Adult Retrospective Reports of Externalizing Behavior: Distinct Dimensions and Key Associations for Past Conduct Disorder Ratings

Abstract

Many studies have examined the correlates and factor structure of the conduct disorder (CD) criteria in child and adolescent samples, finding that the set of behaviors defining CD are heterogeneous in nature. However, the factor structure of the CD criteria has not been examined in adults, even though the CD criteria often must be assessed retrospectively when diagnosing antisocial personality disorder (ASPD) in adulthood. To advance understanding of assessing CD behaviors retrospectively in adults, we present factor analytic and correlational results from a large sample of adult outpatients (N = 1793). Our results indicate that CD ratings are defined by at least two latent factors of Rule Violation (e.g., curfew violations) and Aggression (e.g., using a weapon). Ratings of aggressive behaviors tended to show somewhat stronger associations with other externalizing psychopathology than did rule violation ratings. Furthermore, CD dimensions identified in our factor analyses correlated robustly with ASPD but correlated just as strongly with diagnostic ratings of other externalizing psychopathology such as substance use history. We discuss how these findings from a large adult sample parallel results from child and adolescent samples indicating that the CD criteria are defined by distinct dimensions. Furthermore, we interpret these findings within the context of other recent studies suggesting that a CD history may not be a specific precursor to ASPD in adulthood.