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This research was supported by the Intramural Research Program of the NIH NIMH.
The availability of functional imaging methodologies occurred relatively recently. Although the earliest techniques (e.g., positron emission tomography [PET]) were not suitable for child and adolescent populations because they rely on radioactive isotopes, more recent methodologies, such as functional magnetic resonance imaging (fMRI), can be used with younger participants without major risk. Of course, the field remains in its infancy, and when writing this review, we have had to rely on a variety of studies with adult populations and infer results that we anticipate with child and adolescent samples. However, it is a time of considerable and rapid advance, and thus, the gaps in our knowledge base will likely soon be filled.
The overarching goal of this review is to help understand the neurocognitive impairment(s) that increase the risk for antisocial behavior and thus may incur the Diagnostic and Statistical Manual for Mental Disorders (DSM; American Psychiatric Association, 1994) psychiatric diagnoses of oppositional defiant disorder (ODD) and conduct disorder (CD). The persistent feature of ODD is a pattern of persistently negativistic, hostile, defiant, provocative, and disruptive behavior, which is clearly outside the normal range of behavior for a child of the same age in the same sociocultural context. There is frequently low frustration tolerance. The persistent feature of CD is behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of, for example, aggression, property destruction or theft. These diagnoses are partly age dependent. ODD is usually diagnosed before the age of 9-10 years. CD is usually diagnosed after the age of 9 years. Neither can be diagnosed after the age of 18 years when a diagnosis of antisocial personality disorder (APD) may be warranted.
Although not necessarily the consensus view, many authors consider individuals meeting the criteria of CD and ODD to be heterogeneous with respect to the pathology causing their disorder (Blair, Mitchell, & Blair, 2005; Frick & White, 2008; Steiner & Remsing, 2007). This heterogeneity in causal pathology is arguably reflected in the extent of comorbidity of CD and ODD with other disorders (in some samples up to 80%; Steiner & Remsing, 2007). Many diagnoses are...