Life course persistent antisocial behavior silver anniversary

Journal Pre-proof Life course persistent antisocial behavior silver anniversary

Robert Eme PII:

S1359-1789(19)30003-5

DOI:

https://doi.org/10.1016/j.avb.2019.101344

Reference:

AVB 101344

To appear in:

Aggression and Violent Behavior

Received date:

10 January 2019

Revised date:

8 October 2019

Accepted date:

15 October 2019

Please cite this article as: R. Eme, Life course persistent antisocial behavior silver anniversary, Aggression and Violent Behavior(2018), https://doi.org/10.1016/ j.avb.2019.101344

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© 2018 Published by Elsevier.

Journal Pre-proof Life Course Persistent Antisocial Behavior Silver Anniversary Robert Eme Retired Professor of Clinical Psychology, Illinois School of Professional Psychology A little over 25 years ago Terrie Moffitt (1993) published a paper that proposed a dual developmental taxonomy of antisocial behavior: life-course–persistent (LCP) and adolescent-

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limited (AL) antisocial behavior. The paper triggered a cascade of research on types of criminal

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offending (Farrington, 2015), thereby making it one of the most researched and most influential

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of all developmental theories of antisocial behavior (Farrington & Ttofi, 2015; Piquero, Gonzalez, & Jennings, 2015). Based upon the known facts of criminal offending at the time, the

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dual taxonomy proposed to account for the age-crime curve, “one of the most agreed-upon

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concepts in the study of life-course criminology” (Liu & Bushway, 2018, p.84). This refers to the

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robust finding that crime in the aggregate increases during adolescence, peaks in the late teens or early twenties and then gradually declines thereafter. This curve could result either from a few

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chronic offenders escalating their offending, or from large numbers of adolescents joining the

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ranks of the chronic offenders and then subsequently desisting within a few years (Moffitt, 1993). Existing theories failed to explain both the peak in offending in late adolescence as well the chronicity of antisocial behaviors that began well before adolescence. The dual developmental taxonomy provided an explanation by suggesting that the facts of chronic antisocial behavior and the age-crime curve could be accounted for by positing two distinct subgroups of antisocial individuals with different developmental trajectories and etiologies. The LCP subgroup was relatively small (5%–10%), almost exclusively male, and exhibited antisocial behavior beginning in childhood that persisted into midlife (Moffitt, 1993, 2006, 2018). LCP

Journal Pre-proof was hypothesized to emerge early in life from neuropsychological risks for cognitive deficits, difficult temperament, or hyperactivity caused by inherited or acquired neuropsychological variations (Moffitt, 1993). These difficulties were then hypothesized to be exacerbated by rearing in a high-risk environment characterized by disrupted attachment bonds, inadequate parenting, maltreatment and poverty. The AL subtype referred to a much larger group whose antisocial behavior was limited largely to adolescence. Their delinquent behavior was hypothesized to be

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caused by a maturity gap (such as a desire for autonomy)not neuropsychological risk

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factorswhich prompted youth to temporarily engage in social mimicry of LCP antisocial

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behaviors via peer reinforcement. As these youth matured, they outgrew their motivation for

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delinquency.

Having just passed the silver anniversary (1993-2018) of this landmark publication, it is a

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fitting time to review the accuracy of some its most important predictions, as well new findings,

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and what still needs to be learned. The focus will be on male LCP, since they are the “few, persistent and pathological” (Moffitt, 2006, p. 571) who account for a vastly disproportionate

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share of crime. And, as Moffitt noted in 1993, “researchers will learn more about the etiology of

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severe, persistent antisocial behavior if they single out childhood persistent cases for study and if they begin their studies during infancy, or even prenatally, and follow the same individuals to adulthood” (Moffitt, 1993, p. 696). Female LCP (Odgers et al., 2008) will not be addressed as findings have not reached consensus (Moffitt, 2018), and what is known has been recently reviewed by Broidy and Thompson (2018). Also, given the voluminous literature on the developmental taxonomy, the review will of necessity be selective, synthesizing the conclusions of reviews of the primary literature as well as integrating findings from recent research. The paper will begin by reviewing the evidence for Moffitt’s three key predictions regarding the LCP

Journal Pre-proof group. First, there will be a small group of males (less than 10%) who show extreme behavior during childhood that is sustained at a high level thereafter. Second, in contrast to the AL group, the LCP group’s antisocial behavior will be more pathological, e.g., engage in more violent crime. Third, the LCP group, in contrast to the AL group, will have the origins of its antisocial behavior in neuropsychological problems. Next, the paper will review the findings for early identification of the LCP groupa topic that was only modestly addressed in 1993. Lastly, it

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early-years crime prevention movement (Moffitt, 2018).

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will discuss what is one of most significant impacts of the 1993 article, providing impetus to the

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LCP Group

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The Few Persistently Antisocial Individuals Of all the research that has been conducted since 1993, the most convincing evidence for

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an LCP group comes from the research of the highly influential Dunedin Multidisciplinary

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Health and Development Study (Fairchild, 2018). The Dunedin study is a continuing longitudinal study of health and behavior in a complete one-year birth cohort (n= 1037, 52% males) in

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Dunedin New Zealand that began some 4 decades ago and has published over 1200 papers and

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reports (Poulton, Moffitt, & Silva, 2015). The study defined the LCP group as individuals who had histories of extreme childhood antisocial behavior that was both stable across time (at least three of the assessment ages 5,7,9, and 11) and pervasive across situation (i.e., home and school) and who self-reported extreme delinquency at an age-15 or age-18 interview (Moffitt, Caspi, Harrington, & Milne, 2002; Moffitt, Caspi, Rutter, & Silva, 2001). The LCP group so defined consisted of 10% of the males in the cohort, yielding a male to female sex ratio of 10:1 (Moffitt et al., 2001). This finding prompted Moffitt (2006) to describe LCP as “almost exclusively male” (p. 593) and will subsequently be discussed in more detail. As predicted, follow-ups of the LCP

Journal Pre-proof males in the Dunedin study at ages 26, 32 and 38 have found that as group they have demonstrated more persistence of antisocial behavior compared to groups with low levels of childhood antisocial behavior, childhood limited antisocial behavior, or adolescent onset antisocial behavior. For example, at age 26 compared to the other groups, the LCP group had a higher level of psychopathic traits, more drug-related and violent crime, and were 2-3 times more likely than the adolescent onset group to have been convicted as adults and for more serious

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offenses (Moffitt et al., 2002). At age 32, the LCP group who were identified using a group-

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based trajectory method1 were far more likely to have an official conviction for violence (32.7%)

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than the low antisocial group (0.4%), childhood-limited group antisocial group (6.0%), or

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adolescent-onset group antisocial group (10.2%) [Odgers et al., 2007]. Most recently, approaching midlife (age 38), most LCP men had not desisted from crime: 55% were convicted

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between ages 26 and 38 years, versus 30% of all adolescent onset men, and 18% of all men in

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the cohort (Moffitt, 2018).

Moffitt (2018) estimates that, despite numerous variations in sampling, geographic area,

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historical period, length of observation period, and data sources, the findings of the Dunedin

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studies for a LCP group have been broadly confirmed by reviews of more than 100 longitudinal studies as well as more recent studies (e.g., Carkin & Tracy, 2015; Widom, Fisher, Nagin, & Piquero, 2018). Indeed, some studies, having extended the follow-up period beyond the late 30’s of the Dunedin study, have found a small group of individuals still being regularly convicted in

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The traditional method of using clinical definitions and algorithms to identify a LCP group in the 2001 study was replaced by group trajectory modeling method in subsequent studies to identify LCP as well as other groups (Moffitt, 2018). The traditional method of analyzing data from longitudinal studies through a blend of analysis and insight “… is inevitably subjective…fraught with statistical dangers” (Nagin, 2005, p.2). Formal statistical models were developed that overcame the limitations of traditional methods and were used in the ongoing Dunedin as well as numerous other longitudinal studies.

Journal Pre-proof their 40’s, 50’s, 60’s and even as late as the 70’s (Farrington, 2018a; Moffitt, 2018).2 Thus “It seems unlikely that Sampson and Laub’s (2003) argument that ‘all offenders desist’ is accurate” (Farrington, 2018a).The prevalence of male LCP offenders in the various studies ranged from 1.6% to 29.1%, largely due to differences in definition and measurement features of LCP (Farrington et al., 2017). Nevertheless, the studies collectively indicate that LCP males comprise a small group comparable to Moffitt’s (1993) initial estimate of 5% to 10% (Russell & Odgers,

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2015).

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Lastly, although 25 years of research is broadly consistent with Moffitt’s initial formulation of

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a small group of individuals whose early starting antisocial behavior is LCP, two modifications should be noted. While the terms child-onset CD and LCP were used interchangeably in Moffitt

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(1993), the Dunedin research group was subsequently “surprised” (Moffitt, 2006, p. 577) to find

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a group of males who had exhibited extreme, severe, and persistent antisocial problems during

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childhood, but whose continuing low to moderate antisocial behavior into adolescence was not extreme enough to meet criteria for LCP. Although it was initially thought that these individual’s

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antisocial behavior was “childhood-limited,” having recovered from an antisocial beginning,

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subsequent research by Moffitt and others (McGee & Moffitt, 2018; Moffitt, 2006) has found that these individuals do persist in their antisocial behavior at a low-level into adulthood. This third group, which may constitute as many as 50% to 70% of individuals with child-onset conduct problems (Fairchild van Goozen, Calder, & Goodyear, 2013), has been labeled “low level chronics” (McGee & Moffitt, 2018; Moffitt, 2006). Some research has also suggested that members of this group represent most individuals first convicted as adults (Becker et al., 2016). Lastly, it is important to note some males with early onset severe antisocial behavior can truly 2

The failure of a recent review to find a difference in criminal offending outcome between LCP and AL groups is most probably due to the limitation acknowledged by the authors that “the age of outcome in the studies which we identified was quite low (mean age 22.5)” [Bevilacqua, Hale, Barker, & Viner, 2018, p. 1256].

