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, 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?
There are many factors that can 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.
Children or adolescents from disadvantaged, dysfunctional and disorganized home environments are more likely to develop conduct disorders. Social problems and peer group rejection have been found to contribute to delinquency also. Children and adolescents exhibiting delinquent and aggressive behaviors have distinctive cognitive and psychological profiles when compared to children with other mental health problems and control groups.
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 also occur at times 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 causes or threatens physical harm to others and may include:
- Intimidating behavior
- Physical fights
- Cruelty to others or animals
- Use of a weapon(s)
- Forcing someone into sexual activity, rape or molestation
Destructive conduct may include:
- Vandalism; intentional destruction to property
Deceitful behavior may include:
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, and 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
The goal of cognitive-behavioral therapy is to improve problem solving skills, communication skills, impulse control and anger management skills.
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 can help reduce aggression and may be used if other symptoms or disorders are present, such as impulsivity or trouble paying attention.
Prevention of Conduct Disorder
Some experts believe that a developmental sequence of experiences occurs in the development of conduct disorder. This sequence may start with ineffective parenting practices, followed by academic failure and poor peer interactions. These experiences then often lead to depressed mood and involvement 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 a traumatic experience influence the expression of conduct disorder.
Early detection and intervention into negative family and social experiences may be helpful in disrupting the development of conduct disorder.