Health & Medical Mental Health

What is Conduct Disorder?

Conduct disorder is a complicated set of behavioral and emotional problems in children.
Those with this disorder have great difficulty following rules and behaving in a way that is socially acceptable.
They are often viewed by others as bad, delinquent, or even "evil" rather than mentally ill.
Children or adolescents who exhibit the poor behaviors that indicate conduct disorder should receive a full evaluation.
The Diagnostic and Statistical Manual of Mental Disorders lists the following criteria for a diagnosis of conduct disorder (paraphrase): A pattern of behavior in which the basic rights of others or the major expected societal rules are violated, as shown by: Aggressive behavior toward people and/or animals Destruction of property (frequently by setting a fire or deliberately destroying property) Deceitfulness or theft (breaking and entering into someone's home, car or building; lying to "look good" or con others; non-violent theft) Serious violations of rules (breaks curfew frequently, has run away at least twice; truancy) One of the problems with combating conduct disorder is that where it comes from is not entirely understood.
Several theories have a common thread of the mother-child relationship.
Prenatal and birth conditions provide one particular clue.
Difficult births (forceps extraction, breech, long labor, preeclampsia, etc.
) complicated with the issue of maternal rejection (unwanted pregnancy, attempted abortion, prolonged hospitalization, etc.
) increased the risk of violent behavior later in life.
Maternal age at the birth of the child is another complicating factor.
Young mothers are a known risk factor having children with behavior problems.
The children of teenage mothers have high rates of problems as adolescents and have a higher risk for dropping out of school, delinquency, and teenage pregnancy.
Teenage mothers may exhibit conduct problems as well, which led to the pregnancy.
Early unprotected sexual activity, substance abuse (including smoking cigarettes), and affiliation with deviant peers are frequently seen in young mothers.
A broader context of family problems and separation are also common.
Smoking is a risk factor for conduct disorder and pregnant teenage mothers are more likely to be smokers than their older counterparts.
Prenatal complications, such as poor nutrition, smoking, drug abuse, and low birth weight increase the possibility of conduct disorder.
Postnatally, the environment for child-rearing in these homes is usually less than desirable.
This environment frequently includes domestic violence, harsh and unresponsive parenting, and disruptive relationships.
Behavior problems tend to be seen early as a result.
Delaying childbirth may reduce offspring incarceration by as much as 6%.
Costs of judicial intervention could be reduced by as much as $300 million annually by delaying pregnancy and childbirth.
Several correlates have been found in children with conduct disorder: male gender, chronic health problems, low socioeconomic status (about 18%), parental discord, large family size, harsh and inconsistent parenting, and difficult temperament.
The three factors that have been most clearly identified as most likely agents are harsh, inconsistent parenting, poor academic performance, and exposure to fighting and discord between parents.
Protective factors have been identified as above average intelligence, at least one caregiving and consistent adult relationship, easy temperament, and competence at a skill.
In males with conduct disorder, mothers were significantly more likely absent or had low contact with their sons (81.
2% vs.
8%) than males without conduct disorder.
This is congruent with attachment theory that the mother-son relationship is very important.
It is quite possibly the most significant relationship for a creating and maintaining young man's or young men's development.
Parenting, in general, and discipline styles are also critical.
The parental relationship serves as a role model for interactions with the child.
If the child constantly sees marital discord, fighting, and separation, this impacts his or her development.
Inconsistent use of discipline, excessive use of corporal punishment, and lack of positive reinforcement methods have been linked to conduct disorder in children.
To combat this, discipline should incorporate positive change incentives, and be consistent and fair.
Abuse is significantly correlated with later conduct problems, specifically neglect.
Sexual abuse victims are not likely to exhibit later violence, but male physical abuse victims are significantly more likely to be physically aggressive.
In adulthood, individuals convicted of violent crime show a significant lack of attachment to significant others and increased impulsiveness as compared to their non-violent and sexual offender counterparts.
Childhood victims of neglect are the most likely to be arrested for violent offences.
Neglect, frequently ignored by the child welfare system is, therefore, critically important to recognize and combat.
Genetic studies have been complex and yielded difficult to understand answers to whether or not conduct disorder is an inherited disorder.
One major difficulty with the study of genetic transfer of conduct disorder is the overlap of symptoms between conduct disorder and other behavior disorders seen in children (e.
Oppositional Defiant Disorder and Attention-Deficit Hyperactivity Disorder).
The behavioral association between symptoms of conduct disorder and alcohol and marijuana dependence is believed to be due largely to shared environmental influences rather than genetics in twins studied.
Although a great deal of progress has been made toward finding an answer about biological determinants of conduct disorder, as well as other childhood behavioral disorders over the last 10 years, there is a need to continue to refine the techniques and methods.
The relationship between biology and environment appears to be complex.
Reference: American Psychiatric Association (2000).
Diagnostic and statistical manual of mental disorders (Text Rev.
Washington, D.
: Author.

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