Journal Pre-proof recover (McGee & Moffitt, 2018). For example, in the Dunedin study, 15% of the males in the combined LCP and low-level chronic group exhibited no adjustment problems measured in the study at age 26 and thus truly seemed to have recovered as adults (Moffitt, 2006). Second, similar to the ostensibly “childhood-limited” group, many individuals in the AL group continue their antisocial behavior into adulthood, especially for difficulties related to substance abuse (Fairchild et al., 2013; Jennings et al., 2016; McGee et al., 2015; Moffitt, 2018;

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Odgers et al., 2007). This has prompted the suggestion that the initial taxonomic group name of

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adolescent limited antisocial behavior, which implies desistence from criminal offending in

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young adulthood, should be changed to adolescent onset antisocial behavior (Odgers et al.,

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2007). Moffitt (2018) suggested that this delayed desistence from antisocial behavior initiated in adolescence is due to delayed social maturation, a recent phenomenon not evident in 1993. A

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second reason for the delayed desistence is anchored in the cardinal principle of developmental

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psychopathology that virtually all forms of psychopathology reflect an extreme expression on a continuously distributed dimension rather than expression of membership in a distinct category

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in which the individual either does or does not have a disorder (Hinshaw, 2017). This means that

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since antisocial behavior exists on a continuum from very well behaved to very poorly behaved juveniles and every gradation in between (Lahey & Waldman, 2017), the LCP and AL groups are best understood not as a unique categories of antisocial behavior but as different developmental expressions who differ only relatively, not absolutely in desistence. Maleness Moffitt and colleagues (2001) reported a very large male/female LCP sex of 10:1 in the Dunedin study. Subsequent findings from related research reporting sex ratios ranging from 3:1 to 15:1 are broadly consistent with the Dunedin finding that LCP is almost exclusively male,

Journal Pre-proof i.e., ratio is approximately 10:1 (Broidy & Thompson, 2018; Moffitt, 2006; Russell, Robins, & Odgers, 2014). However, other findings would seem to challenge this conclusion. For example, using group trajectory modeling to assign individuals to the LCP class, a follow-up in the Dunedin study to age 32 reported a male LCP prevalence of 10.5% and a female prevalence of 7.5%, i.e., a sex ratio less than 2:1 (Odgers et al., 2008). Other studies using similar group trajectory methods for classifying LCP have reported sex ratios ranging from 3:1 to 5:1 (Lahey

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& Waldman, 2017). This wide divergence ranging from 10:1 to 2:1 appears to be largely due to

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two methodological differences for identifying persistent trajectories: a) different cut points

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using age, seriousness, or continuity of antisocial behavior, b) the use of gender-specific vs. full

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sample trajectory analysis combining males and females, (Broidy & Thompson, 2018). For example, as previously discussed, different methods for identifying a LCP group were used in

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early and later stages of the Dunedin study. First, the 10:1 ratio cited in Moffitt and colleagues

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(2001) and Moffitt (2006) was based upon clinical definitions and algorithms which identified the most severe cases of conduct problems, requiring persistence across multiple phases,

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pervasiveness and agreement between reporting sources (personal communications with Terri

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Moffitt April 17, 2013; May 10, 2018 and Candace Odgers, April 9, 10, 2013). Second, cutoffs defining the LCP group were not gender specific but were based upon a cohort-wide definition combining males and female. Thus, when the same criteria were used to identify the most severe cases of LCP for both sexes using either clinical criteria or group trajectory modeling methods (personal communication, Moffitt, May 10, 2018) and when data was used beyond age 15, the “majority of girls dropped off the LCP pathway” (Odgers, April 10, 2013), yielding the 10:1 ratio. If LCP definitions are within sex, then a much larger percentage of females (i.e., 7.5%) is identified. Similarly, using data from a nationally representative sample of youth in the

Journal Pre-proof United States,3 Liu (2015) reported a sex difference in persistence in terms of the age-crime curve. Breaking down aggregate arrest curves using group-based trajectory modeling combining both sexes, she found that in contrast to males, females who had one or more arrests per year (ages 12-17) had mostly desisted from crime by age 20. Lastly, it should be noted that even when more liberal criteria are used to identify a LCP group, male LCP outcome is far more virulent than female LCP outcome. In the Dunedin study, 32.7% of the male LCP group had

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been convicted of a violent crime between the ages of 26 to 32 compared to 2.9% of the females

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LCP group, i.e., a 10:1 male female ratio (Odgers et al., 2008).4 In short, as Russell and

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colleagues (2014) noted in their review of 47 trajectory studies “Females following early-onset persistent pathways are virtually absent … in population-based studies using official reports of

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crime, delinquency, or offending as the criterion” (p. 299).

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Similarly, lopsided sex ratios are also found in two types of antisocial behavior closely

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related to LCP: chronic criminal offending and chronic physical aggression (Jolliffe, Farrington, Piquero, MacLeod, & van de Weijer, 2017; Moffitt, 2006; Piquero, Carriaga, Diamond,

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Kazemian, & Farrington, 2012). Male/female sex ratios for chronic offenders range from 9:1 to

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12:1 (DeLisi & Piquero, 2011). Regarding physical aggression, as early as 17 months, mothers report that 5% of boys frequently use physical aggression compared to 1% of girls, with a similar sex difference reported by teachers from school entry to adolescence (Tremblay, Vitaro, & Cote, 2018). By adolescence, approximately 5% of males engage in chronic physical aggression, whereas female cases are rare (Tremblay, 2010, 2014). “Physical violence by females during adolescence is generally so rare that modeling their developmental trajectories 3

The National Longitudinal Survey of youth is a longitudinal study that follows the lives of a nationally representative sample of American youth (n=8,984) born between 1980-84 who were between the ages of 12-17 when first interviewed in 1997. 4 The sex difference in conviction rates cannot be attributed to a bias in decisions for conviction (Piquero, Brame, & Moffitt, 2005).

Journal Pre-proof fails” (Tremblay, 2010, p. 352). In short, sex is the “fundamental correlate of crime” (DeLisi, 2016, p. 20) with men comprising 93.2% of the total world prison population as of 2015 (Walmsley, 2015). Similarly, “The one great universal in the study of violence is that most of it is committed by fifteen-to-thirty-year-old men” (Pinker 2011, p. 104). Lastly, the foregoing discussion is not meant to diminish the importance of studying a female LCP class using less stringent criteria and a sex-specific cutoff. LCP females so defined

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are clearly at increased risk for mental and physical health problems and forms of violence such

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as partner and child abuse (Odgers et al., 2008). Rather, the purpose of the discussion was to

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document that 25 years of research has established that the relatively few individuals whose early starting severe conduct problems persist into adulthood and account for a fraction of crime

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that is vastly disproportionate to their prevalence in the population are “almost exclusively

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male.” This specific pathological outcome of the “few, persistent males” will be discussed next.

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Pathological Outcome

Moffitt (1993) predicted that the primary pathological outcome difference in adulthood

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would be that the LCP group would exhibit higher levels of antisocial behavior than the AL

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group. This prediction was strongly confirmed in the most recent follow-up of the Dunedin study at age 38. The few number of LCP males accounted for 53.3% of all convictions and had significantly more criminal convictions than those of the low antisocial group (LCP: 4.2 vs. Low O.1), childhood-limited antisocial group (0.5), and adolescent onset antisocial group (0.9) (Rivenbark et al., 2018). Despite approaching midlife, most LCP men had not desisted from crime: 55% were convicted between ages 26 and 38 years, versus 30% of AL men and 18% of all men in the cohort (Moffitt, 2018). LCP men had high levels of conviction despite the fact that 25% had been incarcerated an average of 18 month per group member compared with 5%

Journal Pre-proof of AL men for 2 months on average (Moffitt, 2018). This outcome mirrored and added to the long standing finding that a small fraction of the male population accounts for a vastly disproportionate fraction of the crime. In 1972, the landmark Philadelphia birth cohort study of almost 10, 000 boys born in 1945 found that 6% of the boys by age 18 accounted for 52% of all delinquencies, including 69% of aggravated assaults, 71% of homicides, and 73% of rapes (Wolfgang, Figlio, & Sellin, 1972). The study was replicated in 1990 using a 1958 birth cohort

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which found that 7.5% of the males committed 61% of the total delinquencies (Tracy,

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Wolfgang, & Figlio, 1990). Since then numerous studies have established that crime is

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concentrated among a small fraction of the male population (approximately 5%). These few

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males, beginning with severe antisocial behavior in early childhood, engage in crime pathologically and persistently, thereby accounting for more than half of all crime and an even

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larger percentage of the most violent offenses (DeLisi, 2016; Martinez, Lee, Eck, & SooHyun,

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2017; Vaughn, Salas-Wright, DeLisi, & Maynard, 2014). Thus, “It is axiomatic that criminal

2013).

