Which better predicts conduct problems? The relationship of trajectories of conduct problems with ODD and ADHD symptoms from childhood into adolescence

Background: To assess the co-occurrence in deviant trajectories of parent-rated symptoms of conduct disorder (CD), oppositional defiant disorder (ODD) and attention-deficit/hyperactivity disorder (ADHD) from age 4 to 18 years old in a general population sample of Dutch children. Methods: Developmental trajectories of CD, ODD, and ADHD were estimated in a sample of 1,016 males and 1,060 females. Children's disruptive problem behaviors were rated at 5 time-points. The co-occurrence patterns between the deviant CD trajectory, and the high ODD and high ADHD trajectory were studied for males and females separately. Results: Four percent of males and 2% of females followed a deviant CD trajectory. Six percent of the sample followed a high ODD trajectory, and 5% a high ADHD trajectory. Engagement in the deviant CD trajectory was predicted by ODD and ADHD in females, but only by ODD in males. Conclusions: Although ADHD co-occurs with CD, the association between ADHD and CD is largely accounted for by accompanying ODD. Gender differences should be taken into account in understanding the onset of CD.