CONDUCT DISORDER 

"My 5 year old nephew has been getting to the point of being uncontrollable. He doesn't listen to anyone and isn't remorseful for his actions. He's been suspended from school several times, he's also been suspended from the bus for inappropriate behavior. He's been hitting other children almost daily, and even went as far as cutting a child's shirt because the child didn't listen to him. He hits, bites, claws, throws things at teachers and defies all adult authority, especially when he doesn't get his way. He threatened to burn the house down and kill everyone in the house...this is coming from a 5 year old child...." For the rest of the story please click here

Conduct disorder is the repetitive and persistent pattern of behavior by a child or teenager in which the basic rights of others or major age-appropriate societal norms or rules are violated. These behaviors fall into four main groupings:

                    i.            aggressive conduct that causes or threatens physical harm to other people or animals

                  ii.            nonaggressive conduct that causes property loss or damage

                iii.            deceitfulness or theft

                iv.            serious violations of rules time and time again.

Symptoms of Conduct Disorder

According to psychcentral.com, Conduct Disorder is manifested by the presence of three (or more) of the following criteria in the past 12 months, with at least one criterion present in the past 6_months:

Aggression to people and animals

• often bullies, threatens, or intimidates others
• often initiates physical fights
• has used a weapon that can cause serious physical harm to others (e.g., a bat, brick, broken bottle, knife, gun)
• has been physically cruel to people
• has been physically cruel to animals
• has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery)
• has forced someone into sexual activity

Destruction of property

• has deliberately engaged in fire setting with the intention of causing serious damage
• has deliberately destroyed others’ property (other than by fire setting)
  

Deceitfulness or theft

• has broken into someone else’s house, building, or car
• often lies to obtain goods or favors or to avoid obligations (i.e., “cons” others)
• has stolen items of nontrivial value without confronting a victim (e.g., shoplifting, but without breaking and entering; forgery)
  

Serious violations of rules

• often stays out at night despite parental prohibitions, beginning before age 13 years
• has run away from home overnight at least twice while living in parental or parental surrogate home (or once without returning for a lengthy period)
• is often truant from school, beginning before age 13 years

PS: The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.

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 involved in regulating behavior, impulse control, and emotion can lead to behavior disorders. Many children and teens with conduct disorder also have other disorders, such as attention-deficit/hyperactivity disorder (ADHD), learning disorders, depression, substance abuse, or an anxiety disorder, which may contribute to the symptoms of conduct disorder.

Genetics: Children and teens with close family members suffering from mental illnesses, including mood disorders, anxiety disorders, substance use disorders and personality disorders, are more vulnerable to acquire conduct disorder.

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.

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 usually consists of a combination of:

Psychotherapy : Psychotherapy (a type of counseling) 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 : Various drugs may be used to treat some of the distressing symptoms of conduct disorder, as well as any other mental illnesses that may be present, such as ADHD or major depression.

PS: Recognizing and acting on symptoms when they appear can minimize distress to the child and family, and prevent many of the problems associated with the condition. In addition, providing a nurturing, supportive, and consistent home environment with a balance of love and discipline may help reduce symptoms and prevent episodes of disturbing behavior.

References:

http://psychcentral.com/disorders/conduct-disorder-symptoms/

http://www.webmd.com/mental-health/mental-health-conduct-disorder