Ob jec tive: To re view pub lished works on the epi de mi ol ogy, risk fac tors, pro tec tive fac tors, ty polo gies, and ge netic as pects of conduct dis or der (CD).
Method: Find ings from refe reed jour nal ar ti cles and cur rent texts in the field are briefly sum ma rized.For our dis cus sion is on no tri fling mat ter, but on the right way to con duct our lives.
Plato, The Re pub licT his ar ti cle sum ma rizes rele vant find ings on epi de mi ology, en vi ron mental con tri bu tions, sub types, and ge netic as pects of CD. Other im por tant as pects, such as as sess ment, comor bidi ties, neu rop sy chi at ric vul ner abili ties, and treatment have been re cently well-reviewed (1-3). This pa per updates the reader on cur rent think ing about psy cho so cial risk and pro tec tive fac tors and hints at emerg ing bio logi cal risk fac tors, such as ge net ics. We con sulted origi nal ar ti cles and re views in both Med line and Psycinfo, par ticu larly those published over the last 15 years. For fur ther in for ma tion, please con sult the origi nal ref er enced works. Clini cal and pub lic health im pli ca tions are in di cated, where ap pro pri ate.
DefinitionsCD is 1 of 3 dis rup tive be hav iour dis or ders (4), the oth ers being op po si tional de fi ant dis or der (ODD) and attention-deficit hy per ac tiv ity dis or der (ADHD). As in di cated in the DSM-IV, CD con notes a se vere ex ter nal iz ing dis or der com pris ing se rious ag gres sive and an ti so cial be hav iours such as fight ing, bul ly ing, cru elty, rob bery, forc ing sex ual ac tiv ity, fire set ting, theft, con ning, tru ancy, and other rule vio la tions. An ti so cial be hav iour de scribes ac tions con trary to the rights of oth ers and rules of so ci ety. Ado les cent an ti so cial be hav iour that breaks the law (and gets caught) may re sult in con tact with po lice and the courts; the terms "de lin quent" and "young offender48 would then ap ply. Thus, CD rep re sents a con stel lation of an ti so cial be hav iours; a sub group of youths with se vere CD will be de lin quents (5). We will also use the terms "ag gres sion" and "vio lence" in this over view. Ag gres sion is de fined as out ward de struc tive be hav iour that re sults from the con flu ence of longer-term fac tors (for ex am ple, bio logi cal, psy cho logi cal and per son al ity, fam ily, peer, school, and commu nity), short-term in flu ences (for ex am ple, in ter nal states of an ger, bore dom, or in toxi ca tion) and situa tional op por tu nity. Vio lence-a par ticu lar form of overt and in ten tional ag gression-uses or credi bly threat ens to use physi cal force such as beat ing, kick ing, chok ing, us ing a weapon, forc ing sex, and throw ing ob jects.