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career extremity is inversely related to onset” (DeLisi, Neppi, Lohman, Vaughn, & Shook,

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Lastly, other pathological outcomes for the LCP group at age 38 in the Dunedin study were also observed. The LCP group accounted for 15% of all hospital bed nights, 16% of all emergency room visits, 21% of all prescription refills, 13% of all injury claims, and 25% of all welfare benefits (Rivenbark et al., 2018). Findings such as these, as well as similar findings from a longitudinal study that found that by age 28, individuals with childhood conduct disorder accumulated 10 times the public expenditures as those without conduct problems (Scott, Knapp, Hendersen, & Maughan, 2001) prompted Burt and colleagues (2018) to declare childhood conduct problems to be a “public health crisis” (p. 711). In sum, Moffitt’s 1993 prediction

Journal Pre-proof regarding the pathological outcome of a male LCP group has been robustly confirmed. Conclusion Twenty-five years of research has provided resounding confirmation for Moffitt’s (1993) identification of a small group of males who exhibit extreme, pervasive, persistent antisocial behavior from early childhood into adulthood, thereby accounting for majority of violent crime. A LCP group has been acknowledged in other developmental typological theories of criminal

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behavior and has been identified in studies using group-based modeling methods to identify

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groups of individuals with different developmental trajectories of antisocial behavior (Morizot,

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2018). It is regarded as “one of the most important findings in criminological history” (DeLisi,

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2016, p. 56). The childhood risk factors that Moffitt (1993) hypothesized contributed to the etiology of LCP will now be considered, with a focus on inherited and acquired

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neuropsychological/neurodevelopmental factors.5

Neurodevelopmental Risk Factors

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The reasons for the focus on neurodevelopmental rather than environmental risk factors

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for LCP are twofold. First, one of the most important contributions of Moffitt (1993) was to emphasize the role of such factors on the development of antisocial behavior. These factors had historically been neglected since the dominant model for understanding criminal behavior for most of the twentieth century was built almost exclusively on social and sociological models (Loeber, Byrd, & Farrington, 2015a; Raine, 2013). Her article was an important influence in correcting this neglect as it is now recognized that these factors must be included in studies of developmental and life-course criminology (Farrington, 2018b; Farrington & Ttofi, 2015). 5

The terms “neuropsychological” and “neurodevelopmental” will be used interchangeably. Although at the time of Moffitt (1993) “neuropsychological” was the common usage, with advent of the Developmental Origins of Disease and Health paradigm “neurodevelopmental” has become the preferred rubric.

Journal Pre-proof Indeed, the importance of these factors is such that arguments are now being made that severe disruptive behavior in early childhood, childhood onset CD, and life-long male violence should be conceptualized as neurodevelopmental disorders (McDonough-Caplan & Beauchaine, 2018; Raine, 2018a, 2019; Wakschlag et al., 2017. Second, neuropsychological risk factors were hypothesized to explain why early onset severe antisocial behavior was persistent and why it was almost exclusively male (Moffitt, 1993, 2006). A related issue is whether AL offenders share the

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same risk profile (neuropsychological and environmental) as LCP offenders (Moffitt, 2018).

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Moffitt (2018) has provided a clarification of the taxonomy’s conceptualization of risk in this

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regard. LCP offenders are conceptualized as evincing extreme risk on childhood risk factors,

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whereas AL offenders show population normative risk levels, but not zero risk. Her review of the literature, as well as those of others (Assink et al., 2015; Fairchild et al., 2013, 2016; Jolliffe et

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al., 2017) have found that while neuropsychological risks factors play a role in adolescent onset

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antisocial behavior, these factors are more common and more severe in LCP.

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Inherited Neuropsychological Variation

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In her 1993 article Moffitt did not explicitly discuss genes. Since then numerous studies have found evidence of elevated genetic influence for LCP antisocial behavior compared with AL antisocial behavior (Choy et al., 2018; Moffitt, 2018; Van Hulle, Waldman, & Lahey, 2018). However, Moffitt implicitly considered genes in terms of their effect on temperament which is commonly conceived as having strong genetic influences (Rothbart & Bates, 2006). It has long been known that from early infancy onward children differ from one another in early developing, biologically rooted behavioral and emotional reactions to the environment which have come to be known as temperament (Krieger & Stringaris, 2016; Rothbart, 2012).

Journal Pre-proof Since 1993 numerous studies have established that temperament influences the development of various forms of psychopathology, including externalizing behavior and criminality (DeLisi & Vaughn, 2014; Frick & Morris, 2004; Krieger & Stringaris, 2016; Nigg, 2006; Rothbart & Bates, 2006). Perhaps the most useful way to conceptualize this influence is to view temperament as a component in what becomes a dynamic process of transactions between the child and the environment, gradually producing different adjustment outcomes (Bates, Schermerhorn, &

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Petersen, 2014). At least seven different models have been proposed to explain how these

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complex transactions can result in the development of various disorders (Stifter & Dollar, 2016).

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Among these various models, the vulnerability model incorporates many of the proposed links

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between temperament and psychopathology that have been posited by the other models (Martel, Gremillion, & Tackett, 2014; Stifter & Dollar, 2016). This model, which is analogous to the

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classic, widely accepted diathesis-stress model of psychopathology (Stifter & Dollar, 2016),

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proposes that extreme levels of temperamental dimensions place an individual at increased risk for developing various disorders because they render the individual more vulnerable to the

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pathogenic elements of whatever environments they are exposed to. In addition, additive effects

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are possible such that multiple temperamental vulnerabilities linearly increase the child’s risk for developing antisocial behavior. Although debate persists over the precise dimensional structure of temperament, there is a convergence on three broad dimensions from which subdimensions emerge: Attention/Regulation, Activity Level, and Emotionality (Bates et al., 2014; Chen & Schmidt, 2015; Krieger & Stringaris, 2016; Stifter & Dollar, 2016). The relation of these dimensions to the development of LCP that research has identified in the 25 years post Moffitt (1993) will be discussed. After describing the temperamental dimension, the discussion will address the risk for

Journal Pre-proof antisocial behavior that an extreme level of the dimension confers, a sex difference on the dimension, and a possible biological explanation for the sex difference.

Attention/Regulation Regulation can be defined as the “ongoing, dynamic, and adaptive modulation of an

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internal state (emotion, cognition) or behavior” (Nigg, 2017a, p. 361). Regulation by oneself which emerges increasingly during development is self-regulation, a concept that holds “almost

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unparalleled importance” in understanding the emergence of various psychopathologies,

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including antisocial behavior” (Nigg, 2017a, p.361). Because of the unparalleled importance of

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self-control or self-regulation (SR), which are equivalent terms for most authors from a diverse

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number of fields, there is a variety of terminology to describe self-regulation6 which has resulted in considerable definitional confusion and conceptual clutter (Eisenberg, 2017; McClelland,

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Geldhof, Cameron, & Wanless, 2015; Nigg, 2017a). This clutter has been addressed by Nigg

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(2017a) in an attempt to create a clear differentiation among the various constructs and to establish a standard terminology. One such construct is effortful control (EC).

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EC designates temperamental self-regulation (Eisenberg, 2017) and was coined by personality scholars to describe the temperamental precursor to the personality trait of conscientiousness (McClelland et al., 2015). As defined by Nigg (2017a), EC is a “dispositional trait-level representation to be able to employ top-down control to self-regulate” (p. 363). Because control is deliberate and therefore requires effort it was designated EC to distinguish it from more reactive forms of regulation (Stifter & Dollar, 2016). EC also includes the abilities to shift and focus attention when needed, and to inhibit inappropriate behavior or activate behavior 6

The terminology consists of constructs such as: self-regulation, self-control, executive functioning, effortful control, cognitive control, impulsivity, risk-taking, and inhibition (Nigg, 2017a).

Journal Pre-proof when one does not want to do so (Eisenberg et al., 2013). In short, EC is the temperamental disposition to exercise SR when doing so is difficult (Diamond, 2013). EC feeds into and provides the core of higher levels of SR involving processing such as planning and coping strategies (Eisenberg, 2017; Nigg, 2017a).

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Risk

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A low level of EC is the temperamental risk most often linked to the development of antisocial behavior, even after controlling for other risk factors since by definition impairment in

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the ability to inhibit inappropriate impulses and follow societal norms is expected to increase the

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likelihood of antisocial behavior (DeLisi & Vaughn, 2014; Stifter & Dollar, 2016). Indeed,

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impaired SR may be the single most important variable in explaining the developmental origins of antisocial behavior (Moffitt, 2012; Moffitt et al., 2011). SR theory has been proclaimed the

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Tyrannosaurus rex of criminology that is poised to devour criminal justice theorizing (De Lisi,

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2011). “In terms of empirical tests of its theoretical ideas, citations, influence on the field, self-

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control theory is “peerless” (DeLisi, 2011, p. 103). The risk impaired SR poses for the development of criminal behavior is most clearly seen in Attention-Deficit/Hyperactivity Disorder (ADHD) which is best understood as a “global self-regulation disorder” (Nigg, 2017b, p. 17) that is “paradigmatic of problems in the domain of self-regulation” (Nigg, 2016, p. 593). ADHD is associated with “profound impairments in school readiness, academic and social functioning, and, in the longer term, delinquency and substance abuse” (Daley & Van der Oord, 2018, p. 333). As Beauchaine and colleagues (Beauchaine, Constantino, & Hayden, 2018; Beauchaine & McNulty, 2013; Beauchaine, Shader, & Hinshaw, 2016; Beauchaine, Zisner, & Sauder, 2017; Neuhaus & Beauchaine, 2017) have repeatedly noted, for over 50 years since the

Journal Pre-proof publication of Robin’s (1966) landmark text,7 scientists across disciplines including sociology, psychiatry, and criminology have identified a developmental trajectory that begins with the hyperactive/impulsive and combined presentations of ADHD. In turn, ADHD in interaction and transaction with various environmental adversities, can progress to Oppositional Defiant Disorder, early-onset Conduct Disorder, Substance Use Disorder, culminating in juvenile delinquency and adult criminality. “This developmental pathway may account for most

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individuals who engage in lifelong delinquent behavior” (Beauchaine et al., 2017, p. 345). Not

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surprisingly therefore, the prevalence rate of ADHD among incarcerated males is approximately

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25% (Eme, 2018; Young, Moss, Sedgwick, Fridman, & Hodgkins, 2015).

