Childhood disruptive behaviour disorders: review of their origin, development, and prevention.

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.