title: Significance of childhood conduct problems to later development of conduct disorder among children with ADHD: a prospective follow-up study.
abstract: This study investigates whether low to moderate levels of childhood oppositional defiant disorder (ODD) and conduct disorder (CD) behaviors contribute to the development of clinically diagnosed CD in adolescence, in children with attention deficit hyperactivity disorder (ADHD). Participants were 207 White boys (ages 6-12) with ADHD free of conduct disorder diagnoses. Parent and teacher ratings were obtained. Participants were assessed at mean age 18 by clinicians blind to childhood status. A non-ADHD group (recruited in adolescence) was also studied. ODD behavior ratings did not predict CD in adolescence, whereas CD behavior ratings did. No single ODD or CD behavior predicted adolescent outcome. ADHD probands with very low ratings (Not at all, Just a little) by parents and teachers on all CD behaviors were still at significantly increased risk for CD in adolescence, compared to non-ADHD controls. The same relationships were found between childhood ODD and CD behaviors, and antisocial personality disorder in adulthood (mean age, 25). We conclude that childhood ADHD is a developmental precursor of later antisocial disorder, even in the absence of comorbid ODD or CD in childhood. However, low levels of CD-type problems are not innocuous, because they predict later CD among children with ADHD without comorbid CD.
authors.affiliation: New York University Child Study Center, NYU School of Medicine, New York, New York 10016, USA. sal.mannuzza@med.nyu.edu
authors.forename: Salvatore
authors.initials: S
authors.lastname: Mannuzza
authors.forename: Rachel G
authors.initials: RG
authors.lastname: Klein
authors.forename: Howard
authors.initials: H
authors.lastname: Abikoff
authors.forename: John L
authors.initials: JL
authors.lastname: Moulton
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000987:Antisocial Personality Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D019955:Conduct Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D002658:Developmental Disabilities / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012307:Risk Factors; D012720:Severity of Illness Index