Conduct Disorders in Childhood and Adolescence

Books

Alan E. Kazdin

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  • Developmental Clinical Psychology and Psychiatry Series

    Series Editor: Alan E. Kazdin, Yale University

    Recent volumes in this series …

    • 8: LIFE EVENTS AS STRESSORS IN CHILDHOOD AND ADOLESCENCE

      by James H. Johnson

    • 9: CONDUCT DISORDERS IN CHILDHOOD AND ADOLESCENCE SECOND EDITION

      by Alan E. Kazdin

    • 10: CHILD ABUSE

      by David A. Wolfe

    • 11: PREVENTING MALADJUSTMENT FROM INFANCY THROUGH ADOLESCENCE

      by Annette U. Rickel and LaRue Allen

    • 12: TEMPERAMENT AND CHILD PSYCHOPATHOLOGY

      by William T. Garrison and Felton J. Earls

    • 14: MARRIAGE, DIVORCE, AND CHILDREN'S ADJUSTMENT

      by Robert E. Emery

    • 15: AUTISM

      by Laura Schreibman

    • 18: DELINQUENCY IN ADOLESCENCE

      by Scott W. Henggeler

    • 19: CHRONIC ILLNESS DURING CHILDHOOD AND ADOLESCENCE

      by William T. Garrison and Susan McQuiston

    • 20: ANXIETY DISORDERS IN CHILDREN

      by Rachel G. Klein and Cynthia G. Last

    • 21: CHILDREN OF BATTERED WOMEN

      by Peter G. Jaffe, David A. Wolfe, and Susan Kaye Wilson

    • 22: SUBSTANCE ABUSE IN CHILDREN AND ADOLESCENTS

      by Steven P. Schinke, Gilbert J. Botvin, and Mario A. Orlandi

    • 23: CHILD PSYCHIATRIC EPIDEMIOLOGY

      by Frank C. Verhulst and Hans M. Koot

    • 24: EATING AND GROWTH DISORDERS IN INFANTS AND CHILDREN

      by Joseph L. Woolston

    • 25: NEUROLOGICAL BASIS OF CHILDHOOD PSYCHOPATHOLOGY

      by George W. Hynd and Stephen R. Hooper

    • 26: ADOLESCENT SEXUAL BEHAVIOR AND CHILDBEARING

      by Laurie Schwab Zabin and Sarah C. Hayward

    • 27: EFFECTS OF PSYCHOTHERAPY WITH CHILDREN AND ADOLESCENTS

      by John R. Weisz and Bahr Weiss

    • 28: BEHAVIOR AND DEVELOPMENT IN FRAGILE X SYNDROME

      by Elisabeth M. Dykens, Robert M. Hodapp, and James F. Leckman

    • 29: ATTENTION DEFICITS AND HYPERACTIVITY IN CHILDREN

      by Stephen R Hinshaw

    • 30: LEARNING DISABILITIES

      by Byron P. Rourke and Jerel E. Del Dotto

    • 31: PEDIATRIC TRAUMATIC BRAIN INJURY

      by Jeffrey H. Snow and Stephen R. Hooper

    • 32: FAMILIES, CHILDREN, AND THE DEVELOPMENT OF DYSFUNCTION

      by Mark R. Dadds

    • 33: ADOLESCENTS AND THE MEDIA

      by Victor C. Strasburger

    Copyright

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    Dedication

    To Eve and her remarkable warmth and élan

    Series Editor's Introduction

    Interest in child development and adjustment is by no means new. Yet only recently has the study of children benefited from advances in both clinical and scientific research. Advances in the social and biological sciences, the emergence of disciplines and subdisciplines that focus exclusively on childhood and adolescence, and greater appreciation of the impact of such influences as the family, peers, and school have helped accelerate research on developmental psychopathology. Apart from interest in the study of child development and adjustment for its own sake, the need to address clinical problems of adulthood naturally draws one to investigate precursors in childhood and adolescence.

    Within a relatively brief period, the study of psychopathology among children and adolescents has proliferated considerably. Several different professional journals, annual book series, and handbooks devoted entirely to the study of children and adolescents and their adjustment document the proliferation of work in the field. Nevertheless, there is a paucity of resource material that presents information in an authoritative, systematic, and disseminable fashion. There is a need within the field to convey the latest developments and to represent different disciplines, approaches and conceptual views to the topics of childhood and adolescent adjustment and maladjustment.

    The Sage Series Developmental Clinical Psychology and Psychiatry is designed to serve uniquely several needs of the field. The Series encompasses individual monographs prepared by experts in the fields of clinical child psychology, child psychiatry, child development and related disciplines. The primary focus is on developmental psychopathology, which refers broadly here to the diagnosis, assessment, treatment, and prevention of problems that arise in the period from infancy through adolescence. A working assumption of the Series is that understanding, identifying, and treating problems of youths must draw on multiple disciplines and diverse views within a given discipline.

    The task for individual contributors is to present the latest theory and research on various topics, including specific types of dysfunction, diagnostic and treatment approaches, and special problem areas that affect adjustment. Core topics within clinical work are addressed by the Series. The present monograph focuses on conduct disorder and serious antisocial behavior such as aggressive acts, theft, vandalism, setting fires, and related behaviors in children and adolescents. The nature and scope of the problem, as well as its prevalence and costs to society, make antisocial behavior one of the most socially significant mental health problems. The present book integrates current findings on description, diagnosis, assessment, treatment, and prevention of conduct disorder. In addition, new models to approach the investigation and treatment of antisocial behavior are identified to guide future research.

    Alan E.Kazdin, Ph.D.

