Low Salivary Cortisol and Persistent Aggression in Boys Referred for Disruptive Behavior

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Abstract
CONDUCT disorder (CD)1,2 refers to a pattern of antisocial behavior in childhood or adolescence that lasts at least 6 months but which in some cases becomes a lifelong personality style. Two types3 are operationally distinguished by whether the first symptom appears before or after age 10 years. In many cases, adolescent-onset CD is confined to a stage of dalliance with delinquent behavior (often with the encouragement or coparticipation of peers) and remits with continued socialization and maturation.4-6 The more severe childhood-onset CD is typically marked by more aggressiveness, more severely disturbed peer relations, and a lengthier course than seen with adolescent-onset CD.7 Childhood-onset CD is notoriously difficult to treat. Children who exhibit this pattern often sustain severely antisocial behavior into the fourth or fifth decade of life, along the way accounting for a hugely disproportionate percentage of total crimes committed and acts of victimization on others.

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