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Impact of Early Intervention on Psychopathology, Crime, and Well-Being at Age 25
Open accessAbstract
OBJECTIVE: This randomized controlled trial tested the efficacy of early intervention to prevent adult psychopathology and improve well-being in early-starting conduct-problem children. METHOD: Kindergarteners (N=9,594) in three cohorts (1991-1993) at 55 schools in four communities were screened for conduct problems, yielding 979 early starters. A total of 891 (91%) consented (51% African American, 47% European American; 69% boys). Children were randomly assigned by school cluster to a 10-year intervention or control. The intervention goal was to develop social competencies in children that would carry them throughout life, through social skills training, parent behavior-management training with home visiting, peer coaching, reading tutoring, and classroom social-emotional curricula. Manualization and supervision ensured program fidelity. Ninety-eight percent participated during grade 1, and 80% continued through grade 10. At age 25, arrest records were reviewed (N=817, 92%), and condition-blinded adults psychiatrically interviewed participants (N=702; 81% of living participants) and a peer (N=535) knowledgeable about the participant. RESULTS: Intent-to-treat logistic regression analyses indicated that 69% of participants in the control arm displayed at least one externalizing, internalizing, or substance abuse psychiatric problem (based on self- or peer interview) at age 25, in contrast with 59% of those assigned to intervention (odds ratio=0.59, CI=0.43-0.81; number needed to treat=8). This pattern also held for self-interviews, peer interviews, scores using an "and" rule for self- and peer reports, and separate tests for externalizing problems, internalizing problems, and substance abuse problems, as well as for each of three cohorts, four sites, male participants, female participants, African Americans, European Americans, moderate-risk, and high-risk subgroups. Intervention participants also received lower severity-weighted violent (standardized estimate=-0.37) and drug (standardized estimate=-0.43) crime conviction scores, lower risky sexual behavior scores (standardized estimate=-0.24), and higher well-being scores (standardized estimate=0.19). CONCLUSIONS: This study provides evidence for the efficacy of early intervention in preventing adult psychopathology among high-risk early-starting conduct-problem children.
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“Providing early intervention is known to be more effective and cost-efficient than waiting until adulthood when problems are entrenched [28, 84].”
From Optimizing parenting and child outcomes following parent–child interaction therapy – toddler: a randomized controlled trial (2024) · cites this paper as [28]
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“This program resulted in a 34.7% relative decline in substance-related convictions and a 30.9% relative decrease in violent crime convictions at age 25.20”
From Community investment interventions as a means for decarceration: A scoping review (2022) · cites this paper as [20]
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Metadata
- Authors
- Dodge, K. A., Bierman, K. L., Coie, J. D., Greenberg, M. T., Lochman, J. E., McMahon, R. J., Pinderhughes, E. E., & for the Conduct Problems Prevention Research Group
- Affiliations
- Tufts University (US)
- ORCID
- Venue
- American Journal of Psychiatry
- Published
- 2015-01-01
- Volume
- 172
- Issue
- 1
- Pages
- 59-70
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC4485380
- OpenAlex
- W1967914586
- Cited by
- 213
- References
- 44
- Citations by year
- 2026: 12 · 2025: 12 · 2024: 27 · 2023: 13 · 2022: 24 · 2021: 15 · 2020: 18 · 2019: 14 · 2018: 24 · 2017: 19 · 2016: 19 · 2015: 16
- FWCI
- 21.30
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5p20da017589-05)
- National Institute of Mental Health (R18 MH 50953, R18MH050951, R18 MH50951, R18MH48043, K05MH000797, K05MH-00797, R18-MH50952, R18MH048043, K05MH01027, R18MH050953, K05MH001027, R18MH050952)
- National Institute on Drug Abuse (DA 16903, R01DA016903, P20- DA017589, P30DA023026, K05DA015226, DA017589)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Education › Early Childhood Education and Development
- Social Sciences › Sociology and Political Science › Crime Patterns and Interventions
- Keywords
- early intervention, social skills training, home visiting, peer coaching, reading tutoring, adult psychopathology, substance abuse, violent crime, drug offenses, sexual risk behavior, well-being, arrest records, kindergarten screening, vulnerable children, African American children, European American children, gender differences
- MeSH terms
- Adolescent, Adult, Behavior Therapy, Mental Disorders, Child, Child, Preschool, Crime, Female, Humans, Longitudinal Studies, Male, Personal Satisfaction, Schools, Treatment Outcome, Conduct Disorder
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