Table Of ContentBehavior Disorders
of Adolescence
Research, Intervention, and
Policy In Clinical
and School Settings
Bebavlor DIsorders
of Adolescence
Research, Intervention, and
Pollcy In Cllnlcal
and School Settings
Edlted by
Robert J. McMahon
University of Washington
Seattle, Washington
and
Ray DeV. Peters
Queen's University
Kingston, Ontario
Canada
Springer Science+Business Media, LLC
Llbrary of Congress CataJoging-ln-PubJlcatlon Oata
Sanff InternatIonal Conferenee on Sehavioural Seienee (20th 1988
SanH, Alta.)
Behavior disorders of adolescence research, intervent1on, and
poliey in elinieal and sehool settings I edited by Robert J. MeMahon
and Ray OeV. Peters.
p. em.
"Sased on the proeeedings of the Twentieth Sanff International
Conferenee on Sehavioral Seienee--Sehavior Disorders of Adoleseenee,
Research, Intervention, and Poliey In Clinieal and Sehool Settings,
held March 20-24, 1988, in BanH, Alberta, Canad."--T.p. verso.
Ineludes bibll0graphieal referenees.
Ineludes Index.
ISBN 978-1-4613-6662-1 ISBN 978-1-4615-3734-2 (eBook)
DOI 10.1007/978-1-4615-3734-2
1, Adoleseent psyehiatry--Congresses. I. MeMahon, Robert J.
(Robert Joseph), 1953- I!. Peters, Ray DeV., 1942-
II1. T11le.
[DNLM, 1. Adolescent Sehavior--congresses. 2. Adolescent
Psychiatry--congresses. 3. Behavlor Therapy--in adoleseence
-congresses. 4. Juvenile Delinquency--in adolescence--eongresses.
WS 463 S215b 1988J
RJ503.S36 1988
616.89·022--dc20
DNLM/DLC
for Library of Congress 91-1957
CIP
Based on the proceedings of the Twentieth Banff International Conference
on Behavioural Science-Behavior Disorders of Adolescence: Research,
Intervention, and Policy in Clinical and School Settings,
held March 20-24, 1988, in Banff, Alberta, Canada
ISBN 978-1-4613-6662-1
© 1990 Springer Science+Business Media New York
Originally published by Plenum Press,New York in 1990
Softcover reprint ofthe hardcover 1st edition 1990
All rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted
in any form or by any means, electronic, mechanical, photocopying, microfilming,
recording, or otherwise, without written permission from the Publisher
To Patrick and Colleen, Jessica, Tim,
Katie, and Johanna. Thanks for the
memories and the wonderful times to come.
CONTRIBUTORS
Gary A. Bernfeld, St. Lawrence Youth Association, Kingston, ON
A. Roger Blackman, Department of Psychology, Simon Fraser University, Burnaby, BC
Karen A. Blase, William Roper Hull Child and Family Services, Calgary, AB
Charles M. Borduin, Department of Psychology, University of Missouri, Columbia, MO
Michael H. Boyle, Department of Psychiatry, McMaster University, Hamilton, ON
Virgina P. Brinthaupt, Western Psychiatric Institute and Clinic, School of Medicine,
University of Pittsburgh, Pittsburgh, PA
Brenna H. Bry, Graduate School of Applied and Professional Psychology, Rutgers -The
State University of New Jersey, Piscataway, NJ
David N. Cox, Department of Psychology, Simon Fraser University, Burnaby, BC
Ronald J. Dyck, Provincial Suicidologist, Alberta Department of Health and Department of
Psychiatry, University of Alberta, Edmonton, AB
Dean L. Fixsen, William Roper Hull Child and Family Services, Calgary, AB
Rex Forehand, Department of Psychology, University of Georgia, Athens, GA
Paul E. Garfinkel, Clarke Institute of Psychiatry and Department of Psychiatry, University of
Toronto, Toronto, ON
Stephanie M. Green, Western Psychiatric Institute and Clinic, School of Medicine,
University of Pittsburgh, Pittsburgh, PA
Dennis Mac Greene, Graduate School of Applied and Professional Psychology, Rutgers -
The State University of New Jersey, Piscataway, NJ
S.L. Hamm, Centre for Behavioural Rehabilitation, Chedoke-McMaster Hospitals,
Hamilton, ON
Scott W. Henggeler, School of Human Behavior, United States International University, San
Diego, CA
vii
William A. Lang, Banff Centre, Banff, AB
Rolf Loeber, Western Psychiatric Institute and Clinic, School of Medicine, University of
Pittsburgh, Pittsburgh, PA
Catherine Lord, Greensboro TEACCH Center, Greensboro, NC
Robert J. McMahon, Department of Psychology, University of Washington, Seattle, WA
David R. Offord, Department of Psychiatry, McMaster University and Chedoke Child and
Family Centre, Hamilton, ON
