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Risk factors for disruptive behaviours: protocol for a systematic review and meta-analysis of quasi-experimental evidence
  1. Lucy Karwatowska1,
  2. Simon Russell1,
  3. Francesca Solmi2,
  4. Bianca Lucia De Stavola1,
  5. Sara Jaffee3,
  6. Jean-Baptiste Pingault4,5,
  7. Essi Viding4
  1. 1Great Ormond Street Institute of Child Health, University College London, London, UK
  2. 2Division of Psychiatry, University College London, London, UK
  3. 3Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  4. 4Department of Clinical, Educational and Health Psychology, University College London, London, UK
  5. 5Social, Genetic, and Developmental Psychiatry, King’s College London, London, UK
  1. Correspondence to Ms Lucy Karwatowska; lucy.karwatowska.18{at}


Introduction Disruptive behaviour disorders, including oppositional defiant disorder and conduct disorder, are a common set of diagnoses in childhood and adolescence, with global estimates of 5.7%, 3.6% and 2.1% for any disruptive disorder, oppositional defiant disorder and conduct disorder, respectively. There are high economic and social costs associated with disruptive behaviours and the prevalence of these disorders has increased in recent years. As such, disruptive behaviours represent an escalating major public health concern and it is important to understand what factors may influence the risk of these behaviours. Such research would inform interventions that aim to prevent the development of disruptive behaviours. The current review will identify the most stringent evidence of putative risk factors for disruptive behaviour from quasi-experimental studies, which enable stronger causal inference.

Methods and analysis The review will be carried out according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An electronic search of references published between 1 January 1980 and 1 March 2020 will be conducted using Medline, Embase, PsycINFO and Web of Science. Initial abstract and title screening, full-text screening and data extraction will be completed independently by two reviewers using Evidence for Policy and Practice Information (EPPI)-Reviewer 4 software. Quasi-experimental studies in the English language examining the association between any putative risk factor and a clearly defined measure of disruptive behaviour (eg, a validated questionnaire measure) will be included. We will conduct meta-analyses if we can pool a minimum of three similar studies with the same or similar exposures and outcomes.

Ethics and dissemination The proposed review does not require ethical approval. The results will help to identify risk factors for which there is strong evidence of causal effects on disruptive behaviours and also highlight potential risk factors that require further research. The findings will be disseminated via publication in a peer-reviewed scientific journal and through presentations at international meetings and conferences.

PROSPERO registration number CRD42020169313.

  • child & adolescent psychiatry
  • personality disorders
  • statistics & research methods
  • epidemiology

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  • Contributors LK designed the study and developed the review questions, with guidance from BLDS, J-BP, EV and SRJ. LK drafted and registered the protocol. All authors contributed to revising the protocol manuscript. LK and FS will independently complete the initial screen. LK and SR will independently complete the data extraction and quality assessment. LK will conduct the meta-analyses. LK will write the first manuscript draft and all authors will read and approve the final version of the manuscript. LK will be the guarantor of the review.

  • Funding LK is supported by a PhD studentship from the Economic and Social Research Council and the Biotechnology and Biological Sciences Research Council (ES/P000347/1). J-BP is supported by the Medical Research Foundation 2018 Emerging Leaders Prize in Adolescent Mental Health.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.