Conduct Disorder
Definition |Causes | Who is affected? | Symptoms | How is it diagnosed? | Treatment | Prevention | Contact us
What is conduct disorder (CD)?
Conduct disorder is a behavior disorder, sometimes diagnosed inchildhood, that is characterized by antisocial behaviors whichviolate the rights of others and age-appropriate social standardsand rules.
Antisocial behaviors may include irresponsibility, delinquentbehaviors, violating the rights of others (such as theft) and / orphysical aggression toward others (such as physical assault orrape). These behaviors sometimes occur together, however, one orseveral may occur without the other(s).
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What causes conduct disorder?
There are many factors that can contribute to the development ofa conduct disorder. Neuropsychological testing has shown thatchildren and adolescents with conduct disorders seem to have animpairment in the frontal lobe of the brain that interferes withtheir ability to plan, avoid harm and learn from negativeexperiences.
Children or adolescents from disadvantaged, dysfunctional anddisorganized home environments are more likely to develop conductdisorders. Social problems and peer group rejection have been foundto contribute to delinquency also. Children and adolescentsexhibiting delinquent and aggressive behaviors have distinctivecognitive and psychological profiles when compared to children withother mental health problems and control groups.
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Who is affected by conduct disorder?
Approximately 6 percent of children have conduct disorders. Thedisorder 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 disordersoften have other psychiatric problems as well. These otherpsychiatric conditions may contribute to the development of theconduct disorder. The prevalence of conduct disorders has beenobserved to increase over recent decades. Aggressive behavior isthe reason for one-third to one-half of the referrals made to childand adolescent mental health services.
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What are the symptoms of conduct disorder?
Most symptoms seen in adolescents with conduct disorder alsooccur at times in adolescents without this disorder. However, inadolescents with conduct disorder, these symptoms occur morefrequently and interfere with learning, school adjustment and,sometimes, with the adolescent's relationships withothers.
The following are the most common symptoms of conduct disorder.However, each adolescent may experience symptoms differently. Thefour main groups of behaviors include the following:
- Aggressive Conduct
Aggressive conduct causes or threatens physical harm to others and may include the following: - 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 the following: - Vandalism; intentional destruction to property
- Arson
- Deceitfulness
Deceitful behavior may include the following: - Lying
- Theft
- Shoplifting
- Delinquency
- Violation of Rules
Violation of ordinary rules of conduct or age-appropriate norms may include the following: - Truancy (failure to attend school)
- Running away
- Staying out at night past curfew
The symptoms of conduct disorder may resemble other medicalconditions or behavioral problems. Always consult your adolescent'sphysician for a diagnosis.
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How is conduct disorder diagnosed?
An adolescent medicine physician, child and adolescentpsychiatrist or a qualified mental health professional usuallydiagnoses conduct disorders in adolescents. A detailed history ofthe adolescent's behavior from parents and teachers, observationsof the adolescent's behavior and, sometimes, psychological testingcontribute to the diagnosis. Parents who note symptoms of conductdisorder in their adolescent can help by seeking an evaluation andtreatment early. Early treatment may prevent future problems.
Further, conduct disorder often coexists with other mentalhealth disorders, including mood disorders, anxiety disorders,substance abuse, attention-deficit / hyperactivity disorder andlearning disorders, increasing the need for early diagnosis andtreatment. Consult your adolescent's physician for moreinformation.
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Treatment for Conduct Disorder
Specific treatment for adolescents with conduct disorders willbe determined by your adolescent's physician based on:
- Your adolescent's age, overall health and medical history
- Extent 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. - 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.
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Prevention of Conduct Disorder
Some experts believe that a developmental sequence ofexperiences occurs in the development of conduct disorder. Thissequence may start with ineffective parenting practices, followedby academic failure and poor peer interactions. These experiencesthen often lead to depressed mood and involvement in a deviant peergroup. Other experts, however, believe that many factors, includingchild abuse, genetic susceptibility, history of academic failure,brain damage and / or a traumatic experience influence theexpression of conduct disorder.
Early detection and intervention into negative family and socialexperiences may be helpful in disrupting the development of conductdisorder.
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Contact us
For additional information on this or any Health Topic, pleasecall the Family Resource Center, 513-636-7606, or yourpediatrician.
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rev. 5/06
