Conduct Disorder Among Adolescent Alcohol and Drug Abusers

Objective: Delinquent behavior is prevalent among adolescents who abuse alcohol and other drugs. The present study examined the extent to which conduct disorder type behavior predates substance use involvement among 166 adolescents in treatment for alcohol and other drug abuse, and the prognostic significance of conduct disorder behaviors for the clinical course of teens during the first 2 years following treatment.

Method: This was prospective longitudinal study of 166 alcohol and other drug abusing adolescents, 67 girls and 99 boys, averaging 15.9 years of age. Consecutive admissions were recruited from two adolescent inpatient alcohol and drug treatment facilities. Subjects were interviewed during treatment and again at 6 months and 1 and 2 years posttreatment.

Results: Whereas the vast majority (95%) of teens entering alcohol and drug abuse treatment programs displayed a history of conduct disorder type behavior, only 47% met DSM-III-R criteria when behaviors directly or indirectly related to alcohol and drug involvement were excluded. Boys displayed a greater number of conduct disorder behaviors than girls, but the relative incidence of these behaviors was comparable across sexes. A history of conduct disorder independent of alcohol and drug involvement was related to both greater posttreatment alcohol involvement and a later diagnosis of antisocial personality disorder.

Conclusions: This study shows that a significant portion of the delinquent behaviors found in adolescents treated for alcohol and drug abuse is secondary to involvement with alcohol and other drugs. A primary diagnosis of conduct disorder was found to be associated with poorer clinical course in the first 2 years following treatment.