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Sex Difference

A meta-analysis by Else-Quest and colleagues (2006) reported a large sex difference in

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EC disfavoring males (d = –1.01), and greater male variability. Subsequent research supports this

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sex difference (Else-Quest, 2012). Similarly, males outnumber females for childhood ADHD in the general population by ratios ranging from 2.5:1 to 3:1 (Hinshaw, 2018; Owens, Cardoos, &

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Hinshaw, 2015) and also experience more severe symptoms of ADHD than females (Arnett,

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Pennington, Willcutt, DeFries, & Olson, 2015). Biological Basis

Although the cause(s) of the greater male prevalence in ADHD, as well as other neurodevelopmental disorders, has largely eluded researchers (Davis, 2018), recent search has examined two possibilities: a sex difference in the genetic risk burden of the liability for ADHD, and a sex difference in the biological risk factors that can trigger/activate this inherited liability.

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Robins seminal study Deviant Children Grown Up: A Sociological and Psychiatric Study of Sociopathic Personality presented the findings of a 30- year follow-up of 524 white juveniles (73% male) most of whom were referred for antisocial behavior to a child guidance clinic in the 1920’s. This study proved to be of paramount importance for the succeeding 50 years of the study antisocial behavior.

Journal Pre-proof The latter possibility is the more viable and will be addressed in the discussion on acquired neuropsychological variation. Regarding the first possibility, it is theorized that girls are in some way “protected” from developing ADHD (Davis, 2018). Because of this protective effect, females would have a higher threshold to cross to develop the disorder that in turn would require a higher genetic loading. Males, lacking this protection, would only need to cross a lower threshold and consequently would be more likely to develop ADHD. As a consequence of the

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hypothesized greater female liability, this model would also predict that there should be an

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increased risk for ADHD among first-degree relatives of affected females compared with

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affected males because the presumably greater liability would generate greater risk among relatives (Eme, 1992). The two most sophisticated studies to date to test this theory have been

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conducted by Martin and colleagues (2018a,b). The first study, using the world’s largest genetic

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data set of people with and without ADHD (about 55,000 people), found that the same genetic

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variants increased ADHD for both sexes, with no evidence to suggest that females had a greater genetic burden (Martin et al., 2018a). The second study, using family data from 2 million people,

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found that siblings of girls with ADHD were at slightly higher risk for ADHD than siblings of

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affected boys, thereby suggesting there might be a somewhat greater genetic burden for females (Martin et al., 2018b). Overall though, since it seems that “mostly the same genes contribute to ADHD in males and females” (Davis, 2018, p. e56), the sex difference in ADHD prevalence cannot currently be explained by a sex difference in inherited genetic liability. Activity Level Activity level refers to tempo and vigor of energetic behavior (Stifter & Dollar, 2016). It is comprised of a number of additional subdimensions, including high-intensity pleasure, as exemplified by rough and tumble play (R&T) (Else-Quest, 2012), i.e., play fighting (Geary,

Journal Pre-proof 2015; Pellis & Pellis, 2011). R&T, or play fighting, is the most common form of play among male mammals and typically involves components such as chasing, wrestling, pouncing and jumping on partners, pushing, etc. (Geary, 2015).

Risk

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Play fighting is a blend of competition and cooperation (Pellis & Pellis, 2011). It is

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competitive in humans, because participants attempt to gain some advantage over one another,

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such as throwing and pinning the partner to the ground. It is cooperative and thus differs from

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physical aggression because participants usually do not take advantage of their success in a way that occurs in real fighting. The universal distribution of R&T among mammals and among

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humans across virtually every culture suggests that it evolved to serve the adaptive functions of

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allowing practice of fighting skills under safe conditions, and establishment and maintenance of immediate or long term social dominance necessary for success in one-on-one competitions

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(Geary, 2010, 2015; Martel, 2013; Pinker, 2011). From an evolutionary perspective, success in

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dominance aggression served as a solution to several adaptive problems, including enhancing reproductive success (Buss, 2012). From a social learning perspective, R&T creates opportunities that facilitate and reinforce the expression of physical aggression (Kung, Li, Golding, & Hines, 2018). As Tremblay and colleagues (2018, p. 385) have observed

Those who argue that there is a genetic-instinctual basis to physical aggression generally do not deny that there are also learning components. It seems obvious that, for aggression, as for other physical skills that have a strong genetic-instinctual basis (eating,

Journal Pre-proof running, jumping, smelling, tasting, etc.), there is much an individual must learn to use that skill effectively. This may be the reason why play fighting is common during the early development of cats, dogs, monkeys, and humans.

Play fighting can become a vulnerability because it frequently puts males “on the verge of aggression” (Maccoby, 1998, p. 51). In fact, teachers often have difficulty telling the

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difference between play fighting and real fighting, and see play fighting as problematic because

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it can turn into real fighting (Blackmore, Berenbaum, & Liben, 2008). Play fighting increases in

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frequency during the juvenile years and then declines slowly, often merging into real fighting

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during adolescence (Geary, 2010). Most recently, impressive empirical support for the association between R&T and increased risk for physical aggression was provided in a 10-year

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longitudinal study of a large representative sample of boys and girls that measured gender-typed

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play in preschool (parental report), including R&T, and physical aggression in early adolescence (self-report) (Kung et al., 2018). After controlling for a range of variables, including conduct

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problems, preschool children who engaged in more masculinized play reported significantly

Sex Difference

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more physical aggression than those whose play was less masculinized.

Research on activity level has consistently found that boys are more active and impulsive, and more likely to derive pleasure from engaging in high-intensity activities than girls (Else-Quest, 2012; Else-Quest et al., 2006). Furthermore, the sex difference in R&T is much larger than for high-intensity-pleasure (Geary, 2010, 2015). By the time they are 3 years old, boys in all societies in which it has been studied begin to enthusiastically engage in R&T (Geary, 2010, 2015). Although girls do engage in R&T, males do so much more frequently and with more

Journal Pre-proof vigor and greater zest. This sex difference is most evident with groups of three or more children when adults are not present. Absent adult supervision, groups of boys engage in R&T three to six times more frequently than girls, with the magnitude of the difference greater than d=2.0 (Kung et al., 2018). The difference peaks between ages 8 and 10, and increases in roughness as boys enter puberty, where the distinction between play and genuine physical aggression begins to dissolve. Furthermore, unlike younger boys for whom physical aggression is often associated

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with social rejection, older tough boys who engage in physical aggression in the form of bullying

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are relatively popular among both boys and girls (Juvonen & Graham, 2014; Olweus, 2013).

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This would be expected from an evolutionary perspective as social dominance hierarchies

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become established (Geary, 2010, 2015). In sum, to hark back to the prior discussion on risk, since males engage much more frequently and with more vigor and greater zest in play fighting

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than females, it follows that they can be far more easily socialized than females into antisocial

Biological Basis

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forms of real fighting.

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Greater male exposure to prenatal testosterone provides a biological explanation for the sex

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difference in R&T. As described by Hines (2015), at 6–7 weeks prenatally the Sry (sex-region determining) gene on the Y chromosome induces differentiation of neutral gonads into testes. In the absence of the Sry gene, and with involvement of other genes, neutral gonads develop into ovaries at about 12 weeks. The testes begin to produce testosterone prenatally, whereas ovaries do not. This sex difference appears to be maximal between 8 and 24 weeks and then tapers off by birth. There is also a surge of testosterone during early postnatal development for males (sometimes referred to as mini-puberty), peaking at about one to three months and declining to minimal levels at about 6 months where it remains until puberty (Hines et al., 2016).

Journal Pre-proof Although studies examining the effects of the postnatal surge on male neurobehavioral development are just beginning to emerge (Hines et al., 2016), there are thousands of studies across numerous species ranging from rodents to non-human primates showing unequivocally that sex hormones have organizational effects because they produce permanent changes to brain structures and the behaviors these structures subserve, including R&T and aggression (Hines, 2015; Hines, Constantine, & Spencer, 2015). The experimental nature of animal studies makes it

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possible to rule out psychosocial environmental confounds, an ever-present source of ambiguity

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in human studies.

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The most extensively studied “natural experiment” on the effects of testosterone on

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human behavior is congenital adrenal hyperplasia (CAH). These studies provide the strongest evidence for a prenatal sex difference in testosterone on human behavior (Hines et al., 2016).

