Annual Research Review: Early conduct problems – precursors, outcomes, and etiology

During the toddler and preschool period, nearly all children engage in some level of aggression, defiance, stealing, and temper tantrums. While the frequency and intensity of these behaviors tends to decrease across early childhood, a subset of children engage in these conduct problem behaviors at a higher intensity early in life and/or do not desist from these behaviors. Instead, these behaviors escalate across childhood and adolescence into serious forms of antisocial behavior (e.g., aggression, rule breaking). Given the negative impacts of these behaviors on children engaging in them, victims, and society, childhood conduct problems are a major public health concern. Here, we provide an updated review of the research identifying the trajectory of conduct problems; risk factors for their emergence, persistence, and escalation; and mechanisms through which risk impacts behavior, using a biopsychosocial and ecological lens. We describe how child and parent attributes contribute to a coercive dyadic cycle that leads to escalating problem behaviors, and how the broader context undermines these proximal relationships to increase risk for conduct problems. Next, we consider the role that genetics plays in these processes and describe how gene-environment interplay shapes early conduct problems. Further, we describe the ways in which these environmental and genetic risk processes impact brain development to increase risk for conduct problems. Finally, we discuss recent approaches to prevent and treat conduct problems and discuss research needs to better support our understanding of the development, prevention, and treatment of early conduct problems.