What Happens to “Bad” Girls? A Review of the Adult Outcomes of Antisocial Adolescent Girls

OBJECTIVE: The purpose of this article is to review critically the data on the adult outcomes of adolescent girls with antisocial behavior. METHOD: Five literature databases were searched for studies on the adult outcomes of girls with either conduct disorder or delinquency. RESULTS: Twenty studies met the inclusion criteria. As adults, antisocial girls manifested increased mortality rates, a 10- to 40-fold increase in the rate of criminality, substantial rates of psychiatric morbidity, dysfunctional and often violent relationships, and high rates of multiple service utilization. Possible explanations for these findings include a pervasive biological or psychological deficit or baseline heterogeneity in the population of antisocial girls. CONCLUSIONS: This review establishes that female adolescent antisocial behavior has important long-term individual and societal consequences. At present, there are insufficient data to enable us to prevent these outcomes or treat them if they occur. Future research should include cross-sectional studies detailing the phenomenology of female antisocial behavior and longitudinal investigations that not only track development into adulthood but also explore the role of potential modifiying variables such as prefrontal lobe dysfunction and psychiatric comorbidity. (Am J Psychiatry 1998; 155:862–870)