disorder—particularly those with adolescent-onset type and those with few and milder
symptoms—achieve adequate social and occupa tional adjustment as adults. However, the
early-onset type predicts a worse prognosis and an increased risk of criminal behavior,
conduct disorder, and substance-related disord ers in adulthood. Individuals with conduct
disorder are at risk for later mood disorders, anxiety disorders, posttraumatic stress dis-
order, impulse-control disord ers, psychotic disorders, so matic symptom disorders, and
substance-related disorders as adults. 
Symptoms of the disorder vary with age as the individual develops increased physical
strength, cognitive abilities, and sexual ma turity. Symptom behaviors that emerge first
tend to be less serious (e.g., lying, shoplifti ng), whereas conduct problems that emerge last
tend to be more severe (e.g., rape, theft wh ile confronting a victim ). However, there are
wide differences among individuals, with some enga ging in the more damaging behaviors
at an early age (which is predictive of a worse prognosis). When individuals with conduct
disorder reach adulthood, symptoms of aggres sion, property destruction, deceitfulness,
and rule violation, including violence against co-workers, partners, and children, may be ex-
hibited in the workplace and the home, such that antisocial personality disorder may be
considered. 
Risk and Prognostic Factors
Temperamental. Temperamental risk factors include a difficult undercontrolled infant
temperament and lower-than-average intelligence , particularly with regard to verbal IQ.
Environmental. Family-level risk factors include parental rejection and neglect, inconsis-
tent child-rearing practices, harsh discipline, physical or sexual abuse, lack of supervision,
early institutional living, freque nt changes of caregivers, large family size, parental criminal-