Ray DeV. Peters, Department of Psychology, Queen's University and Beechgrove
Children's Centre, Kingston, ON
Yvonne A. Racine, Department of Psychiatry, McMaster University, Hamilton, ON
Richard F. Ramsay, Faculty of Social Welfare, University of Calgary, Calgary, AB
Ahmos Rolider, Department of Psychiatry, McMaster University, Hamilton, ON
Sam Sheps, Department of Health Care and Epidemiology, University of British Columbia,
Vancouver, BC
Bryan L. Tanney, Department of Psychiatry, University of Calgary, Calgary, AB
Roger J. Tierney, Counselling Services, Mount Royal College, Calgary, AB
Roger S. Tonkin, Department of Pediatrics, University of British Columbia and B.C.
Children's Hospital, Vancouver, BC
Ron Van Houten, Department of Psychology, Mount Saint Vincent University, Halifax,
Novia Scotia
Larry Williams, Surrey Place Centre, Toronto, ON
FrankD. Young, Private Practice, Calgary, AB
viii
PREFACE
This volume is one in a continuing series of publications sponsored by the Banff Inter
national Conferences on Behavioural Science. The conferences have been held each spring
since 1969 in Banff, Alberta, Canada. They serve the purpose of bringing together out
standing behavioral scientists and professionals in a forum where they can present and dis
cuss data related to emergent issues and topics. Thus, the International Conferences, as a
continuing event, have served as an expressive "early indicator" of the developing nature and
composition of behavioral science and scientific application.
Distance, schedules, and restricted audience preclude wide attendance at the confer
ences. Consequently, the publications have equal status with the conferences proper. They
are not, however, simply publications of the papers presented at the conference. Presenters
at the Banff Conferences are required to write a chapter specifically for the forthcoming
book, separate from their presentation and discussion at the conference itself.
The original conference had as its theme "Ideal Mental Health Services." The policy
consciously adopted at that conference, and followed ever since, was to identify for the pre
sentation of each year's theme those behavioral researchers who could best identify the state
of the art. In 1969, the conference faculty were Nathan Azrin, Ogden Lindsley, Gerald Pat
terson, Todd Risley, and Richard Stuart.
The conference topics for the first 19 years were as follows:
1969: I. "Ideal Mental Health Services"
1970: II. "Services and Programs for Exceptional Children and Youth"
1971: III. "Implementing Behavioral Programs for Schools and Clinics"
1972: IV. "Behavior Change: Methodology, Concepts, and Practice"
1973: V. "Evaluation of Behavioral Programs in Community, Residential, and
School Settings"
1974: VI. "Behavior Modification and Families and Behavior Modification
Approaches to Parenting"
1975: VII. "The Behavioral Management of Anxiety, Depression, and Pain"
1976: VIII. "Behavioral Self-Management Strategies, Techniques, and Outcomes"
ix
1977: IX. "Behavioral Systems for the Developmentally Disabled"
A. "School and Family Environments"
B. "Institutional, Clinic, and Community Environments"
1978: X. "Behavioral Medicine: Changing Health Lifestyles"
1979: XI. "Violent Behavior: Social Learning Approaches to Prediction,
Management, and Treatment"
1980: XII. "Adherence, Compliance, and Generalization in Behavioral Medicine"
1981: XIII. "Essentials of Behavioral Treatments for Families"
1982: XIV. "Advances in Clinical Behavior Therapy"
1983: XV. "Childhood Disorders: Behavioral-Developmental Approaches"
1984: XVI. "Education in '1984'"
1985: XVII. "Social Learning and Systems Approaches to Marriage and the
Family"
1986: XVIII. "Health Enhancement, Disease Prevention and Early Intervention:
Biobehavioral Perspectives"
1987: XIX. "Early Intervention in the Coming Decade"
The Banff Conferences have been more than places where theories and research data are
presented and discussed. The magnificent Banff natural environment and recreational op
portunities, as well as the pleasurable ambience and resources of the Banff Centre where the
conference is held, contribute enormously to the vigor and stimulation of the conference.
