Pathways

The path from childhood conduct disorder to poor adult outcome is neither inevitable nor linear.

Different sets of influences impinge as the individual grows up and shape the life-course. Many of these can accentuate problems. Thus a toddler with an irritable temperament and short attention span may not learn good social skills if he is raised in a family lacking them, and where he can only get his way by behaving antisocially and grasping for what he needs. At school he may fall in with a deviant crowd of peers, where violence and other antisocial acts are talked-up and give him a sense of esteem. His generally poor academic ability and difficult behaviour in class may lead him to truant increasingly, which in turn makes him fall further behind in education. He may then leave school with no qualifications and fail to find a job, and resort to drugs. To fund his drug habit he may resort to crime and, once convicted, find it even harder to get a job. From this example, it can be seen that adverse experiences do not only arise passively and independently of the young person's behaviour; rather, the behaviour predisposes them to end up in risky and damaging environments. Consequently, the number of adverse life events experienced is greatly increased. (48> The path from early hyperactivity into later conduct disorder is also not inevitable. In the presence of a warm supportive family atmosphere it is far less likely than if the parents are highly critical and hostile.

Other influences can, however, steer the individual away from an antisocial path. Examples are being separated from a deviant peer group, marrying a non-deviant partner, moving away from a poor neighbourhood, and military service which imparts skills (but not harsh boot camps).

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