, suicidality, and substance use) and CP, depression and their comorbid presentation were examined using both continuous and categorical measures. In addition, gender and ethnicity differences were examined. This study used a gender-balanced, ethnically diverse sample of 435 children from high-risk neighborhoods in four sites around the country. Youth-, parent-, and teacher-report of symptomatology were collected in fifth grade. Multiple-reporter measures of adolescent adjustment, including academic achievement, social competence, and suicidality were collected in seventh grade. Youth-report of antisocial peer relations and substance use was also collected in seventh grade.Results indicate that CP predicts depression longitudinally, but depression does not predict CP. Comorbid symptomatology is the most stable over time, followed by CP. Depression is the least stable symptomatology over time. Continuous analyses indicate that depression and CP are both risk factors for multiple negative adjustment outcomes. Categorical analyses suggest that comorbid CP and depression is generally no worse than CP-alone and depression-alone is similar to no symptomatology in terms of level of adjustment problems. No gender differences were found in the relationship between symptomatology and adjustment. The utility of using continuous vs. categorical scoring methods in predicting adolescent adjustment is discussed