Chapter 6 Notes
Although the most lethal forms of youth violence in the United States have
been steadily decreasing since 1994, the prevalence of other forms of
antisocial behavior remains alarmingly high, and the proportion of
females involved in violent crimes has increased
Based on a survey in the US of high school students: in 2009 found that
about 32% had been in a physical fight in the past year, 18% reported
carrying a weapon in the last month, and 8% re- ported being threatened or
injured with a weapon on school property.
Description of conduct problems
•Aggressive behaviors are an adaption to home and neighborhood violence
•Conduct problem(s) and antisocial behavior(s) are terms used to
describe a wide range of age- inappropriate actions and attitudes of a child
that violate family expectations, societal norms, and the personal
or property rights of others
• • The nature, causes, and outcomes of conduct problems in children are
wide-ranging, requiring that we consider several different types and
•Children with severe conduct problems usually grow up in extremely unfortunate family
•Some children that have conduct problems, do so with a cause. For example a child that stabs
his father after viewing his father rape his mother, is acting out due to the tragic family situation.
• many individuals have the following opinions about the nature of youth violence:
o Most future offenders can be identified during early childhood.
o Child abuse and neglect inevitably lead to violent behavior later in life.
o AfricanAmerican and Hispanic youths are more likely to become involved in
violence than other racial or ethnic groups.
o Getting tough with juvenile offenders by trying them in adult criminal courts
reduces the likelihood that they will commit more crimes.
o Most violent youths will end up being arrested for a violent crime.
o Nothing works with respect to treating or preventing violent behavior.
o ALL THEABOVE STATEMENTSARE FALSE Context,Cost and Perspectives
•Most young people break rules from time to time.
•In 2009, about 72% of high school students in the U.S. had consumed alcohol, 46% had smoked
cigarettes, and 37% had smoked marijuana.
•Very few adolescents (about 6%) refrain from antisocial behavior entirely.
•Antisocial behaviors appear and then decline during normal development
•About 50% of parents report that their preschoolers steal, lie, disobey, or destroy property, in
contrast to 10% of parents who report the same about young adolescents.
o This decline partially reflects the parents’ lack of awareness of the trouble their
teens may be getting into.
•Antisocial behaviors vary in severity, from minor disobedience to fighting.
• •Some antisocial behaviors decrease with age (e.g., disobeying at home), whereas others
increase with age and opportunity (e.g., hanging around kids who get into trouble).
• •Antisocial behaviors are more common in boys than girls during childhood, but this
difference narrows in adolescence.
• •Longitudinal studies find aggressive acts such as persistent physical fighting to be highly
stable, with an average correlation of about 0.70 for measures of these behaviors taken at
different times. This makes aggressive behavior about as stable as IQ scores!
• Social and Economic Cost
• •Although antisocial acts are universal in young people, an early, persistent, and extreme
pattern of antisocial behavior occurs in only about 5% of children
• •More teenagers in the United States die from fire- arm injuries than from all diseases combined,
and they are more than twice as likely as adults to be victims of violence, most often committed
by other teens
• •The additional public costs per child with conduct problems across the healthcare, juvenile
justice, and educational systems are enormous, at least $10,000 or more a year
• •The lifetime costs to society for one youth to leave high school for a life of crime and substance
abuse has been estimated to be at least two million dollars
•These include the legal, psychological, psychiatric, and public health perspectives Legal
• Conduct Problems= delinquent or criminal acts
•The broad term juvenile delinquency describes children who have broken a law, ranging from
sneaking into a movie without paying to homicide.
•Legal definitions depend on laws that change over time or differ across locations. Legal
definitions exclude antisocial behaviors.
•Youths who display antisocial behavior and are apprehended by police may differ from youths
who display the same patterns but are not apprehended because of their intelligence or
•The minimum age of criminal responsibility is 12 in most states and provinces, but this has
fluctuated over the years in relation to society’s tolerance or intolerance of antisocial behavior in
•A legal definition of delinquency may result from one or two isolated acts, whereas a mental
health definition usually requires the child to display a persistent pattern of antisocial behavior.
Thus, only a subgroup of children who meet a legal definition of delinquency will also meet the
definition for a mental disorder
•Conduct problems fall along a continuous dimension of externalizing behavior. which includes
a mixture of impulsive, overactive, aggressive, and rule-breaking acts.
•The externalizing dimension itself consists of two related but independent sub-dimensions
labeled “rule-breaking behavior” and “aggressive behavior”
•Two additional independent dimensions of antisocial behavior have been identified: overt–
covert and destructive–nondestructive
o The overt–covert dimension ranges from overt visible acts such as fighting to
covert hidden acts such as lying or stealing.
o Children who display overt antisocial behavior tend to be negative, irritable, and
resentful in their reactions to hostile situations and to experience higher levels of
family conflict. In contrast, those displaying covert antisocial behavior are less
social, more anxious and more suspicious of
o The destructive–nondestructive dimension ranges from acts such as cruelty to
animals or physical assault to nondestructive behaviors such as arguing or
o Figure 6.2, crossing the overt–covert with the destructive–nondestructive
dimension results in four categories of conduct problems: (A) covert– destructive, or property violations(Steals,Vandalism,lies); (B) overt–destructive, or
aggression(fights,cruel,bullies); (C) covert–nondestructive, or status
violations(runaway,swears,truancy,substance use); and (D) overt–nondestructive,
or oppositional behavior(Temper,argues,touchy,stubborn).
