Risk and Protective Factors as Predictors of Outcome in Adolescents With Psychiatric Disorder and Aggression

To identify predictors of behavioral outcomes in high-risk adolescents with aggression and serious emotional disturbance (SED). Three hundred thirty-seven adolescents from a statewide North Carolina treatment program for aggressive youths with SED were followed between July 1995 and June 1999 from program entry (T 1) to approximately 1 year later (T 2). Historical and current psychosocial risk and protective factors as well as psychiatric symptom severity at T 1 were tested as predictors of high and low behavioral functioning at T 2. Behavioral functioning was a composite based on the frequency of risk-taking, self-injurious, threatening, and assaultive behavior. Eleven risk and protective factors were predictive of T 2 behavioral functioning, while none of the measured T 1 psychiatric symptoms was predictive. A history of aggression and negative parent–child relationships in childhood was predictive of worse T 2 behavior, as was lower IQ. Better T 2 behavioral outcomes were predicted by a history of consistent parental employment and positive parent–child relations, higher levels of current family support, contact with prosocial peers, higher reading level, good problem-solving abilities, and superior interpersonal skills. Among high-risk adolescents with aggression and SED, psychiatric symptom severity may be a less important predictor of behavioral outcomes than certain risk and protective factors. Several factors predictive of good behavioral functioning represent feasible intervention targets.