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CAH is an autosomal genetic recessive disorder that occurs in approximately 1:5000 to 1:15,000

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male and female births and results in increased production of androgen from the adrenal gland. Among females, exposure to excess androgen beginning early in gestation has many of the same

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effects as testosterone produced naturally by the testes among males during gestation. Although

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girls with CAH are typically born with partially virilized genitalia (Hines, 2015; Pasterski, Golombok, & Hines, 2011), there are rare cases when genital virilization is so severe that girls were mistaken for boys and reared as such (Hines, 2013). Nowadays, the disorder is typically diagnosed at birth, and girls are surgically feminized during infancy, reared as female, and provided ongoing medical treatment to prevent further virilization (Berenbaum & Belz, 2011). Findings in observational studies of CAH females are similar to findings from experimental studies involving animals. In over a dozen studies from several independent research groups in several different countries, CAH girls show increased male-typical toy, playmate, and activity

Journal Pre-proof preferences (Hines et al., 2015). Furthermore, CAH girls exhibit more R&T and more physical aggression compared with their non-affected sisters, cousins and unrelated girls who are matched on age and socioeconomic status (Berenbaum & Belz, 2011; Hines, 2015; Pasterski et al., 2011; Spencer et al., 2017). Emotionality Emotionality, both positive and negative, describes intensive and temporal variations in

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emotion expression (Stifter & Dollar, 2016). In addition to negative emotionality (which will

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subsequently be discussed), low fearfulness is the temperamental trait most commonly linked to

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increased risk for antisocial behavior (Beauchaine et al., 2017; Corr & McNaughton, 2016;

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Kriegar & Stringaris, 2016). Fear

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In defining fear, it is important to note that it is not a unitary construct but has two

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components: threat reactivity which involves unconscious, automatic bodily reactions to imminent threat and the conscious experience of that threat (Hoppenbrouwers, Bulten, & Brazil,

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2016). Although the difference between fear and anxiety has long been debated, there appears to

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be at least one core defining difference. Namely, fear involves a surge of physiological reactivity in response to clear and impending danger, whereas anxiety is a more diffuse emotion in which the threat is less certain and arousal is sustained, even after the removal of the threat (Hoppenbrouwers et al., 2016). Risk Temperamental fear is negatively associated with the development of antisocial behavior, with, for example, infants’ expression of fear in the laboratory predicting lower maternal reports of aggression when the children were 7 years old (Stifter & Dollar, 2016). In addition,

Journal Pre-proof Beauchaine and colleagues (2017) have reviewed the evidence that establishes trait anxiety as a moderator of the expression of trait impulsivity. Namely, depending upon whether an impulsive individual scores high or low on trait anxiety (rooted in temperament), their impulsivity may be amplified, resulting in progression to more severe antisocial outcomes, or mitigated. Moreover, there is “overwhelming evidence” (Raine, 2013, p. 117) for a fear deficit in antisocial individuals, especially psychopaths (Hoppenbrouwers et al., 2016). This deficit, at least with

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regard to psychopathy, is primarily in threat reactivity, as evidence for reduced subjective

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experience of fear is far less compelling (Hoppenbrouwers et al., 2016). Yet it is possible that the

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deficiency in threat reactivity indirectly leads to less intensive conscious experiences. The

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different explanations for how the fear deficit results in a vulnerability include impairments in the appropriate processing and responding to both threats and distress in others, and a weak

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defensive system which results in behavioral avoidance being less likely to occur in the presence

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of environmental cues signaling danger. Regarding the latter explanation, since moral socialization is partly dependent upon negative arousal (i.e., fear) evoked by potential

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punishment, a diminished fearful inhibition will make it more difficult for a child to internalize

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societal norms (Krieger & Stringaris, 2016). In turn, diminished fearful inhibition may be one temperamental precursor to callous-unemotional traits (Krieger & Stringaris, 2016; Viding & McCrory, 2015) which are an important risk factor for the development of antisocial behavior that will subsequently be discussed. Sex Difference There is a considerable body of work indicating that women, beginning in childhood, are more fearful than men (Campbell, 2013, 2016). There is a small sex difference in fear among children, evident in infancy, with girls being more fearful than boys (d=0.12) (Chaplin & Aldao, 2013).

Journal Pre-proof Evidence for this difference is based mainly on parent reports of their children’s distress or withdrawal from sudden changes or novelty (Chaplin & Aldao, 2013). This difference increases from kindergarten through 6th grade, when girls are twice as likely as boys to be rated by teachers (17.4% vs. 8.6%) as fearful, i.e., “fearful or afraid of new things; is worried, worries about many things; cries easily”) [Cote, Tremblay, Nagin, Zoccolillo, & Vitaro, 2002]. By adolescence and continuing into adulthood, the sex difference increases to d=0.40 (Else-Quest,

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2012), when women are twice as likely as men to have a phobia (American Psychiatric

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Association, 2013). This difference is even larger for situations that pose physical threats to

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bodily integrity, the type of fear most relevant to avoiding physical aggression (Campbell, 2013;

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2016; Campbell & Cross, 2012).

Lastly, a sex difference is also found in callous-unemotional (CU) traits. CU traits with

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and without the presence of CD are three to five times more common in boys than girls (Viding

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& McCrory, 2015). Boys score higher than girls on various measures of these traits from preschool to adolescence (Essau, Sasagawa, & Frick, 2006; Ezpeleta, Osa, Granero, Penelo,

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& Domenech, 2013; Frick, Bodin, & Barry, 2000; Humayun, Kahn, Frick, & Viding, 2014).

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They are also four times more likely than girls to be on a stable-high trajectory for the development of CU traits in middle childhood (Fontaine, Rijskijk, McCrory, & Viding, 2010). Biological basis Low resting heart rate (LHR), a measure of autonomic hypoarousal, is a risk factor for antisocial behavior as it is thought to index a lower level of fear in individuals who would then be more likely to engage in antisocial behavior (Raine, 2015). Importantly, this finding appears to be specific to antisocial behavior as it has not been found to be linked to other disorders such as anxiety, depression, schizophrenia (Portnoy et al., 2014). When measured in childhood, LHR

Journal Pre-proof predicts both adolescent conduct problems and violence (American Psychiatric Association, 2013; Murray et al., 2016; Portnoy et al., 2012). A systematic review and meta-analysis of resting heart rate and antisocial behavior found that LHR coincided with a 22% increase in violence (Portnoy & Farrington, 2015) which the authors remarked was “quite a substantial effect” (p. 40). In an exceptional study based on data on 710, 264 Swedish men, Latvala, KujaHalkola, Almquist, Larsson, and Lichtenstein (2015) found that LHR at age 18 predicted a 49%

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increased risk for adult violence more than 30 years later, after taking into account multiple

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confounding factors. More recently, Choy, Raine, Venables, and Farrington (2017) in a study

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involving 894 subjects found that lower resting heart rates in males at age 11 partly explained

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their higher rates of crime at age 23. They concluded that this was the first time in a formal mediation test that a biological characteristic helped to account in part for the sex difference in

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offending. In sum LHR is “widely regarded as the best-replicated biological correlate of

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antisocial and criminal behavior” (Choy et al., 2017, p. 468). Furthermore, as reviewed by Choy and colleagues (2017), considerable evidence also

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shows that males have a lower LHR than females at every age from 1 to 79. This difference is

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evident in newborns, and at age 3 boys have a resting heart rate that is approximately 6.1 beats per minute (d = 0.36) lower than that of girls (Raine, 2013). The emergence of this difference at such an early age renders less likely an interpretation that a physiological adaptation to differential exposure to social adversity rather than an innate biological difference might explain the lower male LHR (Choy, et al., 2015). Acquired Neuropsychological Variation Moffitt (1993) proposed that a second possible source of neuropsychological variation was a disruption in the development of the fetal brain which could be caused by various prenatal

Journal Pre-proof and postnatal factors resulting in neuropsychological impairments, noting that the link between neuropsychological impairment and antisocial outcomes was one of the most robust effects in the study of antisocial behavior. Since then the evidence linking numerous non-inherited biological factors to increased risk for antisocial behavior has increased dramatically, with birth complications, especially low birth weight (5lbs. 8oz or less at birth) and prematurity (born <37 weeks), being the best documented (Choy et al., 2018; Graham, Glass, & Mattson, 2016;

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Pinsonneault, Parent, Castellanos-Ryan, & Sequin, 2016; Raine, 2013, 2018a; Tibbits & Rivera,

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2015; Wolke, 2018). These complications, which have commonly been taken as proxy measures

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of exposure to an adverse prenatal environment (Van Den Bergh, Dahnke, & Mennes, 2018), are

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thought to index increased risk for disordered brain development and thus increased risk for subsequent neuropsychological impairments (Hornman et al., 2016; Joseph et al., 2016). Two of

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the most prominent impairments related to birth complications are low general intelligence and

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impaired executive functions which in turn have been robustly linked to increased risk for antisocial behavior (Farrington, 2015; Hornman de Winter et al., 2016; Joseph et al., 2016; Lim

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et al., 2018; Matthewson et al., 2017; Nigg & Song, 2018; Pinsonneault et al., 2016; Sutton &

Sex Difference

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Darmstadt, 2014; Wolke, 2018).

