An examination of the relation between conduct disorder, childhood and adulthood traumatic events, and posttraumatic stress disorder in a nationally representative sample

Abstract

Background Clinical data has indicated that exposure to trauma and meeting diagnostic criteria for posttraumatic stress disorder (PTSD) are common among individuals with a history of conduct disorder. However, these relationships have not been adequately examined in a population-based sample. Methods Data were drawn from Wave 2 of the U.S. National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) collected in 2004–2005 ( n = 34,653, response rate = 86.7%). Multivariate logistic regression analyses were conducted to examine relations between conduct disorder, traumatic life events, and PTSD in the full sample, and separately for males and females. Results The main findings indicate that childhood maltreatment was associated with conduct disorder (Adjusted Odds Ratio [AOR] ranging from 2.4 to 4.7) after adjustment for sociodemographic variables. Additionally, respondents with a history of conduct disorder compared to respondents without conduct disorder were more likely to report experiencing any traumatic event (AOR = 2.7, 95% CI = 2.0–3.6) and PTSD (AOR = 2.2, 95% CI = 1.8–2.7) after adjusting for sociodemographic variables. Although sex differences were noted, conduct disorder was associated with the greatest odds of assaultive violence for males and females. The majority of individuals (72.9%) diagnosed with both conduct disorder and PTSD developed conduct disorder symptoms before PTSD symptoms. Conclusions Results of this study provide the first known sex-stratified examination of the relationship between conduct disorder, traumatic events, and PTSD in a large, population-based sample of adults and are consistent with clinical impressions. Policy and clinical implications are discussed.