Conduct disorder: A biopsychosocial review

Objective: To review published works on the epidemiology, risk factors, protective factors, typologies, and genetic aspects of conduct disorder (CD). Method. Findings from refereed journal articles and current texts in the field are briefly summarized. Results: CD is commonly encountered in clinical practice. Factors strongly predictive of future delinquency include past offenses, antisocial peers, impoverished social ties, early substance use, male sex, and antisocial parents. Factors that moderately predict recidivism include early aggression, low socioeconomic status (SES), psychological variables such as risk taking and impulsivity, poor parent-child relationships, poor academic performance, early medical insult, and neuropsychological variables such as poor verbal IQ. Mildly predictive variables include other family characteristics such as large family size, family stress, discord, broken home, and abusive parenting, particularly neglect. Protective factors include individual factors such as skill competence (in social and other arenas), adult relationships, prosocial and proeducational values, and strong social programs and supports. Conclusions: We know a great deal about psychosocial risk factors for CD. Some research into protective factors and genetic contributions exists but is in its early stages. Future work will increase our knowledge about subtypes, developmental pathways, and CD treatment.