What Is Conduct Disorder?
Every child will undoubtedly have behavior problems from time to time. Temper tantrums, pouting, calling names, throwing objects, and even occasionally hitting someone when they do not get their way, are all signs that a child is human. Because they lack the proper skills to sort things out in a civil manner, children will do so the only way they know how: by showing their dislike and disapproval of the situation using their anger and frustration. Thankfully, most children soon realize that this type of behavior is unacceptable to the parent and to society as a whole.
There are children though who seem to never adopt the societal norms and will continue to act on their anger. When a child or adolescent repeatedly behaves in this manner it is referred to as behavior or conduct disorder. Much like antisocial disorder, a child with a conduct disorder has little regard for authority and constantly challenges the rules of society. Typically a child is diagnosed with conduct disorder if the behavior is consistent for more than six months.
The United States Department of Health and Human Services (2003) has laid out the following warning signs of conduct disorder which are:
- Aggressive behavior that harms or threatens other people or animals
- Destructive behavior that damages or destroys property
- Lying or theft
- Truancy or other serious violations of rules
- Early tobacco, alcohol, and substance use and abuse
- Precocious sexual activity
- Higher rates of depression, suicidal thoughts, suicide attempts, and suicide
- Academic difficulties
“Associated features of conduct disorder include an inability to appreciate the importance of others’ welfare and little guilt or remorse about harming others. Adolescents with conduct disorder often develop skills in outwardly verbalizing remorse to obtain favor or avoid punishment, but do not experience any apparent guilt” (Searight, Rottnek, & Abby, 2001). The doctors go on to say that there are other disorders that share similar symptoms such as, attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder, mood disorder (major depression, dysthymia, bipolar disorder), substance abuse and intermittent explosive disorder.
If these signs are displayed in a child, it should be addressed immediately. Early intervention can mean the difference between the child growing up to be antisocial or a successful member of society. Parents and teachers should pay close attention to such symptoms and not hesitate to investigate the matter by talking to a professional who can either confirm or dispel the possibility of conduct disorder. In the majority of cases, the child or adolescent does not understand that his or her behavior is unacceptable, so it is up to the adult to follow through with help.
There are several causes for conduct disorder. These being “inconsistent parenting (i.e., the failure to provide a consistently supportive and nurturing environment; inconsistent use of discipline; and an over-reliance on punishment to change behavior), genetic and biological factors (temperament, sociability, and impulsivity), poor social skills, and maladaptive beliefs about one’s personal worth” (Barkoukis, Reiss, & Dombeck, 2008). Trauma to the brain may also cause conduct disorder. With patience and diligence, children with conduct disorder can be rehabilitated.
Behavioral and cognitive-behavioral therapy is used to treat the disorder, which includes parent management training, cognitive problem-solving skills training, functional family therapy, and multisystemic therapy. In regards to behavioral therapy, Barkoukis, Reiss, & Dombeck state that “The basic idea is that behavior patterns are in large part learned from exposure to rewards and consequences, and therefore, inappropriate behaviors can be “unlearned”, and replaced by more appropriate pro-social behaviors through the systematic manipulation of rewards and consequences that promote pro-social behavior and discourage antisocial behavior.” (2008). Likewise, the cognitive therapy teaches the patient anger management skills, relaxation techniques, and alternative ways to dealing with stress.
Medications such as Ritalin, Dexedrine, and Cylert, are sometimes used to treat conduct disorder. They work by removing the impulsiveness that so often drives a child to act out in aggressive ways. Lithium has also been used in some cases in order to help prevent mood swings and irritability.
Barkoukis, A., Reiss, S. R., Dombeck, M. (2008). Treatment of conduct disorder. Retrieved August 15, 2010, from http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=14503&cn=37
Searight HR, Rottnek F, Abby SL (2001). Conduct disorder: diagnosis and treatment in primary care. AmericanFamily Physician. 2001 Apr 15; 63(8):1579-88.
United States Department of Health and Human Services (2003). Children’s mental health facts: children and adolescents with conduct disorder. Retrieved August 15, 2010, from http://mentalhealth.samhsa.gov/publications/allpubs/CA-0010/default.asp