What is a Conduct Disorder?
Conduct disorder involves problems in the self-control of emotions and behaviors, and results in impulsive actions that violate age-appropriate social standards and rules, such as lying and running away, or violations of the rights of others, such as bullying and theft. Children and adolescents with conduct disorder are often viewed as “bad” or “delinquents” rather than youth in need of help.
What Causes Conduct Disorder?
Brain injury, past abuse or neglect, a history of trauma, negative family and social experiences, disorganized home life, school failure, and genetic factors can all contribute to the development of a conduct disorder. Neuropsychological testing has shown that children and adolescents with conduct disorders seem to have impairment in the frontal lobe of the brain that interferes with their ability to plan, avoid harm and learn from negative experiences.
Who Is Affected by Conduct Disorder?
The disorder is more common in boys than in girls by a 4:1 ratio and is believed to be more prevalent in urban (city) rather than in rural (country) settings. Children and adolescents with conduct disorders often have other psychiatric problems as well. These other psychiatric conditions may contribute to the development of the conduct disorder. The prevalence of conduct disorders has been observed to increase over recent decades. Aggressive behavior is the reason for one-third to one-half of the referrals made to child and adolescent mental health services.
What Are the Symptoms of Conduct Disorder?
Most symptoms seen in adolescents with conduct disorder can also occur in adolescents without this disorder. However, in adolescents with conduct disorder, these symptoms occur more frequently and interfere with learning, school adjustment and, sometimes, with the adolescent's relationships with others.
The following are the most common symptoms of conduct disorder. However, each adolescent may experience symptoms differently. The four main groups of behaviors 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 may include:
- Truancy (failure to attend school)
- Running away
- Staying out at night past curfew
The symptoms of conduct disorder may resemble other medical conditions or behavioral problems. Always consult your adolescent's physician for a diagnosis.
How Is Conduct Disorder Diagnosed?
There is no specific test for conduct disorder. An adolescent medicine physician, child and adolescent psychiatrist or a qualified mental health professional gathers a detailed history of the adolescent's behavior from parents and teachers, observes the adolescent's behavior, and sometimes requests psychological testing to contribute to the diagnosis. Parents who see symptoms of conduct disorder in their adolescent can help by seeking an evaluation and treatment early.
Conduct disorder often looks like or occurs with other mental health disorders, including mood disorders, anxiety disorders, substance abuse, attention-deficit/hyperactivity disorder and learning disorders, increasing the need for early diagnosis and treatment. Consult your adolescent's physician for more information.
Treatment for Conduct Disorder
Early treatment may prevent future problems. It is important for the entire family to be involved in treatment. The child or adolescent with conduct disorder can have problems with trust toward authority and may not want to cooperate, which can make treatment difficult. The course of treatment will be determined by:
- Your adolescent's age, overall health and medical history
- Severity of your adolescent's symptoms
- Your adolescent's tolerance for specific medications, procedures or therapies
- Expectations for the course of the condition
Treatment May Include
Cognitive-behavioral Approaches
The goal of cognitive-behavioral therapy is to improve problem-solving skills, communication skills, impulse control and anger management skills.
Family Therapy
Family therapy is often focused on making changes within the family system, such as improving communication skills and family interactions. The family may need help carrying out special education or behavior plans in the home and at school.
Peer Group Therapy
Peer group therapy is often focused on developing social skills and interpersonal skills.
Medication
Medication can help reduce aggression and may be used if other symptoms or disorders are present, such as impulsivity or trouble paying attention.