Boys are not only more likely than girls to be exposed to a host of biological hazards during prenatal developmental, but they are also more likely than girls in many instances to suffer adverse effects from such exposures (DiPietro & Voegtline, 2017; Garstein & Skinner, 2018; Geary, 2010). This increased exposure coupled with increased vulnerability has been termed “double jeopardy” (DiPietro & Voegtline, 2017, p. 7). For example, boys are more likely to be born preterm and/or of low birth weight; and when matched for gestational duration and/or

Journal Pre-proof weight at birth, boys are less likely to survive are generally more likely to show poorer developmental outcomes (Anderson et al., 2016; Balsara, Faerber, Spinner, & Feudtner, 2013; DiPietro & Voegtline, 2017; Joseph et al., 2016; Kent, Wright, & Abdel-Latif, 2012; Vu, Dickinson, & Kandasamy, 2018).8 Furthermore, since LBW and prematurity characterize a substantial portion of ADHD cases, making it the single strongest known environmental risk factor for ADHD (Kim et al., 2018; Nigg & Song, 2018), this may partially explain the greater

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male prevalence of ADHD. Boys are more likely to experience a range of obstetric

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complications such as umbilical cord anomalies and maternal gestational diabetes, and are at

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higher risk for congenital anomalies and respiratory disorders associated with such complications

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(DiPietro & Voegtline, 2017). Boys experience greater deficits than females from prenatal exposure to various neurotoxins (e.g., alcohol, lead, marijuana, methylmercury, nicotine, opiods)

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[Ji et al., 2018; Lewis & Kestler, 2012; Terasaki, Gomez, & Schwartz, 2016]. Boys are more

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vulnerable than girls to infections, and malnutrition (Eriksson, Kajantie, Osmond, Thornberg, & Barker, 2010; Garstein & Skinner, 2018; Rutter, Caspi, & Moffitt, 2003). Boys are 20% more

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likely than girls to die in utero (Davis et al., 2007; Migeon, 2007). Boys are more likely than

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girls to develop externalizing problems in early childhood when exposed to maternal medical risks (e.g., diabetes, lung disease, renal disease) during pregnancy (Jackson & Vaughn, 2018). An exception to these uniform findings appears to be a greater female vulnerability to maternal prenatal stress which has been linked to elevated risk for anxiety and depressive disorders (Sutherland & Brunwasser, 2018). This exception may be due to maternal prenatal stress being inherently different from other exposures such as neurotoxins, malnutrition, infection, etc. (DiPietro & Voegtline, 2017).

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A recent notable exception to the typical finding of double jeopardy is the study by Kim and colleagues (2018) which found that sex did not moderate LBW risk for ADHD.

Journal Pre-proof In short, compared to females, “Boys Live Dangerously in the Womb” (Eriksson, Kajantie, Osmond, Thornberg, & Bakker, 2010, p.330). Biological Basis Although the etiology of the greater male vulnerability to numerous prenatal and perinatal adversities is largely unknown, several mechanisms have been proposed to account for some of the findings (DiPietro & Voegtline, 2017). First, Schore (2017) has proposed that the

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stress-regulating circuits of the male brain mature more slowly than those of the female in the

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critical prenatal, postnatal, and perinatal periods. This maturational delay results in males being

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more vulnerable over time to toxins in the physical environment and stressors in the social

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environment, as it is a basic developmental principle that a less mature organism is more susceptible to deleterious effects of adverse events than a more mature organism (Tanner, 1990).

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This greater male vulnerability in turn is hypothesized to contribute to the greater male

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vulnerability to several disorders, including ADHD and CD (Schore, 2017). Second, boys grow faster than girls in the womb which makes them more vulnerable if their nutrition is

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compromised (Eriksson et al., 2010). This faster growth, at first glance, might seem incompatible

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with greater male developmental immaturity. However, note that developmental immaturity simply means that boys are not as close as girls to their final developmental status (Tanner, 1990). Thus, boys can be simultaneously larger and longer at birth than girls because of faster growth and also be less close than girls to their final developmental status. Third, the previously discussed male exposure to higher androgen levels during prenatal and early postnatal development leads to increased plasticity, i.e., increased responsivity to different environmental conditions (Del Giudice et al., 2018). Increased responsivity to harsh or poor prenatal conditions translates into greater male vulnerability to these conditions. Fourth, the male placenta has been

Journal Pre-proof found to be more vulnerable than the female placenta to complications of pregnancy (Eriksson et al., 2009; Khalife et al., 2012; Nugent, O’Donnell, Epperson, & Bale, 2018; Ursini et al., 2018). One reason for this greater male vulnerability that has been identified is a sex difference in an Xlinked gene that produces a placental enzyme that confers variation in vulnerability to prenatal insults (Nugent, O’Donnell, Epperson, & Bale, 2018). This enzyme is expressed in higher levels in females most likely because of genes that escape X-inactivation (Nugent et al., 2018). In

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reflecting on the finding that the greater vulnerability of the male placenta to the stresses

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associated with complicated pregnancies is implicated in the etiology of schizophrenia (Ursini et

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al., 2018), the leader of the research team, Dr. Daniel Weinberger, observed “The missing link

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between complications during pregnancy and the development of the fetal brain has been hiding in sight for a long time. It is the placenta. We suggested that placentas of male fetuses seem to be

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more susceptible at the genetic level. I am very confident the same story is going to be there for

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autism, A.D.H.D. and other developmental behavior problems” (quoted by Mandavilli, 2018, D1,2). Lastly, since all biological sex differences are the result of the inequality in effects of the

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sex chromosomes (male XY and female XX) [Arnold, 2017], and since it appears that XX and

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XY cells may do their molecular business a “bit differently from each other” (Page, 2018, p. 366), it may well be that the cause of the sex difference in prenatal vulnerability may reside in this ultimate source of all biological sex differences for reasons similar to their greater vulnerability than females to sex-linked disorders (Knopik, Neiderhiser, DeFries, & Plomin, 2017; Migeon, 2007). Early Identification Moffitt’s identification in 1993 of an LCP antisocial trajectory provided the impetus for the development of the early years crime prevention movement (Moffitt, 2018). Thus, there is

Journal Pre-proof virtually unanimous agreement, that the prevention of the development of serious antisocial behavior should be initiated during early childhood, if not even earlier, i.e., during pregnancy (Raine, 2018a; Shaw, 2013; Shaw & Taraban, 2017; Tremblay et al., 2018). As a prerequisite of early intervention is early identification of children at high risk for LCP, this issue will be addressed first, followed by a discussion of some of the more common early interventions that have been implemented. The most important individual characteristics/behaviors that predict

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LCP discussed by Moffitt (1993) and expanded upon in subsequent research are: low general

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intelligence, physical aggression, impaired self-control, irritability, and callous-unemotional

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traits. Moffitt (1993) also stipulated that that numerous non-individual/environmental risk

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factors involving family and neighborhood influences also obviously contribute to LCP risk (Moffitt, 1993). For example, factors identified by her as well as subsequent researchers include

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child rearing involving harsh punitive discipline, rejection, deficient parental supervision,

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maltreatment, parental criminality/substance abuse, and maternal depression (Fagin & Benedini, 2018; Farrington, 2015; Shaw, 2013; Shaw & Taraban, 2017). Risky neighborhoods are those

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characterized by “socioeconomic disadvantages, social disorganization, structural inequality,

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residential instability, poverty” all of which are indicative of “general neighborhood disorder” (Jennings, Perez, & Gonzalez, 2018, p.73). Individual characteristics/behaviors will be focused on as they are key to early identification of at-risk individuals. Low General Intelligence The most widely accepted model of mental abilities describes a hierarchy of three levels of abilities derived from factor analytic research (Benisz, Dumont, & Kaufman, 2016; Canivez, Dombrowski, & Watkins, 2017; Nisbett et al., 2012). General intelligence is at the top level. At the second level are a number of broad abilities (e.g., visual-spatial, short-term memory) which

Journal Pre-proof can be fractionated into about 80 narrower abilities at the third level. General intelligence/general mental ability can be defined as “…the ability to reason, plan, solve problems, think abstractly, comprehend complex ideas, learn quickly and learn from experience. It is not merely book learning, a narrow academic skill, or test-taking smarts” (Nisbett et al, 2012, p. 131). Low general intelligence has been reliably linked to externalizing behaviors including delinquency and violence by increasing risk for educational failure (Choy et al., 2018;

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Farrington, 2015; (Pinsonneault et al., 2016). Educational failure in turn has been linked to

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increase risk for criminal offending through three mechanisms (Savage, Ferguson, & Flores,

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2017; Wertz et al., 2018). First, school problems are likely to engender frustration and negative

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emotions which play a role in much aggressive and violent behavior. Second, these same problems are likely to weaken school attachment which has been found to protect against crime

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through commitment to school and its social norms. Third, less schooling may leave juveniles

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with fewer legitimate methods to achieve wealth or status, increasing incentives to pursue crime. General intelligence can be accurately identified in early childhood and has been found to

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Physical Aggression

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correlate nearly .60 with general intelligence at age 15 (Mackintosh, 2011).

Aggressive behavior can be defined as behavior through which individuals intentionally cause physical or psychological harm to others (Eisner & Malti, 2015). Examples of the most common physical aggressions in early childhood would include: hitting, slapping, kicking, biting, pushing, grabbing, pulling, shoving, beating, twisting (Tremblay, 2010). There is pervasive agreement that early appearing, frequent physical aggression is a major risk factor for the development of more serious forms of antisocial behavior (Eiser & Malti, 2015; Shaw, 2013; Shaw & Taraban, 2017; Tremblay, 2010, 2014; Tremblay et al., 2018; Wakschlag et al., 2014).

Journal Pre-proof Richard Tremblay, who has been studying chronic physical aggression for half a century and is arguably its foremost researcher, has noted that chronic physical aggression rarely onsets after early childhood and that the small group of males who increase in frequency and seriousness of physical aggression during adolescence were the ones on the highest trajectory in terms of frequency and seriousness since early childhood (Tremblay et al., 2018). Furthermore, given the salience of physical aggression, its identification during early childhood probably makes it the

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easiest risk factor to identify (Tremblay, 2015).