    Preface

    Conduct disorder refers to a clinical problem among children and adolescents that encompasses aggressive acts, theft, vandalism, firesetting, running away, truancy, defying authority, and other behaviors referred to as “antisocial.” Many antisocial behaviors, in mild form, emerge over the course of normal development, and hence prove to be of little consequence. Persistent and extreme patterns of these behaviors among children and adolescents reflect a serious clinical problem with broad personal and social impact. These more extreme patterns are delineated here as conduct disorder.

    The significance of conduct disorder stems in part from the fact that it constitutes one of the most frequent bases for referral of children and adolescents for psychological and psychiatric treatment. Children with severe antisocial behavior are not only seriously impaired as youths, but also are likely to manifest psychiatric problems, criminal behavior, and social maladjustment when they become adults. The problem does not end when the antisocial youths reach adulthood; as parents, they are likely to pass along antisocial behaviors to their offspring who continue the cycle.

    The costs of conduct problems are exorbitant. There are, in addition, the personal costs to the many victims of aggressive, violent, and cruel acts completed by youths with conduct disorder. Such youths are victims themselves given the abuse, neglect, and poor care to which they are often subject. Apart from the personal and often tragic consequences of antisocial behavior, the dysfunction continues as one of the most costly of childhood disorders. These children and adolescents and their families use multiple social services and are in frequent contact with the mental health and criminal justice systems. The lifelong impairment absorbs enormous resources.

    The significance of the clinical and social problem that conduct disorder reflects is heightened by the absence of clear solutions. Parents, teachers, and victims of all ages are confronted with youths who engage in severe antisocial acts; policymakers struggle to redress the problem with programs of all sorts. To date, it seems as if little can be recommended to curb the problem; also, it seems that no treatment or prevention program is available or in sufficiently widespread use to have significant impact. Actually, within the past few years significant advances have been made both in treatment and prevention.

    This book describes the nature of conduct disorder and what is currently known from research and clinical work. Findings are drawn from such areas as criminology, epidemiology, psychiatry, and psychology. The subject matter brings us to such topics as psychiatric diagnosis, child rearing practices, parent psychopathology, the contributions and interactions of heredity and environment, sex differences in development, psychotherapy research, and others. The book considers core areas of work that occupy current research efforts. These include elaboration of contemporary diagnosis and methods to assess conduct disorder, identification of risk and protective factors that influence the onset of the disorder, the paths and courses of conduct disorder over the life span, and current methods of treating and preventing the dysfunction. The purpose is to provide a comprehensive yet concise view of conduct disorder in children and adolescents and to point to new areas of work. To that end, the book ends by outlining new models for and approaches to critical questions regarding diagnosis and treatment of antisocial youths.

    The second edition takes the opportunity to showcase many advances and lines of research that have moved the field forward. Gains have been made in many areas in terms of diagnosing and delineating subtypes of dysfunction and elaborating how early influences unfold leading to conduct problems. Also, within the past few years, the evidence for treatment and prevention has made significant gains. The range of procedures and strength of the evidence in their behalf has increased. In this edition, an effort has been made to elaborate findings in diverse areas that build on the core knowledge of the field regarding the nature of the problem and its impact on the individual and others.

    The many influences that shaped this book cannot be fully elaborated, but a few had very special impact during the preparation of this edition. First, the ambience and support of Yale University, in particular the Department of Psychology and Child Study Center, are conducive to the type of work this monograph represents. Stimulating colleagues and students, as well as the clinical staff with whom I work on a daily basis, have been of enormous help and education. Second, interactions with colleagues in the John D. and Catherine T. MacArthur Network on Psychopathology and Development (Chair, Dr. David Kupfer) have shaped much of my thinking about the complexities of developmental psychopathology and their impact on the conceptualization of dysfunction. Finally, the support of a Research Scientist Award (MH00353) and funding to develop treatments for conduct disorder children and their families (MH35408) from the National Institute of Mental Health have been central to my development and understanding of childhood dysfunction. To each of these influences and the many individuals they encompass, I am pleased to acknowledge the support and input.

    A. E.K.
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    Author Index

    About the Author

    Alan E. Kazdin, Ph.D., is Professor of Psychology at Yale University. He is also Professor in the Child Study Center (Child Psychiatry) at the School of Medicine and Director of the Yale Child Conduct Clinic, an outpatient treatment service for children with aggressive and antisocial behavior. He received his Ph.D. in clinical psychology from Northwestern University (1970). Prior to coming to Yale, he was on the faculty of the Pennsylvania State University and the University of Pittsburgh School of Medicine. Dr. Kazdin has been a fellow of the Center for Advanced Study in the Behavioral Sciences, President of the Association for Advancement of Behavior Therapy, recipient of the Award for Distinguished Scientific Contribution to Clinical Psychology, and editor of various journals (Journal of Consulting and Clinical Psychology, Behavior Therapy, and Psychological Assessment). Currently he is editor of Clinical Psychology: Science and Practice and of the Sage Book Series on Developmental Clinical Psychology and Psychiatry. He is a Diplomate of the American Board of Professional Psychology and Fellow of the American Psychological Association. He has written, co-authored, or coedited more than 30 books. Some of the recent titles include Child Psychotherapy: Developing and Identifying Effective Treatments (Allyn & Bacon); Treatment of Antisocial Behavior in Children and Adolescents (Brooks/Cole); Research Design in Clinical Psychology (Allyn & Bacon); Methodological Issues and Strategies in Clinical Research (American Psychological Association); Cognitive and Behavioral Interventions: An Empirical Approach to Mental Health Problems (with L. Craighead, W. E. Craighead, & M. Mahoney; Allyn & Bacon); and The Clinical Psychology Handbook (with A. S. Bellack & M. Hersen; Pergamon).


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