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PubMedDate not supplied

[Prevalence of dissocial conduct disorder in adolescents using an epidemiological diagnostic questionnaire].

INTRODUCTION: Prevalence of Conduct Disorder has been calculated between 4 to 10%. OBJECTIVE: To estimate the prevalence CD in Colombian adolescents, using a rating scale by self report. PATIENTS AND METHODS: 190 male adolescents from secondary school population, 12 to 16 year-old, were stratified and selected in a randomizing procedure, from Medellín, Colombia. A checklist including 14 diagnostic symptoms taken from the DSM-IV Criterion A for CD was constructed, with a scale of 0 = never to 3 = almost always (Reliability alpha coefficient: 0.86). Prevalences were calculated as follow: (1) codifying as 'Probable TDC' a T score over 60; (2) codifying as Adolescent Antisocial Behavior (AAB) having three or more answers qualified with 1 or more points, and (3) codifying as CD obtaining three or more answers qualified with 2 or 3 points. RESULTS: The most prevalent CD symptoms were 'staying out at night before 13 year-old' (10.5%), 'having been cruel to animals' (8.4%), 'having been cruel to people' (7.4%), 'having broken into someone else's house or car' (7.3%), and 'using weapon or other objects that can cause serious physical harm to others' (6.9%). The prevalence of 'Probable CD' was 13.7%; prevalence of AAB was 56.8% and prevalence of CD was 8.4%. It was not found significant differences between socioeconomic strata. CONCLUSION: The prevalence of CD in the studied sample was 8.4%, independent of the socioeconomic strata.

Adolescent↗
PubMed1984

A comparison of the psychological evaluation of adolescents with anorexia nervosa and of adolescents with conduct disorders.

Cognitive and projective psychological tests were administered to ten inpatient adolescents with anorexia nervosa and ten inpatient adolescents with conduct disorders. All subjects were selected on the basis of race, sex and overall intelligence. Results indicate that there are high numbers of neuropsychological deficits in both groups, but that neuropsychological deficits are especially numerous in the anorexia group. The two groups showed striking similarities in terms of some psychological functions, but results indicate that some aspects of personality style in the two groups are significantly different. A significant finding was that there were far more suicidal indicators on the Rorschach records of the anorectic group as compared with those found on the records of the conduct disorder group.

Adolescent↗
PubMed1993

Mother-adolescent agreement on the symptoms and diagnoses of adolescent depression and conduct disorders.

OBJECTIVE: To determine rates and correlates of mother-adolescent agreement on the symptoms and diagnoses of depression and conduct disorders. METHOD: The Schedule for Affective Disorders and Schizophrenia in School Age Children was administered to a community sample of 460 adolescents and their mothers. Race, gender, family adaptability and cohesion, and living arrangement were evaluated as predictors of agreement. RESULTS: Mother-adolescent agreement was low (kappa < 0.40) for all diagnoses and symptoms with these exceptions: feeling tired (kappa = 0.40), inattention (kappa = 0.50), vandalism (kappa = 0.50), and chronic violation of rules (kappa = 0.72). Cohesion and adaptability were associated with mother-adolescent agreement on the symptoms and diagnosis of depression. This association was not demonstrated as consistently for agreement on the symptoms and diagnosis of conduct disorders. CONCLUSION: Study findings underscore the necessity of collecting data from both a parent and the adolescent when assessing an adolescent's psychological status.

Adolescent↗
PubMed1994

Conduct disorder patients 20 years later: a personal follow-up study.

As a part of a larger study, 75 consecutive patients with conduct disorder (48% men, median age 15, range: 6-19 years) were followed up after 18-21 years (mean: 19) with a clinical interview using DSM-III criteria. At follow-up, 47% had no Axis I disorder, 24% an anxiety disorder, 25% a substance abuse disorder and only one a psychotic disorder. Thirty-three percent fulfilled the criteria of an antisocial personality disorder. An additional anxiety disorder at the time of the primary examination was a strong predictor of a poor outcome, as was also criminal offences. The study shows the severe prognosis of conduct disorder and the importance of this disorder as an antecedent to substance abuse. However, since nearly half of these patients developed into a healthy state during the 20-year follow-up period, work should be continued to develop better treatment for these patients.

Adolescent↗
PubMed2002

Acute effects of baclofen, a gamma-aminobutyric acid-B agonist, on laboratory measures of aggressive and escape responses of adult male parolees with and without a history of conduct disorder.

