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What is Conduct Disorder?
Conduct disorder is a repetitive and persistent pattern of
behavior in children and adolescents in which the rights of others
or basic social rules are violated. The child or adolescent usually
exhibits these behavior 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.
What are the signs and symptoms
of Conduct Disorder?
Behaviors characteristic of
conduct disorder include:
- Aggressive behavior that causes or threatens harm to other
people or animals, such as bullying or intimidating others, often
initiating physical fights, or being physically cruel to
animals.
- Non-aggressive conduct that causes property loss or damage,
such as fire-setting or the deliberate destruction of others’
property.
- Deceitfulness or theft, such as breaking into someone’s
house or car, or lying or “conning” others.
- Serious rule violations, such as staying out at night when
prohibited, running away from home overnight, or often being truant
from school.
Many youth with conduct disorder may have trouble feeling and
expressing empathy or remorse and reading social cues. These youth
often misinterpret the actions of others as being hostile or
aggressive and respond by escalating the situation into conflict.
Conduct disorder may also be associated with other difficulties
such as substance use, risk-taking behavior, school problems, and
physical injury from accidents or fights.
How common is Conduct Disorder?
Conduct disorder is more common among boys than girls, with
studies indicating that the rate among boys in the general
population ranges from 6% to 16% while the rate
among girls ranges from 2% to 9%. Conduct disorder can have its
onset early, before age 10, or in adolescence. Children who display
early-onset conduct disorder are at greater risk for persistent
difficulties, however, and they are also more likely to have
troubled peer relationships and academic problems. Among both boys
and girls, conduct disorder is one of the disorders most frequently
diagnosed in mental health settings.
What does the research say about
Conduct Disorder?
Recent research on Conduct Disorder has been very promising. For
example, research has shown that most children and adolescents with
conduct disorder do not grow up to have behavioral problems or
problems with the law as adults; most of these youth do well as
adults, both socially and occupationally. Researchers are also
gaining a better understanding of the causes of conduct disorder,
as well as aggressive behavior more generally. Conduct disorder has
both genetic and environmental components. That is, although the
disorder is more common among the children of adults who themselves
exhibited conduct problems when they were young, there are many
other factors which researchers believe contribute to the
development of the disorder. For example, youth with conduct
disorder appear to have deficits in processing social information
or social cues, and some may have been rejected by peers as young
children.
Despite early reports that treatment for this disorder is
ineffective, several recent reviews of the literature have
identified promising approaches treating children and adolescents
with conduct disorder. The most successful approaches intervene as
early as possible, are structured and intensive, and address the
multiple contexts in which children exhibit problem behavior,
including the family, school, and community. Examples of effective
treatment approaches include functional family therapy,
multi-systemic therapy, and cognitive behavioral approaches which
focus on building skills such as anger management. Pharmacological
intervention alone is not sufficient for the treatment of conduct
disorder.
Conduct disorder tends to co-occur with a number of other
emotional and behavioral disorders of childhood, particularly
Attention Deficit Hyperactivity Disorder (ADHD) and Mood Disorders
(such as depression). Co-occurring conduct disorder and substance
abuse problems must be treated in an integrated, holistic
fashion.
Why are assessment and treatment
important?
Assessment and diagnosis of conduct disorder - or any emotional
or behavioral disorder of childhood - should be done by a mental
health professional, preferably one who is trained in
children’s mental health. Any diagnosis must be made in
consultation with the child’s family. The assessment process
should include observation of the child, discussion with the child
and family, the use of standardized instruments or structured
diagnostic interviews, and history-taking ,including a complete
medical and family / social history. When assessing and diagnosing
any childhood emotional or behavioral disorder, the mental health
professional should consider the social and economic context in
which a child’s behavior occurs.
Accurate assessment and appropriate, individualized treatment
will assure that all children are equipped to navigate the
developmental milestones of childhood and adolescence and make a
successful adaptation to adulthood. Treatment must be provided in
the least restrictive setting possible.
What can I do if I’m concerned
about a child?
- Learn more about conduct disorder, including recent research on
effective treatment approaches. Contact NMHA for additional
resources on conduct disorder or other emotional or behavioral
disorders of childhood.
- Consult with a mental health professional, preferably one who
is trained in children’s mental health.
- Explore the treatment options available. Treatment must be
individualized to meet the needs of each child and should be
family-centered and developmentally and culturally
appropriate.
- Find a family support group or organization in your
community.
For More
Information:
Contact you local Mental Health Association, community mental
health center or:
National Mental
Health Association
2001 N. Beauregard Street, 12th Floor
Alexandria, VA 22311
Phone 703/684-7722
Fax 703/684-5968
Mental Health Resource Center 800/969-NMHA
TTY Line 800/433-5959
This Fact Sheet is one in a series of Fact Sheets that
NMHA has produced
on major childhood emotional and behavioral disorders, including
bipolar disorder, depression, and anxiety disorders. This Fact
Sheet is intended to generally inform the reader about this
disorder and is not intended to be a substitute for proper
assessment by a trained mental health professional.
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