Conduct disorder refers to a group of behavioral and emotional problems characterized by a disregard for others. Children with this disorder have a difficult time following rules and behaving in a socially acceptable way. Their behavior can be hostile and sometimes physically violent.
In their earlier years, they may show early signs of aggression, including pushing, hitting and biting others. Adolescents and teens with conduct disorder may move into more serious behaviors, including bullying, hurting animals, picking fights, theft, vandalism and arson.
If your child has conduct disorder, they may appear tough and confident. In reality, however, children who have this disorder are often insecure and inaccurately believe that people are aggressive or threatening.
The types are categorized according to the age at which symptoms of the disorder first occur –
• Childhood onset occurs when the signs of conduct disorder appear before age 10.
• Adolescent onset occurs when the signs of conduct disorder appear during the teen years.
• Unspecified onset means the age at which conduct disorder first occurs is unknown.
Characteristic behaviors of conduct disorder develop gradually over time. Children with conduct disorder tend to be impulsive and difficult to manage. They don’t seem to be concerned about the feelings of other people.
Sign & Symptoms –
Characteristic behaviors of conduct disorder develop gradually over time. Children with the disorder tend to be impulsive and difficult to manage. They don’t seem to be concerned about the feelings of other people.
The four core behaviors of conduct disorder include –
• Aggression toward people and animals and/or violating others’ basic rights.
• Destruction of property.
• Deceiving, lying and/or stealing.
• Serious violations of rules.
Signs of aggressive behavior toward others include:
• Physical violence (potentially with a weapon).
• Verbal fights.
• Forcing sexual activity.
• Blaming others for their own behavior.
• Hurting animals.
Signs of the destruction of property include:
• Intentionally setting fires.
• Vandalizing or destroying others’ property.
Signs of deceiving, lying and stealing include:
• Lying to get a favor or to avoid responsibilities.
• Stealing from individual people or stores.
• Breaking into houses or businesses.
Signs of violations of rules include:
• Breaking rules without clear reason.
• Not going to school (truancy).
• Running away from home.
• Frequently breaking any rules set by their parents.
Emotional symptoms of conduct disorder include:
• Lack of remorse: This may appear as an inability to feel guilty about doing something wrong, a failure to feel bad about hurting someone, or indifference to punishment for breaking the rules.
• Lack of empathy: They may disregard the feelings of others and appear cold, callous, or uncaring.
• Disregards expectations: The individual may not care about performing well in school or other activities. They may seem to ignore others’ expectations of them, even if they are given clear tasks.
• Lack of emotional expression: The individual may not display any emotions. They may appear shallow or superficial or may seem to be able to turn emotions “on and off” at will. When they do show emotion, they may use their emotional response to manipulate others.
Other common signs of the disorder include:
• Heavy alcohol drinking and/or heavy substance use.
• Engaging in frequent and risky sex.
• Becoming easily frustrated.
• Making no effort to hide their aggressive behaviors.
• Not showing remorse for their actions.
• Difficulty making and maintaining friendships.
It’s important to note that occasional rebellious behavior is common during childhood and adolescence. The signs and symptoms that lead to the diagnosis demonstrate a disruptive and repetitive pattern
The exact cause of conduct disorder is not known, but it is believed that a combination of biological, genetic, environmental, psychological, and social factors play a role.
• Biological: Conduct disorder has been linked to particular brain regions involved in regulating behavior, impulse control, and emotion. It’s symptoms may occur if nerve cell circuits along these brain regions do not work properly.
• Genetics: Many children and teens with conduct disorder have close family members with mental illnesses, including mood disorders, anxiety disorders, substance use disorders and personality disorders. This suggests that a vulnerability to conduct disorder may be at least partially inherited.
• Environmental: Factors such as a dysfunctional family life, childhood abuse, traumatic experiences, a family history of substance abuse, and inconsistent discipline by parents may contribute to the development of conduct disorder.
• Psychological: Some experts believe that conduct disorders can reflect problems with moral awareness (notably, lack of guilt and remorse) and deficits in cognitive processing.
• Social: Low socioeconomic status and not being accepted by their peers appear to be risk factors for the development of conduct disorder.
Risk Factors –
The following factors may increase your child’s risk of developing this problematic disorder-
• being male
• living in an urban environment
• living in poverty
• having a family history of conduct disorder
• having a family history of mental illness
• having other psychiatric disorders
• having parents who abuse drugs or alcohol
• having a dysfunctional home environment
• having a history of experiencing traumatic events
• being abused or neglected
If your child shows signs of conduct disorder, they should be evaluated by a mental health professional. The professional will ask you and your child questions about their behavioral patterns to diagnose.
For a conduct disorder diagnosis to be made, your child must have a pattern of displaying at least three behaviors that are common to conduct disorder.
Your child must also have shown at least one of the behaviors within the past 6 months. The behavioral problems must also significantly impair your child socially or at school.
Treatment for conduct disorder is based on many factors, including the child’s age, the severity of symptoms, as well as the child’s ability to participate in and tolerate specific therapies. Treatment usually consists of a combination of the following –
• Psychotherapy: Psychotherapy (a type of counseling) is aimed at helping the child learn to express and control anger in more appropriate ways. A type of therapy called cognitive-behavioral therapy aims to reshape the child’s thinking (cognition) to improve problem solving skills, anger management, moral reasoning skills, and impulse control. Family therapy may be used to help improve family interactions and communication among family members. A specialized therapy technique called parent management training (PMT) teaches parents ways to positively alter their child’s behavior in the home.
• Medication:Although there is no medication formally approved to treat conduct disorder, various drugs may be used (off label) to treat some of its distressing symptoms (impulsivity, aggression, dysregulated mood), as well as any other mental illnesses that may be present, such as ADHD or major depression.
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