Treatment Engagement and Trait and Behavioral Impulsivity Among Males and Females with Conduct Problems

Few studies have empirically tested if trait and behavioral impulsivity hinder treatment engagement (TE), which is unfortunate since TE is crucial for treatment success. Therefore, this study collected data from 16- to 17-year-old males (n = 322) and females (n = 110) residing in Flemish youth detention centers or residential (secured) care institutions. Dimensions of TE (i.e., readiness to change, bond with staff, collaboration on goals and tasks, and therapeutic engagement) and trait impulsivity (i.e., positive and negative urgency, sensation seeking, lack of premeditation, and lack of perseverance) were measured through self-report questionnaires, while behavioral impulsivity (i.e., response inhibition, choice impulsivity, and risk-taking) was assessed via computerized tasks. A series of multiple linear regressions was performed, including all facets of trait impulsivity and all indices of behavioral impulsivity as independent variables, and TE dimensions as dependent variables. Self-reported callous-unemotional traits showed a significant negative zero-order correlation with TE and were therefore included as a control variable. Findings showed that various facets of trait impulsivity and indices of behavioral impulsivity were significantly associated with different dimensions of TE in both males and females. Moreover, sex differences were observed in the associations between trait and behavioral impulsivity and TE. The results underscore the need to examine both trait and behavioral impulsivity in future research to clarify how they relate to TE and other treatment outcomes across sex and to inform targeted interventions, thereby potentially enhancing TE and improving treatment success.