Familiarity with the clinical course of a disorder by treatment providers could potentially lead to early recognition of the syndrome and may help to guide the format and timing of prevention and intervention strategies. According to the DSM definitions, the clinical course of ASPD typically begins in early childhood, with one study suggesting that 80% of people with ASPD develop their first symptom by age 11, with boys developing symptoms earlier than girls (Robins, 1966; Robins, 1978). ASPD, as defined by DSM IV and DSM-5, requires a history of childhood conduct disorder (CD). If the behavioral problems persist into adulthood the diagnosis is then changed to ASPD. Of those children who meet criteria for CD, 25% - 40% eventually meet criteria for ASPD depending on the population studied (Nock et al., 2006; Robins, 1978; Rubin, 2020).
