What is Conduct Disorder?
According to the American Academy of Child and Adolescent Psychiatry, conduct disorder describes a collection of behaviors and emotional issues in children. This disorder leads to violation of rules, or difficulty following rules and behaving in a manner that does not conform with socially acceptable standards.
These children engage in abusive or criminal behavior, and have little understanding or respect for others' feelings, needs, or rights. It is estimated that two percent to nine percent of children and adolescents are diagnosed with conduct disorder. It is more commonly diagnosed in boys than in girls. Subtypes include childhood onset conduct disorder and adolescent onset conduct disorder.
Causes of Conduct Disorder:
Conduct disorder can be caused by a variety of factors that include emotional, physical, or sexual abuse, brain injury or damage, genetic predisposition, difficulty or failure in school, trauma, and a failure to develop adequate coping and soothing skills.
Symptoms of Conduct Disorder:
Behaviors that are demonstrative of conduct disorder can be divided into several categories as outlined below:
Aggressive behaviors toward people and animals including things like bullying, threats, use of weapons, cruelty towards people or animals, theft with assault, and/or forcing others in to sexual activity.
Destruction of property, including things such as: fire-setting with intent to cause damage; willful destruction of another's property; and vandalism.
Diagnosis of Conduct Disorder:
Diagnosis of conduct disorder is often made after a comprehensive psychological evaluation, including behavioral history, psycho-social history, and family history. The diagnosis of conduct disorder is frequently made in tandem with other issues such as:
- Mood disorders
- Post Traumatic Stress Disorder
- Substance and alcohol abuse
- Attention Deficit/Hyperactivity Disorder
- Learning disabilities
- Social and interpersonal issues
Treatment for Conduct Disorder:
Treatment for conduct disorder is most effective when it begins early. Often there are on-going family issues when treatment is not obtained - the child's behavior does not improve and major stress is placed on the family. If the child is perceived as a "bad apple," further developmental issues may occur in coping and self-soothing skills. The child may go on to break laws and behave in an antisocial manner, as well.
Treatment course depends upon the severity and type of behaviors exhibited. A treatment plan typically includes the child, parents, teachers, and other important adults in the child's life. Cognitive and psychological therapy is typically utilized to develop coping skills and express emotions, as well as to control anger.
If the child has learning disabilities, s/he may be placed in special education classes or on a individualized education plan (IEP). Social skills development and training for the child, as well as a parenting skills class for the parents, will likely be recommended.
Medication is another option to address issues such as anxiety, ADHD, and mood disorders. It is not uncommon for treatment to continue for years.
Tips for Helping to Manage Conduct Disorder
Children with conduct disorder thrive on power struggles. They like to challenge the rules, refuse to do as they're told, and often fight with others. Here are a few tips to help manage those situations:
- Focus on your reactions to the child's behavior - stay as neutral as possible by maintaining a calm, respectful, even detached manner. Don't engage in the struggle.
- Establish rules for appropriate behavior. You don't need many, just a few. Keep them clear, fair, and above all, constantly enforce them. Make sure everyone knows what is nonnegotiable.
- Avoid issuing direct demands when assigning tasks - give options. "I need the floor swept and the dishes put away. Which one can you help me with?"
- Ask your child to help establish appropriate routines, rules, and expectations. Keep the questions, and the expectations, at an age-appropriate level.
- Praise is important, but make it sincere.
- When the child is calm, talk about different ways they can help manage their anger or assert themselves appropriately. This will help them learn new social skills, conflict resolution, and anger management.
Additional Resources for Conduct Disorder:
American Academy of Child and Adolescent Psychiatry provides a description of conduct disorder, treatment options, and links to other information on related topics.
Mental Health America offers a description and statistics about conduct disorder.
The American Academy of Family Physicians provides the DSM-IV-TR criteria of conduct disorder and illustrative cases.