To examine the state of knowledge about clinically severe conduct disorder and identify key issues.
Method:
This paper surveys the literature on conduct disorder and delineates and discusses the critical issues.
Results:
Conduct disorder is the subject of a vast and growing amount of research on taxonomy, correlates, etiology, outcome, management, and prevention. There are 2 distinctive types: childhood and adolescent onset. Comorbidity with other disorders is common. It remains a costly disorder, however, with a generally poor prognosis for the childhood-onset type. The validity of the separation of conduct and antisocial personality disorder is questionable.
Conclusions:
In view of its huge cost, chronicity, and generally poor outcome, childhood-onset or severe conduct disorder should be considered one of if not the major public health problems of our time, and resources for its study and management should reflect this. The disorder is poorly defined and inadequately studied in females.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd ed.Washington (DC): American Psychiatric Association; 1980.
2.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed.Washington (DC): American Psychiatric Association; 1994.
3.
AndersonJCWerryJS. Emotional and behavioral problems. In: PlessIB, editor. The epidemiology of childhood disorders. New York: Oxford University Press; 1994. p 304–38.
4.
BoyleMHOffordDRRacineYSzatmariPFlemingJESanfordM.Identifying thresholds for classifying childhood psychiatric disorder: Issues and prospects. J Am Acad Child Adolesc Psychiatry1996;35:1440–8.
5.
EarlsF.Oppositional defiant and conduct disorders. In: RutterMTaylorEHersovL, editors. Child and adolescent psychiatry: Modern approaches. 3rd ed.Oxford: Blackwell; 1994. p 308–29.
6.
LaheyBBHartEEPlizkaSApplegateBMcBurnettK.Neurophysiological correlates of conduct disorder: A rationale and review of current research. J Clin Child Psychol1993;22:141–53.
7.
LewisDO. Conduct disorder. In: LewisM, editor. Child and adolescent psychiatry: A comprehensive textbook. 2nd ed.Baltimore: Williams & Wilkins; 1996. p 564–76.
8.
RichtersJECicchettiD.Toward a developmental perspective on conduct disorder. Development and Psychopathology1993;5:1–4.
9.
RichtersJECicchettiD.Mark Twain meets DSM-III-R: Conduct disorder, development and the concept of harmful dysfunction. Development and Psychopathology1993;5:5–29.
10.
HinshawSPLaheySPHartEL. Issues of taxonomy and comorbidity in the development of conduct disorder. Development and Psychopathology1993;5:31–50.
11.
HinshawSPAndersonCA. Conduct and oppositional defiant disorders. In: MashEBarkleyRA, editors. Child psychopathology. New York: Guilford; 1996. p 113–49.
12.
WerryJS. Child psychiatric disorders: Are they classifiable?Br J Psychiatry1992;161:472–80.
13.
OffordDRBennetKJ. Conduct disorder: Long term outcomes and intervention effectiveness. J Am Acad Child Adolesc Psychiatry1994;33:1069–78.
14.
ZoccolilloM.Gender and the development of conduct disorder. Development and Psychopathology1993;5:65–78.
15.
QuayHC. Conduct disorders. In: QuayHCWerryJS, editors. Psychopathological disorders of childhood. 3rd ed.New York: J Wiley; 1986. p 35–72.
16.
MoffittTE. The neuropsychology of conduct disorder. Development and Psychopathology1993;5:135–52.
17.
Zahn-WaxlerC.Warriors and worriers: Gender and psychopathology. Development and Psychopathology1993;5:79–90.
18.
LewisDO. Development of the symptom of violence. In: LewisM, editor. Child and adolescent psychiatry: A comprehensive textbook. 2nd ed.Baltimore: Williams & Wilkins; 1996. p 334–43.
19.
QuayHC. The psychobiology of undersocialized aggressive conduct disorder: A theoretical perspective. Development and Psychopathology1993;5:165–80.
20.
CloningerCR. A systematic method for clinical description and classification for personality variants. Arch Gen Psychiatry1987;44:573–88.
21.
PikeAPlominR.Importance of nonshared environmental factors for childhood and adolescent psychopathology. J Am Acad Child Adolesc Psychiatry1996;35:560–70.
22.
CrickNRDodgeKA. A review and reformulation of social information-processing mechanisms in children's social adjustment. Psychol Bull1994;115:74–101.
23.
LynamDR. Early identification of chronic offenders: Who is the fledgling psychopath?Psychol Bull1996;120:209–34.
24.
FergussonDMLynskeyMT. Adolescent resiliency to family adversity. J Child Psychol Psychiatry1996;37:281–92.
25.
MrazekPJHaggertyRJ. Reducing risks for mental disorders: Frontiers for preventive intervention research. Washington (DC): Institute of Medicine/National Academy Press; 1994.
26.
ShamsieJHluchyC.Youth with conduct disorder: A challenge to be met. Can J Psychiatry1991;36:405–14.
27.
FarringtonDP. The twelfth Jack Tizard Memorial Lecture. The development of offending and antisocial behaviour: Key findings from the Cambridge Study in Delinquent Development. J Child Psychol Psychiatry1995;36:929–64.
28.
SalernoAW. Boot camps: A critique and proposed alternative. Journal of Offender Rehabilitation1994;20:147–58.
29.
BrunsEJBurchardJDYoeJT. Evaluating the Vermont system of care: Outcomes associated with community-based Wrap-Around Services. Journal of Child and Family Studies1995;4:321–40.
30.
ChamberlainP.Community-based residential treatment for adolescents with conduct disorder. In: OllendickTHPrinzR, editors. Advances in Clinical Child Psychology. Volume 18. 1996. p 64–90.
31.
HengellerSWPickrelSGBrondinoMJCrouchJL. Eliminating (almost) treatment dropout of substance abusing or dependent delinquents through home-based multisystemic therapy. Am J Psychiatry1996;153:427–8.
32.
KazdinAE. Treatment of conduct disorders: Progress and direction in psychotherapy research. Development and Psychopathology1993;5:277–310.
33.
SandersMRMarkie-DaddsC.Behavioral family interventions. Needham Heights (MA): Allyn & Bacon; 1993.
34.
MoffittTECaspiASilvaPAStantonW.Childhood-onset versus adolescent-onset conduct disorder in males: Natural history from 3 to 18. Development and Psychopathology1996;8:399–424.
35.
BotteronKGellerB.Disorders, symptoms and their pharmacotherapy. In: WerryJSAmanMG, editors. A practitioner's guide to psychoactive drugs for children and adolescents. 2nd ed.New York: Plenum Press. Forthcoming.
36.
ReidJB. Prevention of conduct disorder before and after school entry: Relating interventions to developmental findings. Development and Psychopathology1993;5:243–64.
37.
BardoniAMMoffittTECaspiADicksonNSilvaPA. Adult mental health and social outcomes in adolescent girls with depression and conduct disorder. Development and Psychopathology1996;8:811–29.
