Conduct Disorder and Antisocial Personality Disorder

The link between conduct disorder and antisocial personality disorder is upon the onset of conduct disorder, that is, if conduct disorder develops early in childhood, the child is likely to develop antisocial personality disorder in adulthood. This means that the problems associated with conduct disorder becomes pervasive and life-long upon entering adulthood. Around 25 to 40 % of children who have early-onset conduct disorder qualifies for a diagnosis of antisocial personality disorder in adulthood. Although a significant majority do not, it is important to understand that early-onset conduct disorder that do not progress to APD, especially among boys, is still a difficult condition, often leading to social problems including the formation of friendships and intimate relationships and participating in social vocational activities.

One possible reason why APD does not commonly result among adolescents who suddenly develop conduct disorder is because those children who have early-onset conduct disorder typically share characteristics that serve as risk factors for behavioral problems. Unlike those who had adolescent-onset conduct disorder, children with early-onset conduct disorder have verbal and neuropsychological problems, impulsive tendency, and attention difficulty.

Environmental factors, such as parental rejection, low socioeconomic status, depression, and bad neighborhoods can also indirectly promote the development of APD among those with conduct disorder. For example, consider this spiral of events. Low socioeconomic status can bring intense stress and precipitate depression among parents. Depressed parents tend to function less productively and guide their children less ably. Lack of guidance is a risk factor for the development of conduct disorder. If the child goes on to develop conduct disorder, the parent may, instead of focusing on remolding the child's disposition, may react aggressively and resort to rejection. When the conduct disordered child feels rejected, he or she may seek the attention of other children or adults who tolerates his or her behavior. If the conduct disordered child lives in a bad neighborhood, he or she has direct and easy access for such deviant groups. If the child comes in contact with an adult that has APD, the adult becomes an efficient "role model" for the child.