The author is an enthusiastic researcher. She is studying psychology as an optional subject for the civil service exam.
What is Conduct Disorder?
Conduct disorder is a behavioral disorder that begins during childhood or adolescence. Children with this disorder become destructive, aggressive, and defiant. They don't behave in a socially acceptable manner and don't care about the feelings of other people. In younger children, this behavior begins with biting, pushing, and nagging. In this article, you'll learn about the following aspects of conduct disorder:
- Symptoms of conduct disorder
- Causes or risk factors
- Comorbid conditions associated with conduct disorder
- Management of conduct disorder
Conduct disorder (CD) has two subtypes: childhood onset and adolescent onset. If childhood conduct disorder is left untreated, it has a poorer prognosis. Specific behaviors that are particular to childhood conduct disorder include aggression, property destruction, and poor peer relationships. In approximately 40% of cases, childhood antisocial personality disorders develop into adult antisocial personality disorders.
Symptoms of Conduct Disorder
Conduct disorder may be severe, moderate, or mild. In mild conditions, little to no behavior change occurs that is needed to diagnose the disorder. In severe cases, it comes up with serious behavioral issues, including rape, breaking, stealing, or use of a weapon. Symptoms are grouped into four categories:
- Aggressive Conduct: It includes bullying, yelling, teasing animals, and the use of weapons.
- Deceitful Behavior: It includes vandalism, forgery, and stealing.
- Destructive Behavior: Lying, cheating, and violence are all destructive behaviors.
- Violation of Rules: it may include truancy, running from home, and drug addiction.
Symptoms of conduct disorder develop early in boys compared to girls. The age of presentation in boys is 12 to 14, whereas, in girls, the usual age of presentation is 14 to 16 years of age.
Causes or Risk Factors
A child with conduct disorder differs greatly from a normal child in many aspects. These differences include low IQ level, poor school performance, low family income, anti-social peers, erratic parental discipline, child physical abuse, and disrupted families. There may be individual, social, or family factors that increase the risk of developing conduct disorder in children.
Poor parental supervision is the most common factor that leads to behavior disorders. Parental conflicts and disrupted families also play a role. Selection theories explain why disrupted families produce children with conduct disorder. Low family income, poor childrearing methods, family conflicts, criminal parents, and child abuse predict delinquency in children.
Numerous individual factors can lead to behavioral disorders. Impulsiveness is considered the most crucial factor that anticipates antisocial behavior. Impulsive actions are always poorly expressed and often result in undesirable consequences. The most extensive study on impulsiveness was done by the Pittsburgh Youth Study. In this study, the measures that have been most strongly associated with self-mentioned delinquency were self-reported impulsiveness, teacher-rated impulsiveness, self-reported under-control (unable to control gratification), motor restlessness, and psychomotor impulsiveness. Other individual factors are low IQ, poor school performance, and lack of self-confidence.
Socioeconomic factors such as low SES (socio-economic status) families and living in subsidized housing have a fair contribution to the antisocial conduct of a child. Low-SES families use poor childrearing methods and have low parental education, which can lead to a child's antisocial behavior. Many children may be involved in antisocial activities because of their school influences. Children with conduct disorder support and encourage offenders. So, they influence their peers to become involved in antisocial conduct.
Recognizing Conduct Disorder
Comorbid Disorders Associated With Conduct Disorder
Comorbidity means one or more medical conditions co-occurring with the main condition. Children with conduct disorders also show internalizing psychopathology (IP). Many juvenile offenders have psychiatric disorders, including alcohol use disorders, bipolar disorder, and attention deficit hyperactivity disorder (ADHD), along with conduct disorders. The rate of comorbidity with attention-deficit hyperactivity disorder (ADHD) is high. The presence of comorbidities confounds the diagnosis, treatment, and prognosis of conduct disorder. The diagnosis of comorbidities is of great importance, and possible comorbidities should be investigated in patients diagnosed with conduct disorder. Before planning treatment, the possibility of comorbidities occurring during follow-up should be taken into account.
Management of Conduct Disorder
Conduct disorder has varying levels of severity. Mild and early stages of conduct disorder can be treated by a family physician. Some severe cases need specialized mental health treatment. It is critical to have an adult caregiver monitor the child's activities. Monitoring and regular checkups are important for the treatment of conduct disorder. The methods given below can help in the management of conduct disorder:
- Multisystemic therapy (MST)
- Psychoeducation (PE)
- 12-step facilitation
- Motivational interviewing (MI)
- Family therapy
It is a family-oriented treatment that uses empirically-supported interventions to analyze and treat antisocial behavior in adolescence. It is recognized as an effective treatment for substance-abusing adolescents with conduct problems. Multisystemic therapy (MST) aims to treat children with conduct disorders within their natural ecology. MST is also effective in improving relationships between adolescents and their siblings.
Psychoeducation is organized, relevant, broad, and up-to-date information about a mental illness or condition that also includes its diagnosis and treatment. It is another intervention used for the treatment of substance abuse among adolescents with conduct problems. The purpose of psychoeducation is to help people understand mental health conditions. The process of psychoeducation may be general or highly specific, depending on the severity of the mental illness.
12-step facilitation is commonly used to treat conduct problems among adolescents. This therapy is presented in the form of three key ideas: acceptance, surrender, and active involvement in 12-step meetings. Acceptance means the offender has to realize that the violation is uncontrollable and that willpower alone is not sufficient to treat it. Surrender means giving yourself over to a higher power and accepting the support and fellowship laid out by the 12-step programs. The third important aspect is active involvement in activities and meetings arranged by the management of the 12-step program.
Motivational Interviewing (MI)
Motivational interviewing is a set of clinical interventions formulated to stimulate behavior changes in children. This concept was first described by William R. Miller in 1983 based on his experience of treating alcoholism. Motivational Interviewing is broadly applicable for the management of drug addiction, smoking cessation, and other conduct disorders. It helps clients change their behavior and makes them aware that the changes will improve their physical and mental health. MI works with four key elements: partnership, acceptance, compassion, and evocation.
Family therapy is a branch of psychology that aims to work with families to facilitate changes and development. Poor parental skills and a lack of cooperation are the leading causes of conduct disorders in children. In family therapy, therapists evaluate how various family members interact with and behave towards each other by watching them in the context of therapy. They try to find particular sorts of structural difficulties within the family that become the reason for the conduct disorders in children.
- Conduct Disorder: Types, Causes, and Symptoms | Healthline
- Psychoeducation | GoodTherapy
- Treatment of Conduct Disorder | Mentalhelp
- Multisystemic Therapy | Early Intervention Foundation
- 12-Step Facilitation | Nova Recovery Center
- Quick Facts on Conduct Disorder | Child Mind Institute
This content is accurate and true to the best of the author’s knowledge and is not meant to substitute for formal and individualized advice from a qualified professional.
© 2022 EK Jadoon