Conduct disorder is a repetitive and persistent pattern of behaviour in children and adolescents in which the rights of others are violated (or they are behaving in a socially unacceptable way). The child or adolescent usually exhibits these behaviour patterns in a variety of settings – at home, at school, and in social situations – and they cause significant impairment in his or her social, academic, and family functioning. Many youth with this disorder have trouble feeling and expressing empathy or remorse and reading social cues. Some may have been rejected by peers as young children. They often misinterpret the actions of others as being hostile and respond by escalating the situation into conflict.
|Early intervention is key. Family therapy, Psychotherapy and Cognitive Behavioural Therapy are usually necessary to help the child appropriately express and control anger.|
The disorder is more common among boys than girls. It can have early onset, before the age of 10, or can start in adolescence.
Many factors can contribute to a child developing conduct disorder. Although it is more common in the children of parents who themselves exhibited conduct problems when they were young, other factors such as brain damage, child abuse, school failure, and traumatic life experiences are also believed to contribute to development of the disorder.
Identifying the Signs of Conduct Disorder
- Aggressive behavior that threatens harm to other people or animals (bullying, intimidating, physical fighting, cruelty to animals, use of weapons, steals from a victim in a confrontational manner)
- Non-aggressive conduct such as fire-setting or deliberate destruction of property
- Theft; breaking in to someone else’s building, car or house, or shoplifting
- Deceitfulness; “conning” or lying to obtain goods or favours or to avoid obligations
- Serious rule violations, such as staying out at night, running away from home, truant from school.
Children that exhibit these behaviours should receive a comprehensive evaluation. Many children with a conduct disorder may have co-existing conditions such as mood disorders, ADHD, anxiety, Post Traumatic Stress Disorder, substance abuse, learning disorders or thought disorders. Intervention is crucial, as without help, these youth are at risk to not adapt into adulthood and will continue to have problems with relationships and holding a job. They often break laws or behave in an antisocial manner.
Treatment of children with conduct disorder can be complex and challenging. Treatment can be provided in a variety of different settings depending on the severity of the behaviours. Adding to the challenge of treatment are the child’s uncooperative attitude and fear and distrust of adults. In developing a comprehensive treatment plan, a child and adolescent psychiatrist may use information from the child, family, teachers, and other medical specialties to understand the causes of the disorder.
The key is early intervention. Family therapy, psychotherapy and Cognitive Behavioural Therapy are usually necessary to help the child appropriately express and control anger. Focus needs to be on building skills like anger management. Drug therapy alone is not sufficient for the treatment of conduct disorder. Special education may be needed for youngsters with learning disabilities. Parents often need expert assistance in devising and carrying out special management and educational programs in the home and at school. Treatment may also include medication in some youngsters, such as those with difficulty paying attention, impulse problems, or those with depression.
Treatment is rarely brief as establishing new behaviour patterns takes time. However, early treatment offers a child a better chance for considerable improvement and hope for a more successful future.
Useful Links/Resources on CONDUCT DISORDERS:
American Academy of Child and Adolescent Psychiatry - www.aacap.org
Child and Parent Resource Institute (CPRI) – 1-519-858-2774 or www.cpri.ca
Mental Health America - www.nmha.org
Parents for Children’s Mental Health parent support group – 519-749-8740 Ext. 212 - www.PCMHwaterloo.com or e-mail:firstname.lastname@example.org