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Classes of conduct disorder symptoms and their life course correlates in a US national sample

Published online by Cambridge University Press:  27 September 2011

J. Breslau ,
N. Saito ,
D. J. Tancredi ,
M. Nock  and
S. E. Gilman
J. Breslau*
Affiliation:
RAND Corporation, Pittsburgh, PA, USA
N. Saito
Affiliation:
University of California, Davis, Center for Health Policy and Research, Sacramento, CA, USA
D. J. Tancredi
Affiliation:
University of California, Davis, Department of Pediatrics, Sacramento, CA, USA
M. Nock
Affiliation:
Harvard University, Department of Psychology, Cambridge, MA, USA
S. E. Gilman
Affiliation:
Harvard School of Public Health, Department of Human Development, Society and Health, Boston, MA, USA
*
*Address for correspondence: Dr. J. Breslau, RAND Corporation, 4570 5th Ave # 600, Pittsburgh, PA 15213–2665, USA. (Email: jabreslau@ucdavis.edu)
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Abstract

Background

Population data on conduct disorder (CD) symptoms can help determine whether hypothesized subtypes of CD are sufficiently disparate in their familial, psychiatric and life course correlates to distinguish separate diagnostic entities.

Method

Latent class analysis (LCA) of CD symptoms occurring before age 15 was conducted in a national sample of adults aged 18–44 years from the National Epidemiological Study of Alcohol and Related Conditions. Associations of latent class membership with parental behavior problems, onset of psychiatric disorders and anti-social behaviors after age 15, adolescent life events (e.g. high school drop-out), and past-year life events (e.g. divorce/separation, bankruptcy) were estimated.

Results

LCA identified a no-CD class with low prevalence of all symptoms, three intermediate classes – deceit/theft, rule violations, aggression – and a severe class. The prevalence of CD, according to DSM-IV criteria, was 0% in the no-CD class, between 13.33% and 33.69% in the intermediate classes and 62.20% in the severe class. Latent class membership is associated with all the familial, psychiatric and life course outcomes examined. Among the intermediate classes, risk for subsequent mood/anxiety disorders and anti-social behavior was higher in the deceit/theft and aggressive classes than in the rule violations class. However, risk for adolescent life events is highest in the rule violations class.

Conclusions

CD symptoms tend to occur in a partially ordered set of classes in the general population. Prognostically meaningful distinctions can be drawn between classes, but only at low levels of symptoms.

Keywords

Conduct disorderepidemiologylatent class analysis
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 5 , May 2012 , pp. 1081 - 1089
Copyright
Copyright © Cambridge University Press 2011

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