This has encouraged substantial program development and evaluation and helped to bring
together policymakers, program administrators, researchers, and clinicians in an effort to
stimulate the adoption in practical settings of many of the programs discussed during the
conference proceedings.
The topic for Banff XX, held in 1988, was "Behavior Disorders of Adolescence: Re
search, Intervention, and Policy in Clinical and School Settings." Leading social scientists
and clinicians from across North America interested in the integration of empirical research
with clinical application presented their current work in the study of behavior disorders of
adolescence. The scope of the p(esented papers (and the chapters in this volume based on
those presentations) ranged from reports on the epidemiology of various types of adolescent
behavior disorders and the role of family factors in the manifestation of adolescent behavior
disorders to detailed representations of state-of-the-art knowledge concerning the basic psy
chopathology and/or treatment of specific disorders, such as substance use, conduct disor
ders/delinquency, eating disorders, suicide, risk-taking behavior, and autism. Policy issues
related to the integration of service delivery systems and adolescent mental health promotion
were also a focus of the conference.
Over the years, many people have contributed notably to the success of these confer
ences. Those who have attended the conferences and participated so enthusiastically in the
presentations and discussions, both formally and informally, contribute enormously to their
success. In particular, we would again like to express our appreciation to Catherine Hardie-
x
Wigram and to Jeri Dellow in the Conferences Division at the Banff Centre. Catherine has
been extensively involved in the planning and coordination of these conferences since 1973.
Her outstanding organizational skills are matched only by her patience in dealing with a
revolving committee of conference planners. Although a relative newcomer to working with
the Behavioural Sciences group, Jeri has become a valued member of our team, and we look
forward to her continued participation. In addition to the editors of this volume, other
members of the conference Planning Committee who contributed substantial help and
guidance to Banff XX were Kenneth D. Craig and L.A. Hamerlynck. We would especially
like to thank Betty Johnson for her diligence in preparing the manuscript for publication, and
Patricia Vann, Melanie Yelity, and Gregory Safford at Plenum Publishing for their expert
guidance and support.
While preparing this volume, Bob McMahon was on the faculty of the University of
Washington and Ray Peters was on the faculty of Queen's University. The assistance of
these institutions is gratefully acknowledged.
R.J.McM.
R.DeV.P.
xi
CONTENTS
Chapter 1: Early Adolescence: Behavior Problems, Stressors, and the Role of
Family Factors ........................................................................... 1
Rex Forehand
Chapter 2: Epidemiology of Behavioral and Emotional
Disorders of Adolescence: Implications
for Treatment, Research, and Policy. ...................................... 13
David R. Offord, Michael H. Boyle, and
Yvonne A. Racine
Chapter 3: Risk-Taking Behavior in Adolescence ................................................ 27
Roger S. Tonkin, David N. Cox, A. Roger
Blackman, and Sam Sheps
Chapter 4: Attention Deficits, Impulsivity, and Hyperactivity
With or Without Conduct Problems:
Relationships to Delinquency and Unique
Contextual Factors. ................................................................ .39
Rolf Loeber, Virginia P. Brinthaupt, and
Stephanie M. Green
Chapter 5: A Multisystemic Approach to the Treatment of
Serious Delinquent Behavior. ................................................. 63
Charles M. Borduin and Scott W. Henggeler
Chapter 6: Empirical Bases for Integrating School-and
Family-Based Interventions Against Early
Adolescent Substance Abuse .................................................. 81
Brenna H. Bry and Dennis Mac Greene
Chapter 7: Anorexia Nervosa and Bulimia Nervosa: What
Knowledge of Diagnosis and Pathogenesis
Has Taught About Treatment. ................................................. 99
Paul E. Garfinkel
xiii
