06.Conduct Disorder

06.1.What is a Conduct Disorder?

Conduct disorder involves problems in the self-control of emotions andbehaviors, and results in impulsive actions that violate age-appropriate socialstandards and rules, such as lying and running away, or violations of therights of others, such as bullying, theft. Children and adolescents withconduct disorder are often viewed as “bad” or “delinquents” rather than youthin need of help.

06.2.What Causes Conduct Disorder?

There are many factors that can contribute to the development of a conductdisorder. Neuropsychological testing has shown that children and adolescentswith conduct disorders seem to have impairment in the frontal lobe of the brainthat interferes with their ability to plan, avoid harm and learn from negativeexperiences.

 Children or adolescents from disadvantaged, dysfunctional and disorganizedhome environments are more likely to develop conduct disorders. Social problemsand peer group rejection have been found to contribute to delinquency also.Children and adolescents exhibiting delinquent and aggressive behaviors havedistinctive cognitive and psychological profiles when compared to children withother mental health problems and control groups.

06.3.Who Is Affected by Conduct Disorder?

The disorder is more common in boys than in girls by a 4:1 ratio and isbelieved to be more prevalent in urban (city) rather than in rural (country)settings. Children and adolescents with conduct disorders often have otherpsychiatric problems as well. These other psychiatric conditions may contributeto the development of the conduct disorder. The prevalence of conduct disordershas been observed to increase over recent decades. Aggressive behavior is thereason for one-third to one-half of the referrals made to child and adolescentmental health services.

06.4.What Are the Symptoms of Conduct Disorder?

Most symptoms seen in adolescents with conduct disorder also occur attimes in adolescents without this disorder. However, in adolescents withconduct disorder, these symptoms occur more frequently and interfere withlearning, school adjustment and, sometimes, with the adolescent's relationshipswith others.

The following are the most common symptoms of conduct disorder. However,each adolescent may experience symptoms differently. The four main groups ofbehaviors include:

 Aggressive Conduct

Aggressive conduct causes or threatens physical harm to others and may include:

 Intimidating behavior

Bullying

Physical fights

Cruelty to others or animals

Use of a weapon(s)

Forcing someone into sexual activity, rape or molestation

Destructive Conduct

Destructive conduct may include:

 Vandalism; intentional destruction to property

Arson

Deceitfulness

Deceitful behavior may include:

 Lying

Theft

Shoplifting

Delinquency

Violation of Rules

Violation of ordinary rules of conduct or age-appropriate norms mayinclude:

 Truancy (failure to attend school)

Running away

Staying out at night past curfew

The symptoms of conduct disorder may resemble other medical conditions orbehavioral problems. Always consult your adolescent's physician for adiagnosis.

 06.5.How Is Conduct Disorder Diagnosed?

There is no specific test for conduct disorder. An adolescent medicinephysician, child and adolescent psychiatrist or a qualified mental healthprofessional gathers a detailed history of the adolescent's behavior fromparents and teachers, and observes the adolescent's behavior and, sometimesrequests psychological testing to contribute to the diagnosis. Parents who seesymptoms of conduct disorder in their adolescent can help by seeking anevaluation and treatment early.

 Conduct disorder often looks like or occurs with other mental healthdisorders, including mood disorders, anxiety disorders, substance abuse,attention-deficit / hyperactivity disorder and learning disorders, increasingthe need for early diagnosis and treatment. Consult your adolescent's physicianfor more information.

 Treatment for Conduct Disorder

Early treatment may prevent future problems. It is important for theentire family to be involved in treatment. The child or adolescent with conductdisorder can have problems with trust toward authority and may not want tocooperate, which can make treatment difficult. The course of treatment will bedetermined by:

 Your adolescent's age, overall health and medical history

Severity of your adolescent's symptoms

Your adolescent's tolerance for specific medications, procedures ortherapies

Expectations for the course of the condition

Treatment May Include

Cognitive-behavioral Approaches

The goal of cognitive-behavioral therapy is to improve problem solvingskills, communication skills, impulse control and anger management skills.

 Family Therapy

Family therapy is often focused on making changes within the familysystem, such as improving communication skills and family interactions. Thefamily may need help carrying out special education or behavior plans in thehome and at school.

 Peer Group Therapy

Peer group therapy is often focused on developing social skills andinterpersonal skills.

 Medication

Medication can help reduce aggression and may be used if other symptoms ordisorders are present, such as impulsivity or trouble paying attention.

 06.6.Prevention of Conduct Disorder

Some experts believe that a developmental sequence of experiences occursin the development of conduct disorder. This sequence may start withineffective parenting practices, followed by academic failure and poor peerinteractions. These experiences then often lead to depressed mood andinvolvement in a deviant peer group.

 Other experts, however, believe that many factors, including child abuse,genetic susceptibility, history of academic failure, brain damage and / or atraumatic experience influence the expression of conduct disorder.

 Early detection and intervention into negative family and socialexperiences may be helpful in disrupting the development of conduct disorder.