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J Psychiatr Res. 2011 Dec;45(12):1564-72. doi: 10.1016/j.jpsychires.2011.08.005. Epub 2011 Sep 7.

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

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1
Departments of Community Health Sciences, Psychiatry, and Family Social Sciences, University of Manitoba, S113-750 Bannatyne Avenue, Winnipeg, Manitoba, R3E 0W5, Canada. T_Afifi@umanitoba.ca

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.

[Indexed for MEDLINE]

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