RATIONALE: The possible role of gamma-aminobutyric acid (GABA) in human aggression was evaluated by administering baclofen, a GABA-B agonist and comparing the effects on laboratory measures of aggression and escape among subjects with and without a history of conduct disorder. METHODS: Twenty male subjects with a history of criminal behavior participated in experimental sessions, which measured aggressive and escape responses. Ten subjects had a history of childhood conduct disorder (CD+) and ten control subjects had no history of CD. Aggression was measured using the point subtraction aggression paradigm (PSAP), which provides subjects with aggressive, escape, and monetary-reinforced response options. RESULTS: Acute doses (0.07, 0.14 and 0.28 mg/kg) of baclofen had remarkably different effects on aggressive responses among CD+ subjects relative to control subjects. Aggressive responses of CD+ subjects decreased, while aggressive responses of control subjects increased following baclofen administration. Baclofen decreased escape responses for both CD+ and control subjects. No changes in monetary-reinforced responses were observed, indicative of no central nervous system stimulation or sedation. CONCLUSIONS: The GABA-B agonist baclofen suppressed aggressive responses in subjects with a history of childhood CD, while producing the opposite effect in control subjects. These suggest a possible unique role for GABA in the regulation of aggression in CD+ population.

Adult↗
PubMed1997

Nonpharmacological response in hospitalized children with conduct disorder.

OBJECTIVE: There is a paucity of research regarding the effects of hospitalization and/or the response to placebo in children with conduct disorder who are hospitalized for chronic and severe aggression. However, many children with this problem are hospitalized and immediately begin pharmacotherapy. In this report, the effects of hospitalization and placebo administration were examined. METHOD: Subjects were forty-four children (37 males, 7 females) with conduct disorder, aged 9.83 to 17.14 years, who were hospitalized for chronic and severe aggression. This was a 4-week double-blind and placebo-controlled study with a 2-week single-blind placebo lead-in period. During the 2-week placebo baseline period, aggression was measured on a 24-hour basis, using the Overt Aggression Scale. Only subjects meeting a specific aggression criterion were randomized to the treatment period of the trial. RESULTS: Of the 44 subjects enrolled, 23 (52.3%) met the aggression criteria for entering the treatment period (baseline nonresponders), while 21 (47.7%) did not (baseline responders). Thus, almost half of the subjects, while taking no active medication, benefited from the inpatient milieu/structure and/or placebo. CONCLUSION: This finding has important treatment and research implications. Medication to treat aggression should not be initiated immediately upon hospitalization because improvements associated with hospitalization may be attributed inaccurately to pharmacotherapy, resulting in unnecessarily medicating children. A placebo baseline period is essential to decrease the risk of a type II error in pharmacological research concerning aggression.

Adolescent↗
PubMed2006

Co-occurrence of conduct disorder and depression in a clinic-based sample of boys with ADHD.

BACKGROUND: Children with attention-deficit/hyperactivity disorder (ADHD) are at risk for the development of comorbid conduct disorder (CD) and depression. The current study examined potential psychosocial risk factors for CD and depression in a clinic-based sample of 203 boys (aged 6-10 years) with ADHD. METHODS: The boys and their mothers participated in an evaluation that involved assessments of cognitive, behavioral, academic, and family functioning. Potential predictors of CD and depression involved four domains: parenting behaviors, family environment, academic/cognitive functioning, and peer relations. ADHD groups were defined using mother- and teacher-report of DSM-IV symptoms. Mother-ratings of DSM-IV symptoms were obtained for a subsample of 91 boys approximately 5 years after the initial assessment. RESULTS: For both mother- and teacher-defined ADHD groups, social problems were related to depression symptoms; hostile, inconsistent, and detached parenting behaviors were related to CD symptoms; and family environment characterized by low cohesion, high conflict, and low marital satisfaction was related to CD and depression symptoms. For the teacher-defined ADHD group, parenting variables also predicted depression symptoms. Academic and cognitive variables did not predict CD or depression symptoms when parenting, family, and peer relationship variables were taken into account. Depression prospectively predicted CD, but not the reverse, and parental hostile control and familial conflict prospectively predicted CD for the teacher-defined ADHD group only. CONCLUSIONS: Source-specificity is a useful consideration when describing the relation of parenting and home environment with CD and depression symptoms in boys with ADHD. Intervention efforts that address these parenting, family, and peer relationship variables may aid in preventing the development of comorbid conditions.

Attention Deficit Disorder with Hyperactivity↗
PubMed1995

Adolescent psychopathy in relation to delinquent behaviors, conduct disorder, and personality disorders.

The purpose of this study was to explore the relationship between psychopathy as measured by The Revised Psychopathy Checklist (PCL-R) and delinquent behaviors, conduct disorder, and personality disorders in psychiatrically hospitalized adolescents. Thirty adolescent inpatients were assessed for psychopathy, delinquent behaviors, DSM-III-R Axis I disorders, and personality disorders using the Revised Psychopathy Checklist (PCL-R), the Diagnostic Interview for Children and Adolescents (DICA-R), and the Structured Interview for DSM-III-R Personality Disorders (SIDP-R). Significant relationships were noted between elevated PCL-R psychopathy scores and delinquent behaviors, conduct disorder, and narcissistic personality disorder. The validity of the PCL-R as a measure of psychopathy in adolescence was supported. Longitudinal studies are needed to clarify the clinical application of the PCL-R to adolescent populations.

