The assessment and treatment of disruptive behavior disorders comorbid with cannabis use disorder

Disruptive behavior disorders (DBDs), including oppositional defiant disorder and conduct disorder, frequently co-occur with cannabis use disorder (CUD). Youth presenting with this comorbidity often show higher levels of family conflict, school failure, and juvenile justice involvement than peers with a single diagnosis. Research highlights the need for integrated approaches that address both behavioral regulation and substance misuse (Burke et al., 2010; Pardini & Fite, 2010). This presentation reviews recent literature on assessment tools, biopsychosocial risk factors, and evidence-based treatments. Emphasis is placed on structured interviews, behavior checklists, and validated substance use screeners for accurate differential diagnosis. Treatment approaches were evaluated based on fidelity, developmental appropriateness, and system-level coordination. Findings show that integrated, multi-systemic interventions are most effective. Cognitive-behavioral therapy (CBT) improves problem-solving and emotion regulation; multisystemic therapy (MST) reduces delinquency and substance use by targeting family and peer systems; motivational interviewing (MI) enhances readiness for change; and contingency management strategies reduce cannabis use. Family involvement consistently strengthens treatment outcomes, and early intervention predicts reduced recidivism and improved long-term functioning (Henggeler et al., 2009; Waldron & Turner, 2008).

In conclusion, youth with DBDs comorbid with CUD require coordinated, evidence-based care that integrates clinical, family, school, and community systems. Early identification and holistic assessment are essential. The most effective interventions are those that are flexible, culturally responsive, and grounded in collaboration across multiple service systems.