•In DSM-IV-TR, disruptive behavior disorders are persistent patterns of antisocial behavior,
represented by the categories of oppositional defiant disorder (ODD) and conduct disorder (CD).
•Both categorical (psychiatric) and dimensional (psychological) perspectives have proven
validity for the classification of conduct problems in youth.
•DSM-5 will likely also include dimensional measures that are sensitive to both the severity of
children’s conduct problems and to subclinical levels of symptoms (troubling symptoms too few
in number to qualify for a categorical diagnosis of CD or ODD).
•This perspective blends the legal, psychological, and psychiatric perspectives with public health
concepts of prevention and intervention.
Oppositional Defiant Disorder(ODD)
•These children display an age- inappropriate recurrent pattern of stubborn, hostile, disobedient,
and defiant behaviors
•ODD usually appears by age 8, and was included in the DSM to capture early displays of
antisocial and aggressive behavior by pre- school and school-age children
•Interestingly, recent findings suggest that symptoms of ODD can be grouped into those of
negative affect (e.g., angry/irritable mood) and those of defiance (e.g., defiant/headstrong
behavior), which differentially predict later emotional and behavioral disorders in early
•In one study, only negative affect predicted later depression, whereas defiance predicted later
•Children with conduct disorder display a repetitive and persistent pat- tern of severe aggressive
and antisocial acts that involve inflicting pain on others or interfering with rights of others
through physical and verbal aggression, stealing, or committing acts of vandalism • They often haveADHD,academic deficiencies & poor relations with peers.
•Their families often use child-rearing practices, such as harsh punishment.
Age of onset
•DSM makes the distinction between youths with an early or late onset of CD. Those with
childhood-onset conduct disorder dis- play at least one symptom of the disorder before age 10,
whereas those with adolescent-onset conduct disorder do not,
o Children diagnosed with childhood-onset CD are more likely to be boys, show
more aggressive symptoms, account for a disproportion- ate amount of illegal
activity, and persist in their antisocial behavior over time
o youths diagnosed with adolescent-onset CD are as likely to be girls as boys and
do not display the severity or psychopathology that characterizes the childhood-
CD and ODD
•There is much overlap between the symptoms of CD and ODD
•Symptoms of ODD typically emerge 2 to 3 years before CD symptoms, at about age 6 years for
ODD versus age 9 years for CD.
•Nearly half of all children with CD have no prior ODD diagnosis, and most children who
display ODD do not progress to more severe CD—at least 50% maintain their ODD diagnosis
with- out progressing, and another 25% cease to display ODD problems entirely.
Antisocial personality Disorder( APD) & Psychopathic Features
•(also referred to as dyssocial personality disorder), a pervasive pattern of disregard for, and
violation of, the rights of others
•In addition to their early CD, adolescents withAPD may also display psychopathic features,
which are defined as a pattern of callous, manipulative, deceitful, and remorseless behavior—the
more menacing side of human nature
•As many as 40% of children with CD developAPD as young adults.
•Youths who display psychopathic features appear to be aware that their aggressive behavior will
cause others to suffer—but they don’t care when it does.
•Children with CD show lack of concern= They display a callous and unemotional (CU)
interpersonal style characterized by traits such as lacking in guilt, not showing empathy, not
•Children who display CU traits also display a lack of behavioral inhibition as reflected in their preference for novel and perilous activities and a diminished sensitivity to cues for danger and
punishment when seeking rewards
•It is the callous–unemotional and interpersonal/narcissistic features of psychopathy that can be
most reliably distinguished from behaviors consistent with ODD, CD, andADHD. Features
associ- ated with impulsivity are more similar to behaviors of children withADHD
•Children with CU traits display a greater number and variety of conduct problems, and they
have more frequent contact with police and a stronger parental his- tory ofAPD than other
children with conduct problems
•CU symptoms in childhood are about as stable as ODD and CD symptoms over time, but
developmental changes have also been noted, suggesting that these are not unchanging
characteristics of the child.
•Bart Simpson would qualify for a DSM diagnosis of CD.
Cognitive and Verbal Deficits
• Studies found that some children with CD show IQ deficit, this deficit cannot be explained
solely by socioeconomic disadvantage,race,or detection by the police. May be due to co-
•Verbal IQ is consistently lower than performance IQ in children with CD, suggesting a specific
and pervasive deficit in language.
