Temper tantrums, stealing and throwing toys around are forms of disruptive behavior that many young children exhibit when growing up. However, if this behavior is “high-intensity,” it could indicate a psychiatric problem that predicts future antisocial behavior.

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While most children lose their temper from time to time, children with conduct disorder frequently display high-intensity antisocial behavior.

The conclusion comes from a new study, published in The Journal of Pediatrics, in which researchers from Washington University School of Medicine in St. Louis, MO, assessed the behavior of children at both preschool age and then school age.

Conduct disorder refers to a range of behavioral and emotional problems that are experienced by children and adolescents. The condition leads to youngsters having difficulty following rules or behaving in a manner deemed socially acceptable.

“Children who had high-intensity symptoms as preschoolers were likely to have conduct disorder,” said first author Dr. Ji Su Hong. “And those symptoms also tended to predict conduct disorder when they reached school age.”

For children exhibiting such symptoms, the researchers recommend that a mental health professional should be seen, in order for any potential disorders to be diagnosed and treated.

“Previously, we did not understand the empirical differences between normal disruptive behaviors in preschoolers – like temper tantrums, for example – and behaviors that signal problems,” says Dr. Joan L. Luby. “If you went to your pediatrician and said, ‘My 3-year-old is having tantrums,’ the pediatrician wouldn’t tell you to see a psychiatrist.”

For the study, 273 children were investigated from preschool age. First, the caregivers of the children were interviewed to assess their child’s mental health. The participating children were then assessed at school age with age-appropriate diagnostic interviews.

The following symptoms were most likely to be exhibited by preschoolers with conduct disorder:

  • Aggression towards others
  • High-intensity deceitfulness (including stealing)
  • High-intensity defiant behavior
  • High-intensity destruction of property
  • High-intensity peer problems.

“We characterize a symptom as high-intensity when it’s really ‘high-pitched’ – so just how severe the anger is,” says Dr. Luby. “A high-intensity symptom is one that is very acute or severe, occurs over a long duration of time and happens in a number of different contexts.”

Young children displaying these symptoms were more likely to continue exhibiting antisocial behavior symptomatic of conduct disorder when they reached elementary school.

Around one in 20 preschool children has conduct disorder, roughly equating to one child in every preschool classroom, according to Dr. Hong.

The researchers also observed a number of disadvantages that were often shared by children with conduct disorder at school age. Almost half came from families with an annual income of $20,000 or less. A total of 57% lived either in a single parent home or did not live with either parent. Around half had a history of abuse or neglect and more than half were diagnosed with preschool depression.

The American Academy of Child & Adolescent Psychiatry (AACAP) stress the importance of treatment for children with conduct disorder:

Without treatment, many youngsters with conduct disorder are unable to adapt to the demands of adulthood and continue to have problems with relationships and holding a job. They often break laws or behave in an antisocial manner.”

The findings of the study could be used as a guide for primary care clinicians to aid them in identifying preschool children with clinical conduct disorder, the authors conclude. “In young children, violent and destructive behavior that’s deliberate really seems to be a key warning sign,” says Dr. Luby.

Earlier this week, Medical News Today reported on a study published in Circulation finding that psychosocial experiences in childhood may influence future cardiovascular health.