Epidemiology Prevalence according to age Preschool children

The prevalence of serious oppositional behaviour in preschool children has been found to be between 4 and 9 per cent. ^M1.) School-age children

Oppositional disorders are found in 6 to 12 per cent, whereas more severe conduct disorders are less frequent, occurring in 2 to 4 per cent of children. (12,1 ,1 and I5 Adolescents

The rate of oppositional disorders has been rated as being as high as 15 per cent, (!°) and that of severe conduct disorders between 6 and 12 per cent. Early-onset versus adolescent-onset patterns Early onset

There are major differences between early and adolescent onset. Those with an early onset display defiant and aggressive behaviour before the age of 8, but it typically begins around 3 years of age. They go on to accrue increasingly antisocial behaviours as they grow older. However, not all young children with this early-onset pattern of problems progress to more severe difficulties later in childhood. Only about half persist; the remainder improve. Compared with the adolescent-onset group, the early-onset children already at 3 years of age show a more difficult temperament (restlessness, inattention, negativity, irritability, etc.). At school age this group have cognitive, language, and motor deficits, reading difficulties, adverse family contexts, and poor parenting. By the age of 18 they have fewer friends and feel socially alienated, victimized, and are callous and suspicious. They continue behaving antisocially as adults. Some have called this group 'early onset-lifetime persistent'.(l6)

Adolescent onset

About three times more common are the adolescent-onset group who have not shown significant antisocial behaviour earlier in their lives. Moreover by their early twenties they have mostly stopped behaving antisocially, so some call them an 'adolescence-limited' group. ^„ft The overall rate of arrests and convictions is somewhat lower than the childhood-onset type, there are more girls (about 2:1 instead of 4:1 for childhood onset). Their behaviour tends to be less aggressive and violent, less impulsive, they have fewer cognitive and neuropsychological deficits, tend to come from less dysfunctional family environments, and tend to have more adaptive social qualities. Crucially, the adolescent-onset group are more likely to stop offending in early adulthood than the early-onset group. Only a small group of individuals (less than 10 per cent of the total) commence persistent antisocial activity in adulthood.

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