Journal of the American Academy of Child & Adolescent Psychiatry
RESEARCH UPDATE REVIEWOppositional Defiant Disorder and Conduct Disorder: A Review of the Past 10 Years, Part II
Section snippets
Scope of the Selected Research
Our intention was to consider research on the diagnoses of ODD and CD. However, many worthwhile studies have examined overlapping constructs. Therefore, where relevant, we include studies of risk factors for delinquency and violence, realizing that such constructs are not identical with DBD. The similarities they share with DBD suggest that risk factors for delinquency and violence may also increase the risk for DBD. In addition, most theories of DBD are based on data from males and probably
DEVELOPMENTAL MODELS
The basic developmental model expressed in the DSM-IV (American Psychiatric Association, 1994) is that DBD are not transient but are stable disorders and that ODD can be a precursor to CD, which in turn can be a precursor to antisocial personality disorder (APD).
CHILD BIOLOGICAL FACTORS
The subcategories into which we have grouped this review of literature on risk factors intrinsic to the child in no way suggest independence among these factors. Clearly, such domains as genetics, neuroanatomy, and neurochemistry are interrelated. As research progresses within circumscribed domains, however, a clearer picture of the interaction among these factors should emerge. One area of particular interest is the relationship of biological processes with DBD. CD is identified by behaviors,
Temperament
Temperament is regarded as a constitutional facet of child development that may be observed very early in childhood, appears biologically based, and, when dysregulated, may evoke maladaptive parenting (Lytton, 1990, Lytton, 1991) and may facilitate the progression from early disruptive problems to CD (Cole and Zahn-Waxler, 1992;Kingston and Prior, 1995). However, the investigation of temperament has been hampered by a lack of consensus regarding definitions of the construct and a difficulty
Parenting
Numerous studies show that poor parenting is related to disruptive behavior (e.g., Frick et al., 1992;Haapasalo and Tremblay, 1994), while favorable parenting behaviors may be protective (McCord, 1991). Little evidence disentangling parenting behaviors from parental psychopathology is available, but Kaplan and Liu (1999) suggest that while both contribute, parental psychopathology may be a stronger determinant of DBD in offspring than parenting behavior. Nonetheless, parenting behaviors may
CONCLUSIONS ABOUT RISK FACTORS
Both ODD and CD have similar risk factors and may evince a common genetic underpinning (Eaves et al., 2000), although we cannot exclude a common exogenous origin. Risk factors have generally proven to be stronger predictors of CD than ODD (Loeber et al., 1993;Pfiffner et al., 1999), but more studies have focused on the predictors of CD or composite indices than ODD alone.
Furthermore, many studies have concentrated on aggregated measures of antisocial behavior, which often include symptoms of
TREATMENT STRATEGIES
CD has long been regarded as relatively intractable and resistant to treatment interventions. Findings from the past 10 years suggest no giant leaps in treatment of CD but, instead, a number of small steps, such as new strategies in service delivery (e.g., Kazdin, 1997). As the preceding review has demonstrated, a diverse range of risk factors has been implicated in the development of CD. Successful interventions commonly use some intervention focused on parenting factors. However, rather than
CONCLUSION
The literature on risk factors for DBD is as varied as the symptoms of the disorders. While the role of some risk factors continues to be refined, it is clear that many questions remain to be answered. Some of these questions result from a lack of sound research, such as the thorough exploration of possible prevention strategies and difficulty in identifying specific mechanisms related to intervention success. Many well-meaning intervention studies have been conducted, yet only a few provide
REFERENCES (224)
Multisystemic treatment of criminality and violence in adolescents
J Am Acad Child Adolesc Psychiatry
(1999)- et al.
Lithium in hospitalized aggressive children with conduct disorder: a double-blind and placebo-controlled study
J Am Acad Child Adolesc Psychiatry
(1995) - et al.
Psychopathy and conduct problems in children, II: implications for subtyping children with conduct problems
J Am Acad Child Adolesc Psychiatry
(1997) - et al.
Serotonin and externalizing behavior in young children
Psychiatry Res
(1999) - et al.
Carbamazepine in aggressive children with conduct disorder: a double-blind and placebo-controlled study
J Am Acad Child Adolesc Psychiatry
(1996) - et al.
Characteristics associated with the persistence of antisocial behavior: results from recent longitudinal research
Aggressive Viol Behav
(1997) - et al.
The concentration of offenders in families, and family criminality in the prediction of boys' delinquency
J Adolesc
(2001) - et al.
