Conduct disorder is a serious behavioural and emotional disorder that can occur in children and teens. A child with this disorder may display a pattern of disruptive/violent behaviour and have difficulty following rules. It is more common in boys than in girls and most often occurs in late childhood or the early teen years.
It is not uncommon for children and teens to have behaviour-related problems at some time during their development. However, the behaviour is considered to be a conduct disorder when it is long-lasting and when it violates the rights of others, goes against accepted norms of behaviour and disrupts the child’s or family’s everyday life.
Symptoms of Conduct Disorder
Symptoms of conduct disorder vary depending on the age of the child and whether the disorder is mild, moderate, or severe. In general, symptoms of conduct disorder fall into four general categories:
- Aggressive behaviour: These are behaviours that threaten or cause physical harm and may include fighting, bullying, being cruel to others or animals, using weapons, and forcing another into sexual activity.
- Destructive behaviour: Intentional destruction of property such as arson and vandalism.
- Deceitful behaviour: Lying, shoplifting, or breaking into homes or cars in order to steal.
- Violation of rules: This involves going against accepted rules of society or engaging in behaviour that is not appropriate for the person’s age. These behaviours may include running away, skipping school, playing pranks, or being sexually active at a very young age.
In addition, many children with conduct disorder are irritable, have low self-esteem, and tend to throw frequent temper tantrums. Some may abuse drugs and alcohol. Children with conduct disorder often are unable to appreciate how their actions can hurt others and generally have little guilt or remorse about hurting others.
Causes of Conduct Disorder
The exact cause of conduct disorder is not known, but it is believed that a combination of biological, genetic, environmental, psychological, and social factors play a role.
- Biological: Some studies suggest that defects or injuries to certain areas of the brain can lead to behaviour disorders. In addition, conduct disorder has been linked to particular brain chemicals called neurotransmitters. Neurotransmitters help nerve cells in the brain communicate with each other. If these chemicals are out of balance or not working properly, messages may not make it through the brain correctly, leading to symptoms.
- Genetics: Many children and teens with conduct disorder have close family members with mental illnesses.Â This suggests that a vulnerability to conduct disorder may be inherited.
- Environmental: Factors such as a dysfunctional family life, childhood abuse, traumatic experiences, a family history of substance abuse, and inconsistent discipline by parents may contribute to the development of conduct disorder.
- Psychological: Some experts believe that conduct disorders can reflect problems with moral awareness (notably, lack of guilt and remorse) and deficits in cognitive processing (how the brain is sorting out and understanding incoming information).
- Social: Low socioeconomic status and not being accepted by their peers appear to be risk factors for the development of conduct disorder.
Treatment of Conduct Disorder
Treatment for conduct disorder is based on many factors, including the child’s age, the severity of symptoms, as well as the child’s ability to participate in and tolerate specific therapies. Treatment usually consists of a combination of the following:
- Psychotherapy is aimed at helping the child learn to express and control anger in more appropriate ways. A type of therapy called cognitive-behavioral therapy aims to reshape the child’s thinking (cognition) to improve problem-solving skills, anger management, moral reasoning skills, and impulse control. Family therapy may be used to help improve family interactions and communication among family members.
- Medication: Although there is no medication formally approved to treat conduct disorder, various drugs may be used to treat some of its distressing symptoms, as well as any other mental illnesses that may be present, such as ADHD or major depression.
If your child is displaying symptoms of conduct disorder, it is very important that you seek help from a qualified doctor. A child or teen with conduct disorder is at risk for developing other mental disorders as an adult if left untreated. These include antisocial personality disorder, mood or anxiety disorders, and substance use disorders.
Children with conduct disorder are also at risk for school-related problems, such as failing or dropping out, substance abuse, legal problems, injuries to self or others due to violent behaviour, sexually transmitted diseases, and suicide. Treatment outcomes can vary greatly, but early intervention may help to reduce the risk for incarcerations, mood disorders, and the development of other comorbidities such as substance abuse.