THE RELATION BETWEEN CHILDHOOD ATTENTION-DEFICIT HYPERACTIVITY DISORDER AND ADULT ANTISOCIAL-BEHAVIOR REEXAMINED - THE PROBLEM OF HETEROGENEITY

A number of authors have argued that childhood attention-deficit hyperactivity disorder (ADHD) is related to adult disorders characterized by antisocial behavior, in particular antisocial personality disorder (ASPD). The results of longitudinal, family and adoption, neuropsychological, psychophysiological, and other laboratory studies relevant to the relation between childhood ADHD and adult antisocial behavior are reviewed. Findings from each of these areas indicate that childhood ADHD is associated with adult disorders characterized by antisocial behavior. Nevertheless, the majority of studies reviewed fail to consider the hypothesis that this association is an artifact of the overlap between ADHD and conduct disorder (CD); hence, this association may simply reflect the persistence of antisocial behavior from childhood to adulthood. Thus, widespread claims of a poor outcome for ADHD children, and of a shared etiology for ADHD and ASPD, appear to be oversimplified and misleading. Future research in this area must include a CD group and a mixed ADHD/CD group to permit proper inferences regarding the link between childhood ADHD and adult antisocial behavior. Potential mechanisms underlying the association between ADHD and CD, and research designs for elucidating these mechanisms, are discussed. © 1990.