ABSTRACT
Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) continue to be the predominant juvenile disorders seen in mental health and community clinics (Frick, 1998; Kazdin, 1995) and are of great concern because of their high degree of impairment (Lahey, Loeber, Quay, Frick, & Grimm, 1997), potential for persistence over time, and association with negative outcomes. Research in recent years has provided a good deal of clarity regarding the course of antisocial behavior from childhood through adulthood. Clearly, much remains to be addressed, from the relevance and prognostic utility of nonsymptomatic early childhood precursors to alternative outcomes in adulthood for those who do not progress to Antisocial Personality Disorder (APD). In this chapter, we discuss the course of ODD and CD (referred to jointly as disruptive behavior disorders [DBD]), including their stability, subtypes with prognostic utility, conditions that are associated with the progression of ODD and CD, and the development from ODD to CD. We review evidence for symptom-driven alternative models of the development of early antisocial and disruptive behavior. We discuss outcomes associated with CD, including APD, as well as violence, substance use, and persisting antisocial behavior not captured by the APD diagnosis. Finally, we present a life-span model of early disruptive behavior to APD. Throughout this review, we highlight available research demonstrating gender differences and similarities. Most theories of DBD are based on data from males and probably apply only in part to females, given differences in pat-
Jeffrey D. Burke Western Psychiatric Institute and Clinic
Rolf Loeber University of Pittsburgh
terns of risk factors between the genders (Pakiz, Reinherz, & Giaconia, 1997).