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Impaired Self-Control

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Moffitt (1993) identified impaired self-control indexed by ADHD symptoms of overactivity,

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impulsivity and inattention as a major risk factor for LCP. Numerous studies, as previously discussed, have provided strong validation of this risk factor. Moreover, as with low general

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intelligence and physical aggression, this risk factor can be accurately detected in early

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childhood. For example, in what is one of the largest studies to date of ADHD begun in early childhood, Lahey and colleagues (2016) examined the stability and long-term consequence of

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ADHD of 125 children (107 boys) recruited from various mental health settings who were

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diagnosed with ADHD at 4-6 years and compared their development to a control group of 130 non-ADHD children. The participants were followed prospectively through age 18 years with good retention for both groups. During 15-18 years of age, more children with ADHD were arrested (based upon adolescent and parent report) at least once (30%) than were comparison children (9%). Similarly, the Dunedin Study found that impaired self-control evidenced in symptoms such as restless, fleeting attention, impersistent, restless, impulsive, emotionally labile, expresses negativism in children 3-5 years old, significantly predicted criminal

Journal Pre-proof convictions at age 32 after controlling for socioeconomic status and IQ (Moffitt et al., 2011; Slutske, Moffitt, Poulton, & Caspi, 2012). Irritability It is widely accepted that emotion dysregulation increases risk for a broad range of psychopathological outcomes (Beauchaine, 2015; Beauchaine & Crowell, in press; Cole et al., 2017; McLaughlin, 2016), including criminality (DeLisi, Fox, Fully, & Vaughn, 2018; DeLisi &

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Vaughn, 2014, 2015; Sitnick, Galan, & Shaw, 2019). Emotion regulation can be defined as a set

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of interrelated processes that drive emotions an individual has and how they are experienced and

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expressed (Ryckaert, Kuntsi, & Asherson, 2018). Emotion dysregulation occurs when these

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processes are impaired and can manifest when: a) emotions endure with regulatory attempts being ineffective, b) emotions interfere with appropriate behavior, c) emotions are context

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inappropriate, d) emotions change too abruptly (Cole, Hall, & Hajal, 2017; Ryckaert et al.,

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2018). The aspect of emotion dysregulation that has been most closely linked to increased risk for antisocial behavior is irritability (DeLisi & Vaughn, 2014, 2015; DeLisi et al., 2018;

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Wakschlag et al., 2018) which can be defined as a “proneness to anger that may reach a

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pathological extent” (Mulraney et al., 2018, p. 200). Clinically significant irritability in the form of being easily frustrated and engaging in destructive temper tantrums can be readily identified in early childhood and is predictive of the development ODD (Wiggins et al. 2018) which is a major risk factor for child-onset CD (Loeber, Burke, & Pardini, 2009; Stringaris & Goodman, 2009; Shaw, 2013; Shaw & Selleby, 2014). Approximately 25% or more of children with ODD going on to develop CD (Kimonis, Frick, & McMahon, 2014; Lahey & Waldham, 2017). And, although the majority of children with ODD do not go on to develop CD (Loeber et al., 2009), if

Journal Pre-proof childhood-onset CD develops, it is almost always preceded developmentally by ODD (Burke, Waldham, & Lahey, 2010). Furthermore, it should be noted that emotion dysregulation is increasingly being recognized as a core symptom of ADHD which along with symptoms of inattention and impulsivity may constitute a subtype of ADHD (Barkley, 2015; Faraone et al., 2019; Graziano & Garcia, 2016; Karalunas et al., 2014; Mulraney, Stringaris, & Taylor, 2018; Musser & Nigg, 2017; Ryckaert,

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Kuntsi, & Asherson, 2018). Thus, “Children with ADHD are often emotionally labile, reacting

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unpredictably and with great intensity to events. Irritability is a characteristic part of emotional

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lability and these children often experience tantrums that are extreme and unprovoked”

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(Mulraney et al., 2018, p. 201). Indeed, Barkley (2015) has argued that the level of negativity and irritability that frequently is present in the combined type of ADHD is such that these

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children can be considered to be “virtually borderline or subthreshold cases of ODD” (p.100).

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Callous-Unemotional Traits

Callous-unemotional traits (CU) reflect a lack of remorse or guilt, callous-lack of

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empathy, unconcerned about performance, and shallow or deficient affect (Frick, Ray,

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Thornton, & Kahn, 2014). They are included in DSM-5 as the core element “with limited prosocial emotions” specifier for CD (American Psychiatric Association, 2013). These emotional deficits are thought to increase risk for antisocial behavior through two major mechanisms: deficient empathy and low fearfulness (Blair, Leibenluft, & Pine, 2014; Herpers, Scheepers, Bons, Buitelaar, & Rommelse, 2014). Deficient empathy to the distress of others decreases the likelihood that the antisocial behavior that triggers distress will be avoided. Similarly, low fearfulness decreases the likelihood that antisocial behaviors that elicit punishment will be avoided. Consequently, these traits characterize an especially severe,

Journal Pre-proof pernicious form of antisocial behavior in youth as such youth have an earlier onset of antisocial behavior, are more likely to persist on an antisocial trajectory and to engage in more serious and destructive forms of antisocial behavior such as severe, premeditated instrumental aggression (Blair et al., 2014; Frick et al., 2014; Frick & Myers, 2018; Wakschlag, et al., 2018). Even after controlling for severity and age of onset of conduct problems, juveniles with CU traits have more antisocial outcomes in adulthood when compared to other

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children with conduct problems without CU traits (Frick et al., 2014; Frick & Ray, 2015;

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Golmanyami & Frick, 2016; Viding & McCrory, 2015). Lastly, as with the previously

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discussed risk factors for LCP, CU traits can be reliably identified and assessed in early

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childhood (Assary, Salekin, & Barker, 2015; Frick & Myers, 2018; Wakschlag, et al., 2018). Conclusion

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Great progress has been made in the past 25 years in identifying individual risk factors

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for LCP in early childhood that were briefly sketched by Moffitt in 1993. Children with these risk factors, especially those being reared in high risk environments, can be identified with

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reasonable accuracy in early childhood (Farrington, 2015; Shaw & Taraban, 2017) and thus

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targeted for intervention. Thus, the primary challenge for the prevention of LCP twenty-five years after Moffitt (1993) is not early identification of children at high risk for LCP, but implementing effective interventions for those children so identified (Shaw & Gilliam, 2017). Prevention of LCP As previously mentioned, Moffitt (1993) provided the impetus for the development of the early years crime prevention movement as the problematic behavior of children at high risk for LCP along with parenting practices associated with its origin and persistence appears to be more malleable during early childhood than later (Shaw, 2013; Shaw & Taraban, 2016). The

Journal Pre-proof effectiveness of various early intervention programs9 for the prevention of LCP has been the subject of numerous articles and reviews (e.g., Brennan & Shaw, 2015; Dekovic et al., 2011; Dodge et al., 2015; Kazdin, 2018; Menting, de Castro, & Matthys, 2013; Piquero et al., 2016; Raine, 2018a; Shaw, 2013; Shaw & Gilliam, 2017; Sandler et al., 2014; Shaw & Taraban, 2017; Tremblay et al., 2018; Zych & Farrington, 2018). This literature has yielded two broad conclusions. First, these programs can produce small to medium effects on reducing antisocial

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behavior over the short term (i.e., 1 to 2 years), although a sizeable group of 1/5 to 1/3 of

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children fail to improve (Brennan & Shaw, 2015; Kazdin, 2018; Piquero et al., 2016; Sandler

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et al., 2014). Second, long-term findings indicate that initial effects often fade or are

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inconsistent over time (Brennan & Shaw, 2015; Menting et al., 2013). A few examples will suffice to illustrate the overall findings. First, the Infancy Nurse Home Visitation program,

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which is the best-known intervention targeting pregnant women at high risk of having LCP

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children and which continued through the child’s second birthday, found reduced arrests at the 19-year follow-up for female, but not male offspring (Eckenrode et al., 2010). However, a

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similar more recent multicomponent early intervention program providing education and social

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support to pregnant women living in low socioeconomic conditions which continued until the child was 4 or 5 had no effect on reducing the risk of a child belonging to a high externalizing trajectory (Cote, Orri, Tremblay, & Doyle, 2018). A second example is the Perry Preschool Program (PPP) which is commonly cited in various reviews (e.g., Raine, 2018a; Tremblay et al., 2018; Zych & Farrington, 2018) as the best example of various preschool programs for socially disadvantaged children “shown to improved academic success in the short term and to

9

In addition to interventions in early childhood, there are of course numerous other developmental interventions beyond early childhood. For a discussion of these interventions, as they are beyond the scope of this review, the interested reader can consult Tremblay and colleagues (2018) and several chapters in the volume edited by Farrington, Kazemian and Piquero (2018).