Childhood sexual abuse and psychiatric disorder in young adulthood, II: psychiatric outcomes of childhood sexual abuse
J Am Acad Child Adolesc Psychiatry
(1996) - et al.
A double-blind pilot study of risperidone in the treatment of conduct disorder
J Am Acad Child Adolesc Psychiatry
(2000) - et al.
A longitudinal twin study of temperament and behavior problems: common genetic or environmental influences?
J Am Acad Child Adolesc Psychiatry
(1997)
Neuropsychological correlates of violence and aggression: a review of the clinical literature
Aggressive Viol Behav
Is psychopathology associated with the timing of pubertal development?
J Am Acad Child Adolesc Psychiatry
Serotonin, aggression, and parental psychopathology in children with attention-deficit hyperactivity disorder
J Am Acad Child Adolesc Psychiatry
Developmental risk factors for youth violence
J Adolesc Health
Violence-prevention programs in schools: state of the science and implications for future research
Appl Prev Psychol
Child, parent and family dysfunction as predictors of outcome in cognitive-behavioral treatment of antisocial children
Behav Res Ther
Parent management training: evidence, outcomes, and issues
J Am Acad Child Adolesc Psychiatry
Therapeutic changes in children, parents, and families resulting from treatment of children with conduct problems
J Am Acad Child Adolesc Psychiatry
Distinguishing the early-onset/persistent and adolescence-onset antisocial behavior types: from birth to 16 years
Dev Psychopathol
Diagnostic and Statistical Manual of Mental Disorders
The Comparative Costs and Benefits of Programs to Reduce Crime
Sociomoral reasoning in behavior-disordered adolescents: cognitive and behavioral change
The efficacy of problem-solving communication training alone, behavioral management training alone, and their combination for parent–adolescent conflict in teenagers with ADHD and ODD
J Consult Clin Psychol
Oppositional children differ from healthy children in frontal brain activation
J Abnorm Child Psychol
Do girls manipulate and boys fight? Developmental trends in regard to direct and indirect aggression
Aggressive Behav
Developmental pathways from child maltreatment to peer rejection
Child Dev
Psychophysiological protective factors for male subjects at high risk for criminal behavior
Am J Psychiatry
Psychiatric sequelae of low birth weight at 6 years of age
J Abnorm Child Psychol
Effective psychosocial treatments of conduct-disordered children and adolescents: 29 years, 82 studies, and 5272 kids
J Clin Child Psychol
Neuropsychiatry of frontal lobe dysfunction in violent and criminal behaviour: a critical review
J Neurol Neurosurg Psychiatry
Children's mental health use across service sectors
Health Aff
Mental health education, child welfare, and juvenile justice service use
Behavioral efficacy of haloperidol and lithium carbonate: a comparison in hospitalized aggressive children with conduct disorder
Arch Gen Psychiatry
Boys' externalizing problems at elementary school age: pathways from early behavior problems, maternal control, and family stress
Dev Psychopathol
Comprehensive community- and school-based interventions to prevent antisocial behavior
A clinical model for parenting juvenile offenders: a comparison of group care versus family care
Clin Child Psychol Psychiatry
Central serotonin activity and aggression: inverse relationship with prolactin response to d-fenfluramine, but not CSF 5-HIAA concentration in human subjects
Am J Psychiatry
Empathy in conduct disordered and comparison youth
Dev Psychol
Issues in the disruptive behavior disorders: attention deficit disorder without hyperactivity and the differential validity of oppositional defiant and conduct disorders
The development of aggression and antisocial behavior
The role of social context in the prevention of conduct disorder
Dev Psychopathol
The development of antisocial individuals
Peer factors and interventions
The Measurement of Moral Judgment: Theoretical Foundations and Research Validation
Emotional dysregulation in disruptive behavior disorders
Violent behavior in children and youth: preventive intervention from a psychiatric perspective
J Am Acad Child Adolesc Psychiatry
Merging universal and indicated prevention programs: the fast track model
Addictive Behav
Evaluation of the first 3 years of the Fast Track prevention trial with children at high risk for adolescent conduct problems
J Abnorm Child Psychol
A pilot study of methylphenidate, clonidine, or the combination in ADHD comorbid with aggressive oppositional defiant or conduct disorder
Clin Pediatr (Phila)
Relational aggression, gender, and socialpsychological adjustment
Child Dev
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This study was supported in part by NIMH grant MH 42529 to Dr. Loeber.
Reprint requests to Dr. Burke, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 3811 O’Hara Street, Pittsburgh, PA 15213; e-mail: [email protected].
DOI: 10.1097/01.CHI.0000024839.60748.E8