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Conduct Disorder and Antisocial Personality Disorder: Axis of Evil

Conduct Disorder: Axis II Disorder in children/adolescents Persistent pattern of maladaptive behaviors and disregard for age-appropriate rules and norms. . Antisocial Personality Disorder (ASPD). Axis II Disorder: Persistent maladaptive behavior pattern, characterized by disregard for and violation of rights of others, beginning in childhood or early adolescence and continuing into adulthood. DSM-IV requires pre-existing conduct disorder to make this diagnosis. .

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Conduct Disorder and Antisocial Personality Disorder: Axis of Evil

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    1. Conduct Disorder and Antisocial Personality Disorder: Axis of Evil? Frank M. Tims, Ph.D. Ojesh Upadhyay, M.P.H.

    2. Conduct Disorder: Axis II Disorder in children/adolescents Persistent pattern of maladaptive behaviors and disregard for age-appropriate rules and norms.

    3. Antisocial Personality Disorder (ASPD) Axis II Disorder: Persistent maladaptive behavior pattern, characterized by disregard for and violation of rights of others, beginning in childhood or early adolescence and continuing into adulthood. DSM-IV requires pre-existing conduct disorder to make this diagnosis.

    4. ASPD Criteria Age at least 18 Law breaking Enjoy taking risks Don’t think about consequences Lying and deceit Trouble holding job/ staying in school Get in physical fights Don’t care if others get hurt

    5. ASPD Criteria Age at least 18 Law breaking Enjoy taking risks Don’t think about consequences Lying and deceit Trouble holding job/ staying in school Get in physical fights Don’t care if others get hurt

    6. ASPD Runs in families More common among males CD+ADHD increases risk Other co-morbidity increases risk Abuse in childhood increases risk Adolescent AOD use increases risk

    7. Aggressive anti-social behavior among youth is clearly linked to frequency of marijuana use Source: NHSDA Household Survey Data, 1994-1996

    8. Correlates of ASPD (At 30 Months Post Intake)

    9. Correlates of ASPD (At 30 Months Post Intake)

    10. PETSA -Two Longitudinal Samples Baseline to 30 Months Cannabis Youth Treatment (CYT) Study – Adolescent Treatment Models (ATM) – Combined sample N=1,208 Clients age 18+ N=801

    11. Measures - Hyler Scale PDQ-4 and GAIN PDQ-4: DSM-IV criteria of ASPD, plus specification of age and previous conduct disorder GAIN Measures for Conduct Disorder, and Mental Disorders Other measures in GAIN and supplemental scales

    12. Client Characteristics at Baseline

    13. CD Category and Violent Symptoms Cross Tabulation

    14. Conduct Disorder and ASPD

    15. Univariate Predictors of ASPD

    16. Univariate Predictors of ASPD

    17. Univariate Predictors of ASPD

    18. Univariate Predictors of ASPD

    19. Univariate Predictors of ASPD

    20. Univariate Predictors of ASPD

    21. Multivariate Predictors (simplified model)

    22. Multivariate Predictors (simplified model)

    23. Implications for Practitioners Screen for multiple diagnoses/ risk factors Importance of family history Assess recovery environment risk Need to provide systems of care that address these considerations Linkages between systems is needed Need multiple outcome measures Interpret outcomes in the context of the disorder

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