four domains of risk that are necessarily interrelated to produce early-onset conduct disorder. These are (1) contributions from the child's organic, biological difficulties (such as difficult temperament and abnormal psychophysiology); (2) factors in the family ecology and family adversity, disruption, and stress; (3) ineffective parental management and socialization; and (4) problems in early parent-child relations (such as insecure attachment in infancy and the preschool years).

It appears that it is the transactional interaction between factors in the child (such as genetic and temperamental factors) and factors in the family environment (any factor that produces a lack of responsivity in the primary caretaker) that produces aggressiveness in early childhood. Aggressive children are apt to be rejected by parents, peers, and teachers. This sets up further negative interaction cycles.

Just as the accumulation of risk factors influences outcomes in childhood, it also influences outcomes further on in the life cycle. A 25-year follow-up study of children with attention deficit hyperactivity disorder by Hechtman has suggested that a combination of measures influence outcome in adulthood (Hechtman, 1991; Weiss and Hechtman, 1986). These include (1) individual personal characteristics (such as IQ, health, and temperament); (2) family parameters (such as socioeconomic status, family composition, mental health of family members, emotional climate of the home, and childrearing practices); and (3) the larger social and physical environment.

Protective Factors

The protective factors that reduce the chance that a child at risk will develop conduct disorder include good intelligence; easy disposition; an ability to get along well with parents, siblings, teachers, and peers; an ability to do well in school; having friends; being competent in non-school skill areas (Rae Grant, Thomas, Offord, and Boyle, 1989); and having a good relationship with at least one parent and with other important adults (Werner and Smith, 1992).

The presence of a positive warm bond between parent and child in early childhood can lead to greater compliance and reciprocity. This good relationship allows the child to empathize with another person 's affective state, and, according to Minde (1992), is an essential prerequisite for prosocial behavior. In contrast, aggressive children tend to misperceive frustration in others as hostility directed toward them, and then respond aggressively (Dodge, 1980). Involvement in extracurricular activities for which recognition is received (Rae Grant et al., 1989), the support of other significant adults in the community (Werner and

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