A recent article in Psychiatric Times reports, unsurprisingly, that decades of study on childhood behavioral disorders have reached a near-unanimous conclusion: adolescent psychiatric patients who suffer from reoccurring conduct problems are much more likely to develop personality disorders, particularly those of the anti-social variety, in their adult lives. Some of the earliest studies on the topic made the logical assertion that adult psych patients with personality afflictions probably had behaviorial issues in childhood and adolescence. They found that many adolescents hospitalized for psychiatric reasons did not later qualify as anti-social, but later researchers argued that, by focusing on only one aspect of adult personality disorders, these study undermined their own conclusions. Studies testing for other variables like substance abuse, crime, and general mental health registered a greater degree of correlation between childhood symptoms and adult problems.
Some of the more interesting topics raised by other studies include a noted gender disparity. Anti-social personality disorder is more likely to develop among boys, where disruptive girls often go on to suffer from borderline personality disorder. Also, adolescents who display symptoms of one disorder have a great chance of multiple diagnoses, qualifying for several Axis I clinical disorders, including depression, paranoia, and passive-aggressive tendencies. In summary:
Available research demonstrates a high prevalence of personality disorder in adults who had conduct disorder or disruptive behavior disorder as children. Disruptive behavior disorder—or, more specifically, conduct disorder—in childhood and adolescence significantly increases the risk of adult personality disorder, with one third to two thirds of these young persons having at least 1 personality disorder (most often antisocial personality disorder) at adult follow-up. In addition, conduct disorder in younger cohorts may be at least partly responsible for rising rates of later nonexternalizing disorders. These findings support the view of conduct disorder as a complex illness with extensive implications for later adult mental health. On a more positive note, primary prevention and early intervention in conduct disorder may be expected to reduce the rates of a broad range of later disorders.
Of course, the fluctuating emotional states of children and teenagers are very difficult to measure with precision, and the subjects of these studies were already undergoing clinical treatment as adolescents, which means that the discouraging patterns recorded will, hopefully, not hold true for children with lesser behavioral problems. Definitive conclusions on this subject clearly require further, more extensive studies which consider all the varieties of psychiatric affliction.
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