Adolescent↗
PubMed2004

Response inhibition in children with conduct disorder and borderline intellectual functioning.

The aim of the study was to investigate impulse control in children with conduct disorder (CD) plus borderline intellectual functioning (BIF), in children with BIF-only, and in a control group with a normal IQ. For this purpose, a Go-No-Go test with varying inter-stimulus-intervals was used. The group CD plus BIF made more errors of commission than the group with BIF only. Therefore, it was concluded that poor impulse control in the group CD plus BIF was associated with CD, not with IQ level. Poor impulse control in the group CD plus BIF was independent of the presentation rate of the stimuli.

Child↗
PubMed1983

Subtypes of aggressive conduct disorder.

The subjects were 46 boys with aggressive conduct disorder who were admitted to a psychiatric ward. We divided them according to level of activity and number of antisocial "symptoms"; then compared the resulting groups on clinical and social variables. Seventy-four per cent of the boys were observed to be hyperactive. Compared to those with a normal level of activity, this group developed their problems earlier, had more frequent speech and language deficits and came from more disrupted homes. Thirty boys were classed as antisocial and 16 as not. The former differed from the latter chiefly in their failure to respond to treatment. At follow-up significantly more non-antisocial boys were improved than antisocial. The results suggest that antisocial behavior affects outcome, while the variations in activity level are related to different origins of the disorder.

Age Factors↗
PubMed1998

Substance-dependent, conduct-disordered adolescent males: severity of diagnosis predicts 2-year outcome.

Most delinquent youths have conduct disorder (CD), often with comorbid substance use disorder (SUD), attention-deficit/hyperactivity disorder (ADHD) and depression. Some youths' conduct problems later abate, while those of others persist into adult antisocial personality disorder. Earlier CD onset and ADHD reportedly predict persisting antisocial problems, but predictors of persisting SUD are poorly understood. Males aged 13-19 years (n = 89), most referred by criminal justice and social service agencies, received residential treatment for comorbid CD and SUD. They had diagnostic assessments for SUD at intake and for CD, ADHD, and depression (as well as drug-use assessments) at intake and 6, 12 and 24 months later. At intake nearly all had DSM-III-R substance dependence (usually on alcohol and marijuana) and CD with considerable violence and criminality. The 2-year follow-ups revealed improvements in criminality, CD, depression and ADHD, but substance use remained largely unchanged. Various aspects of conduct, crime and substance outcomes at 2 years were predicted by intake measures of intensity of substance involvement, and by CD severity and onset age, but not by severity of either ADHD or depression, nor by treatment duration. Earlier CD onset, more severe CD and more drug dependence predicted worse outcomes, supporting the validity of these diagnoses in adolescents.

Adolescent↗
PubMed1992

Stimulant medication and reading performance: follow-up on sustained dose in ADHD boys with and without conduct disorders.

The study examined the sustained effects of methylphenidate on reading performance in a sample of 42 boys, aged 8 to 11, with attention deficit-hyperactivity disorder (ADHD). Two subgroups were formed based on the presence or absence of co-occurring conduct disorders. Subjects were selected on the basis of their positive response to methylphenidate as determined in a series of original medication trials (Forness, Cantwell, Swanson, Hanna, & Youpa, 1991). For the purpose of this study, subjects were placed on their optimal dose of medication for a 6-week period and then tested on measures of oral reading and reading comprehension equivalent to those used in the original trials, retested after a week without medication (placebo), then tested again the following week after return to medication. Only the subgroup with conduct disorders responded, and this response was limited to reading comprehension improvement in only those subjects who also demonstrated improvement in oral reading on original trials. No response differences were found between subjects with or without learning disabilities.

Achievement↗
PubMed1994

Continuity of care for conduct disordered youth.

The objectives of this study were to determine which risk factors associated with chronicity had been displayed by youths who had been treated for conduct disorder in a tertiary level mental health centre and also to count the number of interventions and the number of agencies involved during their many years in treatment. The files of 25 youths with conduct disorder were examined to extract all relevant data. The youths averaged nine years between first intervention and last discharge. Common risk factors were the early onset and the variety of antisocial behaviours and the multiple settings in which behaviours occurred. The youths experienced an average of 19 interventions by 15 agencies. Interventions lasted on average seven months with little occurrence of follow-up. The severity of antisocial behaviours increased from first to last intervention. The apparent ineffectiveness of treatment may be related to the short duration of treatments and the lack of follow-up which resulted in the involvement of many agencies.

