Oppositional defiant disorder and conduct disorder are classified as disruptive disorders. However, they show a wide range of associations with other psychopathological features. Disturbances of emotional regulation, impulse control, narcissism, and paranoid cognitive style may shape the behavioural picture. On the basis of the Heidelberg School Study (n = 6085) those 15 yr old students with externalising behaviour disturbances were analysed regarding internalising behaviour problems, deliberate self harm, suicidal behaviour, living situation, and family problems. Developmental trajectories from infant temperament to adolescent behaviour will be outlined and therapeutic measures like parent training, patient focused cognitive behavioural therapy and multisystemic family interventions will be described on the basis of meta-analytic reviews.