Journal Pre-proof prevent arrests and court referrals in the long term” (Tremblay et al., 2018, p. 397). PPP was a 2 year program conducted in the 1960’s for 3- and 4- year old African American children (58 program, 65 control) which included daily preschool and home visits and was aimed at improving cognitive skills (Belfield, Nores, Barnett, & Schweinhart, 2005; Weikart, 1998) Although the program failed to achieve the primary goal of improving cognitive ability and academic achievement, one of its long term effects was a reduction in criminal offending for

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the program group. This was attributed to the impact of the program on social skills of the

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children rather than the targeted cognitive skills (Heckman, 2006). However, a close

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inspection of the criminal offending outcome suggests that the program was less successful

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than is apparent from a casual reading of the literature. For example, there was only 1 significant difference among the 8 measures of official delinquency records favoring the

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program group, i.e., fewer petition requests submitted to the juvenile court (11 program, 25

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control) [Locurto, 1991]. There were no significant differences for measures such as the percent of persons arrested, total number of arrests, and the number of sentences (Locurto,

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1991). In contrast to the findings in adolescence, at the age 40 the percentages of all types of

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crime were lower in the program group (Schweinhart et al., 2005). For example, in what is perhaps the most important measure of criminal offending, there was a significant difference in official arrest records for violent crime: 48% of the control group had been arrested compared to 32% of the program group (Belfield et al., 2006). However, the finding that 32% of the program group were arrested for violent crime, which is most likely a substantial underestimate since official arrest data greatly understate the actual incidence of crime (Belfield et al., 2006; Kazemian, Farrington, & Piquero, 2018), indicates that PPP was far from a glittering success in preventing criminal offending. A final example is the Carolina

Journal Pre-proof Abecedarian Project (ABC), which is the most intensive and lengthy preschool education program to date (Reynolds & Temple, 2008) ABC was conducted in the 1970’s and provided full-day year-round care and educational intervention from infancy-5 years for 55 African American children with a control group of 54 (Campbell & Ramey, 1995). In stark contrast to the findings of the PPP, at the age 30 follow-up the percentages of the program group and control group with a self-reported criminal conviction were virtually identical: 27% and 28%

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(Campbell et al., 2012). Lastly, even if these legacy interventions (PPP, ABC) had proven

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highly successful in preventing criminality, their current relevance is questionable. As Dodge

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(2018) noted, these interventions were conducted with low-income mothers who stayed at

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hone, whereas today almost all mothers, including low-income mothers, are trying to work outside the home (Dodge, 2018).

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The results from these studies suggest that if interventions are to have a lasting effect they

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will require continued contact with families over the long term (Brennan & Shaw, 2015). The best test of this proposition to date is the Fast Track program. The Fast Track program is a

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randomized controlled study that targeted a large sample of children (n=979) at high risk for

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LCP who were selected from each of 3 kindergarten cohorts (Dodge et al., 2015). The program had 6 components and lasted for 10 years from grades 1 though10. The results were mixed. There was a small effect size (d=.15) on externalizing behavior with the intervention subjects being 10% less likely to have any externalizing, internalizing, or substance use disorder (59% compared to 69% for the control group). Assignment to intervention significantly decreased a severity-weighted violent crime conviction index by 31% for two cohorts, but had an opposite non-significant effect for a third cohort. There were no effects on educational and occupational

Journal Pre-proof outcomes nor were there any effects on convictions for property crime, the most common of all forms of crime (Brent & Loeber, 2015). In conclusion, as Tremblay and colleagues (2018, p. 399) aptly observed regarding prevention efforts, “we are far from having the impact we would like to have.” If early interventions are to have a population impact on preventing the development of serious antisocial behavior several challenges will have to be met. First, a psychosocial system of care

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needs to be developed in which each child in a community attends well-baby health care visits

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where they are screened for incipient problematic behavior and referred to specialists for

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intervention (Dodge, 2018). Second, since parents of high-risk children report barriers to

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referrals for intervention such as perceived intervention demands, perceived relevance of intervention, and obstacles in relation to the individual providing the intervention, this will

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require the development of novel methods of delivery to overcome (Kazdin, 2018). Third, the

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content of intervention programs will need to be modified to fit the risk profile of at-risk families and the effective ingredients in multicomponent programs will need to be identified

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(Brennan & Shaw, 2015; Dodge et al., 2015). Lastly, the consensus that long-term impact will

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require long term interventions faces the steep challenge of implementing programs of proven short-term effectiveness at scale because of the cost and length of commitment required by the program (Brennan & Shaw, 2015; Dodge et al., 2015; Kazdin, 2018; Tremblay et al., 2018). Future Directions Twenty-five years of research has provided overwhelming support for a male LCP antisocial trajectory. These few, persistent, pathological males who account for the majority of criminal violence as well as other adverse outcomes pose a public health crisis. If this public

Journal Pre-proof health crisis is ever to be adequately met, the next 25 years of research should focus on addressing at least three salient issues. First, despite compelling evidence that neurodevelopmental deficits are more characteristic of LCP than AL, a decisive test of this hypothesis is lacking (Moffitt, 2018). Similarly, Raine (2018b) notes there is a deficit in research on whether early impairments in the neural circuitry underlying moral decision making, which are hypothesized to be more characteristic of LCP

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than AL groups, predict later offending. These research deficits are due to the need to combine

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neural imaging research in a longitudinal design which is both difficult to implement and very

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costly. Both Moffitt (2018) and Raine (2018b) offer ways of addressing this arduous

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challenge.

Second, very little research has been done on the characteristics of those individuals with

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early, severe, pervasive conduct problems who do not become LCP (McGee & Moffitt, 2018).

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Although these males are at risk for becoming low-level chronic offenders, this outcome is far less serious than an LCP outcome. Identification of the factors that influence a less severe

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antisocial outcome despite what appears to be an equally ominous beginning would provide

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valuable information to guide early intervention efforts. For example, research might focus on suggestions that this group may have risk factors intermediate between those who exhibit low or no antisocial behavior across development and an LCP group (Russell & Odgers, 2015), or may have off-putting personal characteristics that exclude them from peer groups where most delinquency happens (Moffitt, 2006). Third, the most important and pressing research issue is meeting the previously discussed challenges of designing and implementing interventions that can substantially reducing LPC. Given the consensus that there are parent management interventions of proven effectiveness

Journal Pre-proof over the short-term (Kazdin, 2018; Shaw, 2013; Shaw & Taraban, 2017; Zych & Farrington, 2018), it can be argued that the all-encompassing challenge is, as Kazdin (2018) has contended, one of scalability/reach. Scalability refers to improving the number and proportion of at-risk children who receive treatment. Reach refers to connecting with children in neglected populations. In short, how, beginning in pregnancy, can parenting management interventions be initiated and sustained with families at high risk for having LPC males.

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Regarding scalability, Shaw and Taraban (2017) note that outreach programs for high risk

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children/families already exist in Head Start Centers and in Woman, Infants, and Child

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Nutritional Supplement Centers. These programs could be scaled up and extended to primary

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care centers such as maternity and pediatric units where parents might be open to receiving behavioral health services because of the trust they typically have for physicians. Regarding

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reaching neglected populations, the Cambridge Study in Delinquent Development10 reported

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that 63% of boys with a convicted parent were themselves convicted up to age 40 (Farrington, 2015). Given the magnitude of this risk, it is quite surprising that to the author’s knowledge,

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there is no research on interventions in early childhood with these at-risk males. Lastly, to end

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on an optimistic note, there is the remarkable finding that the substantial risk for antisocial behavior that is associated with lower socioeconomic status/poverty can be completely mitigated by good parenting (Farrington & Ttofi, 2011; Odgers et al., 2012). This provides impressive support for early intervention programs focusing on improving parenting skills in families of high-risk males.

10

This is a prospective longitudinal study of 411 London males who comprised the complete population in six state primary schools aged 8 to 9. They were originally studied in 1961. Their criminal records have been searched repeatedly up to age 61 and their self-reported offending was measured up to age 48. Parents were also interviewed once a year when the boys aged 8 to 15 (Farrington, 2007, 2018a).

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Journal Pre-proof

In 1993 Terrie Moffitt published a paper that proposed a dual developmental taxonomy of antisocial behavior. The paper triggered a cascade of research on types of criminal offending, thereby making it one of the most researched and most influential of all developmental theories of antisocial behavior. The silver anniversary of the paper’s publication seems a fitting time to review the status of the life-course-persistent (LCP) group who Moffitt suggested would enable

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researchers to learn more about the etiology of severe, persistent antisocial behavior from

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studying this group than from studying the group that had its onset of antisocial behavior in

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adolescence. The LCP group was hypothesized to consist of a relatively few males whose early-

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onset of severe antisocial behavior would persist into adulthood and had its origins in neurodevelopmental deficits interacting with various environmental risk factors. This review

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assessed the evidence supporting these hypotheses and reviewed the findings for early

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identification of the LCP groupa topic that was only modestly addressed in 1993. Lastly, the paper discussed what is one of most significant impacts of the 1993 article, providing impetus to

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the early-years crime prevention movement.

Journal Pre-proof

In 1995 Terrie Moffitt published a fully articulated version of a 1993 paper that proposed a dual developmental taxonomy of antisocial behavior. The paper triggered a cascade of research on types of criminal offending, thereby making it one of the most researched and most influential of all developmental theories of antisocial behavior. The silver anniversary of the paper’s publication seems a fitting time to review the status of the life-course-persistent (LCP) group

of

who Moffitt suggested would enable researchers to learn more about the etiology of severe,

ro

persistent antisocial behavior from studying this group than from studying the group that had its

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onset of antisocial behavior in adolescence. The LCP group was hypothesized to consist of a

re

relatively few males whose early-onset of severe antisocial behavior would persist into adulthood and had its origins in neurodevelopmental deficits interacting with various environmental risk

lP

factors. This review assessed the evidence supporting these hypotheses and reviewed the

na

findings for early identification of the LCP groupa topic that was only modestly addressed in 1995. Lastly, the paper discussed what is one of most significant impacts of the taxonomy,

Jo

ur

providing impetus to the early-years crime prevention movement.

Journal Pre-proof Highlights

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Twenty-five years of research has provided robust support for a male life-coursepersistent antisocial trajectory (LPC) Males on this trajectory account for the majority of crime, constituting a public health crisis Etiology of LPC consists of inherited and acquired neurodevelopmental problems interacting with environmental risk factors Males at high-risk for this trajectory can be reliably identified in early childhood Preventative interventions for LCP have yet to have a substantial impact on reducing criminal offending

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