652 CHAPTER 14
act aggressively and antisocially in impulsive ways when distressed. They often feel
bad afterward, but still can’t control their behavior (Pardini, Lochman, & Frick,
2003). These people may fall into a negative interaction pattern with parents: When
a parent brings up the child’s past or present misconduct, the child becomes agi-
tated and then doesn’t appropriately process what the parent says, becomes more
distressed, and then impulsively behaves in an aggressive manner. The parent may
respond with aggression (verbal or physical), creating a vicious cycle (Gauvain &
Fagot, 1995).
This variant of conduct disorder is infl uenced less by genes and more by mal-
adaptive parenting (Oxford, Cavell, & Hughes, 2003); moreover, it is more likely to
arise in children with poor verbal reasoning abilities (Loney et al., 1998).
As noted in Table 14.11, the two DSM-IV-TR types of conduct disorder—
adolescent- and childhood-onset—differ not only in the timing of onset, but also in
other respects.Table 14.11 • Conduct Disorder Facts at a Glance
Prevalence- Studies fi nd a wide range of prevalence rates in the general population (1–10%), depending on
how the study was conducted and the exact composition of the population studied. About 10%
of Americans will be diagnosed with conduct disorder during their lives (Nock et al., 2006). - Conduct disorder is more likely to occur in urban than in rural areas.
- Conduct disorder is one of the more frequently diagnosed psychological disorders in children.
Onset- DSM-IV-TR specifi es that symptoms of the disorder begin in childhood or adolescence. When
symptoms arise before age 10, the diagnosis is childhood-onset type; when there are no
symptoms before age 10, it is adolescent-onset type.
Comorbidity- With the childhood-onset type, common comorbid disorders include oppositional defi ant
disorder and attention-defi cit/hyperactivity disorder (Costello et al., 2003); some studies
estimate that up to 90% of children with conduct disorder exhibit symptoms of attention-
defi cit/hyperactivity disorder (Frick & Muñoz, 2006). - Among teenagers with conduct disorder, comorbid mood disorders are common
(Christophersen & Mortweet, 2001).
Course- The earlier the onset and the more severe the disruptive behaviors, the worse the prognosis
(Barkley et al., 2002; Frick & Loney, 1999). - Individuals with childhood-onset conduct disorder are likely to develop additional symptoms
of the disorder by puberty and continue to have the disorder through adolescence. - Those with the childhood-onset type are more likely than those with the adolescent-onset
type to be diagnosed with antisocial personality disorder in adulthood.
Gender Differences- During their lives, about 12% of American males and 7% of American females will have had
conduct disorder (Nock et al., 2006). - Although more males than females are diagnosed with this disorder (both types), the sex
difference is more marked for the childhood-onset type, with ten males diagnosed for each
female (Moffi tt & Caspi, 2001). - Males with conduct disorder tend to be confrontationally aggressive (engaging in fi ghting,
stealing, vandalism, and school-related problems); females tend to be nonconfrontational
(lying, truancy, running away, substance use, and prostitution).
Source: Unless otherwise noted, the source for information is American Psychiatric Association, 2000.