Conduct Disorder and Alcohol Use Disorder Trajectories, Predictors, and Outcomes for Indigenous Youth

Area of Science:

• Psychiatry
• Developmental Psychology
• Public Health

Background:

• Conduct disorder (CD) and alcohol use disorder (AUD) are prevalent among adolescents.
• Understanding the developmental trajectories of these disorders in Indigenous youth is crucial for targeted interventions.
• Previous research has not fully explored the joint developmental paths of CD and AUD symptoms in this population.

Purpose of the Study:

• To identify distinct and combined developmental trajectories of CD and AUD symptoms in Indigenous youth (aged 10-18).
• To characterize baseline profiles of youth belonging to different joint trajectory groups.
• To examine the association between joint trajectory group membership and later psychosocial outcomes.

Main Methods:

• Longitudinal study involving 673 Indigenous youth from North American reservations (2002-2010).
• DSM-IV Diagnostic Interview Schedule for Children-Revised (DISC-R) used to assess CD and substance use disorder (SUD) symptoms at four time points.
• Group-based trajectory modeling applied to identify distinct developmental paths for CD, AUD, and their joint trajectories.

Main Results:

• Three CD and four AUD trajectories were identified, with the majority of youth showing no symptoms for either disorder (55% for CD, 73% for AUD).
• Eight joint trajectories emerged, with 53% of the sample in the no-symptom group.
• Youth in the no-symptom group exhibited protective factors (e.g., caretaker warmth, positive school adjustment) and lower risk exposure (e.g., less discrimination, fewer deviant peers).
• Symptomatic groups faced higher risks of adverse outcomes like high school dropout, sex under the influence, and arrest.

Conclusions:

• A significant proportion of Indigenous youth navigate adolescence without developing CD or AUD symptoms, despite risk factors.
• CD and AUD symptoms exhibit diverse developmental trajectories, influenced by early risk factors.
• These trajectories are significantly associated with later psychosocial adjustment and outcomes.