Een twee-trajectenmodel voor de ontwikkeling van anti-sociaal gedrag bij kinderen met ADHD. / A two-track model for the development of antisocial behavior in children with ADHD

Describes a model based on 2 developmental pathways which both result in the comorbidity of attention deficit hyperactivity disorder (ADHD) and conduct disorder (CD). It is suggested that disruptive behavior in preschool children can be differentiated according to aggressive and non-aggressive problem behaviors. Each group has its characteristic risk factors and specific developmental risks for childhood and adolescence. Both groups are vulnerable for developing ADHD with comorbid CD. It is also suggested that these comorbid subgroups are distinctive in their symptoms, which has various implications for treatment. The antisocial behavior of the covert-aggressive group has a late onset, while CD in the overt-aggressive group has an early onset. The non-aggressive (covert) antisocial behaviors are indirectly caused by the consequences of ADHD, such as negative parent-child interactions, school problems, peer rejection, drug abuse, and interaction with antisocial people. The aggressive antisocial behaviors have their origin in early childhood. These children are at great risk for later psychosocial maladjustment. The members of this group often come from dysfunctional families, where family treatment seems the treatment of 1st choice. The nonaggressive group may be more responsive to medication.