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Conduct Problems, Substance Use and Social Anxiety: A Developmental Study of Recovery and Adaptation

Columbia University, USA

Hans Steiner

Stanford University, USA

To evaluate the individual developmental significance of disruptive behavior during adolescence, a 16-year-old boy in day treatment for substance abuse was examined. Over the course of 12 weeks, this youth was evaluated in group, individual and family therapy. Before developing conduct disorder symptoms and substance abuse, he was found to have a biological predisposition toward anxiety, and a premorbid history of anxiety and depression. The role of these conduct problems and substance use in alleviating this youth’s isolation and loneliness are considered, as are the maladaptive consequences of these behaviors. The importance of developmental factors in the determination of his behavior, and their significance in treatment planning, are discussed. Although the current definitions of conduct and substance use disorders are useful and valid, attention to individual contextual factors may enhance the clinical utility of these categories.

Key Words: conduct disorder • depression • developmental psychopathology • social phobia • substance abuse

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