Adolescent↗
PubMed1990

Management of a hyperactive-conduct disordered child through correspondence training: a preliminary study.

This study examined the clinical effects of correspondence training procedures in the management of a hyperactive-conduct disordered boy. During the reinforcement of promise-do correspondence procedure, a toy (reinforcer) was given contingent upon the presence of a promise to inhibit target behaviors (e.g., inattention, overactivity, aggression) and the actual inhibition of such behaviors. This intervention was programmed in a multiple baseline design across settings. Consistently lower levels of hyperactivity and conduct disorders were noted during treatment, relative to baseline. A demonstration of the indirect effects of the procedures upon the child's academic performance was also seen.

Attention↗
PubMed1989

Behavioral correlates of maternal depressive symptomatology in conduct-disorder children.

We contrasted two predictive models of the impact of maternal depressive symptomatology on child behavior in a study of 51 mothers and their conduct-disorder children. Relations between global measures of maternal distress and child adjustment and observational measures of mother-child interaction were examined. Children of distressed mothers were more maladjusted than children of nondistressed mothers, when maladjustment was measured on the basis of a global rating, but "better" adjusted when measured on the basis of interactional measures. Measures of maternal indiscriminate responding to the child may account for these findings. Results suggest that (a) although conduct-disorder children are generally more maladjusted when their mothers are distressed, they display this maladjustment in a selective fashion, and (b) maternal distress acts as an adverse contextual factor that maintains mother-child interactional difficulties by disrupting the attentional and monitoring skills required for contingent responding.

Adult↗
PubMed2006

Developmental pathways to conduct disorder.

This article highlights how a developmental approach to understanding the causes of conduct disorder (CD) could be critical for understanding and preventing delinquent and violent behavior in youth. The approach recognizes that there may be multiple causal pathways leading to CD. It also integrates developmental research and theory with research on antisocial and aggressive behavior to explain how normal developmental mechanisms may be disrupted to place a child at risk for showing problem behavior. The article reviews research outlining several such pathways that differ in the age at which serious conduct problems develop and that differ on the presence or absence of callous-unemotional traits. The presence of these different developmental pathways has important implications for how research is conducted to study CD and interventions are implemented to prevent or treat children who have CD.

Adolescent↗
PubMed2002

DSM-IV conduct disorder symptoms in adolescents as markers of registered criminality.

A nationwide sample of 1,079 Norwegian adolescent psychiatric in-patients, 581 males and 498 females, were followed up after 11-33 (mean 23.2) years. On the basis of detailed records from index hospitalisation they were re-diagnosed and retrospectively scored on 14 of the 15 behaviour items listed as diagnostic criteria for conduct disorder in DSM-IV. The patient list was linked to the national criminal registry, and 48% were found to have a criminal record. The ability of the 14 behaviour items to identify overall and specific kinds of registered criminality was investigated. In males, "stealing" was the strongest marker for overall and violent crime. "Having fored someone into sexual activity" was a strong marker for later sex offences. In females, "running away from home" was strongly associated with overall and violent registered criminality. ROC curves were constructed to test the sensitivity and specificity of the sum of conduct disorder behaviour items fulfilled in the identification of individuals with registered criminality. The area under the curve was 0.81 (95% c. i. = 0.78-0.85) in males and 0.75 (95% c. i. = 0.71-0.80) in females. A cutoff at 3 criteria fulfilled seemed optimal in males and somewhat high in females.

Adolescent↗
PubMed2004

Cortisol levels and conduct disorder in adolescent mothers.

OBJECTIVE: To examine the association between cortisol levels and conduct disorder (CD) in adolescent mothers. Past research has shown that low levels of cortisol were associated with CD, particularly with its aggressive symptoms. The authors tested the hypothesis that adolescent mothers with CD would show lower levels of salivary cortisol compared to mothers without CD at 4 and 9 months postpartum. METHOD: Midmorning salivary cortisol levels were measured in 228 adolescent mothers (age at delivery 16.9 +/- 1 years [mean +/- SD]) during a laboratory visit at 4 and 9 months postpartum. CD was diagnosed during pregnancy according to the CD subsection on the criteria for antisocial personality disorder (DSM-III-R). RESULTS: Results did not confirm the hypothesis. Lower cortisol levels were not significantly associated with a CD diagnosis, the number of CD symptoms, or aggressive symptoms. CONCLUSIONS: Despite valid measures and strong statistical power, this study failed to find an association between cortisol levels and CD in a sample of adolescent mothers. The results may have been influenced by the fact that participants were 4 and 9 months postpartum and by comparisons of mothers with CD to mothers living in stressful circumstances.

Adolescent↗