The relationship between attention deficit hyperactivity disorder and the development of conduct disorder and antisocial behavior: A study of neurological and social variables

Numerous research studies have highlighted Attention Deficit Hyperactivity Disorder as a risk factor for the development of antisocial behavior and two disruptive behavioral disorders: Oppositional Defiant Disorder and Conduct Disorder. Children with co-morbid ADHD and a disruptive behavioral disorder are at risk for environmental and social difficulties that may continue throughout their life span. This study focused on children with ADHD who develop Conduct Disorder. Conduct Disorder has become an increasingly prevalent diagnosis, which places a child at risk for the development of antisocial behavior in adulthood. Previous research has suggested different neurological and social variables that contribute to the development of Conduct Disorder. This study compared these variables between populations of children with ADHD who exhibited behaviors that met criteria for Conduct Disorder and children with ADHD only. The goal of this pilot study was to identify what differences existed between these two populations. These differences can be identified as potential risk factors for the development of Conduct Disorder in children with ADHD.; Through parent report and chart review, 20 children were identified as having ADHD plus 2 or more behaviors that met criteria for Conduct Disorder. This group was designated as children with ADHD plus Conduct Disorder Behavior. These children were compared to 20 children with ADHD only. Independent variables were executive function skills, verbal skills, response inhibition, parent relationships and peer relationships. Test results as measured by the IVA continuous performance test indicate that children with ADHD plus conduct disorder behavior possess stronger skills involving focus on visual material (p = 0.05) and attention to visual material (p = 0.02). Although not statistically significant, children with ADHD and Conduct Disorder Behavior exhibited stronger performance with response control and attention skills than children with ADHD only. When the modality of presented material was compared, children with ADHD plus Conduct Disorder Behavior demonstrated more success with visual material compared to auditory material. Test results as measured by the BASC parent checklist indicate that parental perceptions of children with ADHD plus Conduct Disorder Behavior were significantly more negative (p = 0.02) compared to children with ADHD only. These test results suggest that children with ADHD plus Conduct Disorder Behavior exhibit both behavioral differences and a unique neurological profile compared to children with ADHD only. Children with ADHD plus Conduct Disorder Behavior may represent a separate clinical group, requiring different treatment strategies.