Clinically Significant Conduct Problems in Girls in the Elementary School Years: Gender Differences in Trajectories and Risk Factors

Objectives: Because of lower prevalence, few studies have been performed with girls exhibiting clinically significant conduct problems (CPs) in childhood. Recent work in community sample groups has suggested that girls with an elevated level of CP may be at greater risk for persistence relative to boys. This study aims to determine gender differences as follows: 1) in trajectories of CP in elementary school girls and boys presenting with clinically significant CP at study inception; and 2) in factors related to the persistence/desistance of CP. Methods: A total of 326 participants (ages 6–9 years; 155 girls) were recruited among students receiving psychoeducational services for CP in schools in four regions of Québec, Canada. Children retained for the study scored in the clinical range of DSM-oriented scales for CP according to parent or teacher reports. CPs were evaluated annually over a 5-year period (six measurement time points). A selection of well-established risk and protective factors for CP were measured at study inception and were used as predictors of the trajectories. Results: Latent class trajectory analyses revealed that the following three latent trajectories of CP represented the best empirical fit to the data (Bayesian information criterion converges to a minimum; entropy = 0.71, Lo-Mendell-Rubin likelihood ratio test = P < 0.01): 1) a high stable trajectory, with maintenance of CP over the clinical level (33 percent of girls, 18 percent of boys); 2) a high declining trajectory, with clinical CP moving to the high risk zone (50 percent of girls, 64 percent of boys); and 3) a declining trajectory, with clinical CP moving to the normal range (17 percent of girls, 19 percent of boys). Multinomial logistic regression analyses using gender as a moderator showed that most of the predictive factors of the high stable trajectory were similar for boys and girls. However, high levels of callous-unemotional traits, inattention, and peer rejection increased the likelihood to maintain a clinical level of CP specifically in girls (P < 0.01). In contrast, high levels of empathy, school performance, and closeness with teacher decreased this probability specifically in girls (P < 0.05). Conclusions: Although CP declined for most children, girls were more likely than boys to maintain clinically significant CP throughout the elementary school period. The impact of affective-relational factors appeared particularly predictive of girls’ persistent CP compared with boys.