•Verbal deficits are present early in a child’s development, long before the emergence of conduct
problems. However, their presence alone does not predict future aggression—family factors are
o Children with both verbal deficits and family adversity display 4 times as much
aggressive behavior as children with only one factor
•It is important to keep in mind that the relation- ship between different cognitive/verbal deficits
and antisocial behavior may vary for specific types of antisocial behaviors. For example, one
study found that verbal abilities were negatively related to physical aggression, but positively
associated with theft, and that inductive reasoning was negatively associated with increases in
theft across adolescence
•Children with conduct problems rarely consider the future consequences of their behavior or its
impact on others.
o They fail to inhibit their impulsive behavior, keep social values or future rewards
in mind, or adapt their actions to changing circumstances. This pattern suggests
deficits in executive functions similar to those of children withADHD. •The types of executive functioning deficits experienced by children with ODD and CD may
differ from those experienced by children withADHD
o For example, Rubia has made the distinction between cool (as in temperature, not
as in Lady Gaga) cognitive executive functions, such as attention, working
memory, planning, and inhibition, and hot executive functions that involve
incentives and motivation.
o Both cool and hot executive functions are associated with distinct but
interconnected brain networks. Cool executive function deficits are thought to be
more characteristic of children withADHD, whereas hot executive function
deficits are more characteristic of children with conduct problems.
School and Learning Problems
•Children with conduct problems display many schooldifficulties, including academic
underachievement, graderetention, special education placement, dropout, suspension, and
• Children with Conduct problems have an inflated, unstable and/or tentative view of self, which
overtime permits them to rationalize their antisocial conduct.
•Young children with conduct problems display verbal and physical aggression toward other
children & poor social skills.
•Involvement with antisocial peers becomes increasingly stable during childhood and supports
the transition to adolescent criminal acts such as stealing, truancy, or substance abuse
•Unfortunately, many well-intentioned programs such as group therapy, summer programs, or
boot camps tend to create groups for youth with con- duct problems—the very situation that may
produce the most damage.
•Aggressive children also show distortions in how they think about social situations.
o reactive–aggressive children (those showing an angry, defensive response to
frustration or provocation) dis- play a hostile attributional bias, which means
they are more likely to attribute hostile and mean-spirited intent to other children,
especially when the intentions of others are unclear (e.g., when another child
accidentally bumps into a reactive–aggressive child, they are likely to think the
other child did it on purpose).
o proactive–aggressive children (those who use aggressive behavior deliberately to
obtain a desired goal) are more likely to view their aggressive actions as positive
and to value social goals of dominance and revenge rather than affiliation •Box 6.3 Bullies and their victims:
o Bullying occurs when one or more children intentionally and repeatedly expose
another child who cannot readily defend himself or herself to negative actions.
o In 2007, about 32% of students age 12–18 reported having been bullied at school
o Interestingly, in one study, youths with a particular genotype (involving the se-
rotonin transporter 5-HTT gene) were found to be less likely to suffer adverse
effects following bullying victimization—another example of G x E interaction
•Family problems are among the strongest and most consistent correlates of conduct problems
•Two types of family disturbances are related to these problems in children:
o General family disturbances include parental mental health problems, a family
history of antisocial behavior, marital discord, family instability, limited
resources, and antisocial family values.
o Specific disturbances in parenting practices and family functioning include
excessive use of harsh discipline, lack of supervision, lack of emotional sup- port
and involvement, and parental disagreement about discipline.
•Young people with persistent conduct problems en- gage in many behaviors that place them at
high risk for personal injuries, illnesses, overdoses from drug abuse, sexually transmitted
diseases, substance abuse, and physical problems as adults
•Rates of premature death (before age 30) due to various causes are 3 to 4 times higher in boys
with conduct problems than in boys without these problems (contrary to popular belief, it’s not
only the good that die young!)
•The evidence indicates that conduct problems during childhood are a risk factor for adolescent
and adult substance abuse, and this relationship is mediated by drug use and delinquency during
early and late adolescence
Accompanying Disorders and Symptoms
•Most children with conduct disorder also haveAHD, depression and anxiety.
Attention-Deficit/Hyperactivity Disorder (ADHD)
•More than 50% of children with CD also haveADHD •Possible reasons for this overlap:
o Ashared predisposing vulnerability such as impulsivity, poor self-regulation, or
temperament may lead to bothADHD and CD.
o ADHD may be a catalyst for CD by contributing to its persistence and escalation
to more severe forms, particularly when shaped by ineffective parenting
emotional reactions and behaviors.
o ADHD may lead to childhood onset of CD, which is a strong predictor of
•Two lines of research suggest that CD &ADHD are distinct:
1. CD and ADHD consistently provides a better fit to the data than a model based on only
a single disorder
2. CD is less likely thanADHD to be associated with cognitive impairments,
neurodevelopmental abnormalities, inattentiveness in the classroom, and higher rates of
Depression & Anxiety
• •About 50% of youths with conduct problems also receive a diagnosis of depression or anxiety
• •Recent evidence suggests that it is ODD and not CD that best account