Antisocial Behavior in Children with ADHD: Clinical Presentation, Epidemiology, Etiology, Prognosis and Treatment Approaches

摘要

This chapter provides a review of the literature pertaining to the clinical presentation, epidemiology, etiology, prognosis and treatment of Oppositional Defiant Disorder (ODD) and antisocial behavior in children with Attention Deficit Hyperactivity Disorder (ADHD). The pervasive effects of ODD in children with ADHD may have an impact on their cognitive, behavioral, emotional and academic performances. ODD type behavior in ADHD school-aged children is characterized by talking back to adults, rejection by peers and failure in school. Followed into adolescence, some of these children may exhibit a significantly elevated risk for delinquent behaviors such as stealing and disobedient acts. The clinical presentation of antisocial behavior in adults is characterized by the progression of criminal behaviors and severe personality disturbance. A combination of genetic predispositions leading to cognitive deficits, combined with exposure to environmental risk factors contributes to the link between ADHD, ODD and antisocial behavior. Only in some cases, do children with ADHD continue to show these behaviors into adolescence and adulthood. Thus, there is generally a gradual decrease in antisocial behaviors and rates of dysfunctions and they may never be exhibited in later stages. An early intervention that aims to control the symptoms of ADHD and reduce the impact of antisocial and ODD type behavior at each developmental stage should be utilized. These interventions can consist of medication and a variety of psychosocial interventions, such as parent-child therapy, parent training, positive behavioral support, and collaborative problem solving.