What is Conduct Disorder?

Conduct disorder is often confused with Oppositional Defiant Disorder (ODD).  However, conduct disorder is typically considered to be the more serious of the two disorders.  Individuals with conduct disorder are often described as lacking empathy- they simply have a very difficult time understanding or even caring for that matter how their behavior(s) may physically or emotionally hurt others.  This callous disregard for others often begins with pushing, hitting, and biting in early childhood to later progressing to bullying, cruelty, and violence in adolescence.  Children and adolescents with conduct disorder display a repetitive and persistent display of behavior in which they are violating the rights of others and basic social rules.  These behaviors occur in a variety of settings and cause significant impairment in his or her social, academic, and family functioning.

The difference between Oppositional and Conduct Disorder.

A key difference between oppositional defiant disorder and conduct disorder lies in the role of control.  Children with oppositional defiant disorder do not like being controlled, so much so that they will fight against it at every opportunity.  Children who have either begun to move or already moved into conduct disorder will not only fight against being controlled, but will attempt to control those around them as well.  This sort of behavior often looks like them manipulating others to do what they want, taking things that do not belong to them, or using aggression or physical intimidation to control situations.

The symptoms of conduct disorder generally fall into the following four categories:

  • Aggressive behavior: These are behaviors 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 behavior: This involves intentional destruction of property such as arson (deliberate fire-setting) and vandalism (harming another person’s property).

  • Deceitful behavior: This may include repeated 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 behavior that is not appropriate for the person’s age. These behaviors may include running away, skipping school, playing pranks, or being sexually active at a very young age.

A lot of parents with children with conduct disorder describe feeling scared- fear of living with their child, fear of disciplining their child, or just fear in general.  If this sounds like you or your child, help is available.

Why does my child have conduct disorder?

Many parents of children with conduct disorder wonder what caused their child to have conduct disorder.  This wonder often turns to self-blame, if this sounds familiar, it’s important to keep in mind that there is no one thing you as a parent did to cause your child to have conduct disorder.  In fact, the exact cause of conduct disorder is unknown.  Instead, many professionals believe that conduct disorder is a combination of biological, genetic, environmental, psychological, and social factors.  Biologically speaking, some studies have suggested that defects or injuries to certain parts of the brain can lead to behavior disorders, such as oppositional defiant disorder or conduct disorder.  In other studies, conduct disorder has been linked to particular brain regions involved in regulating behavior, impulse control, and emotion.  If the nerve cell circuits of these brain regions do not work properly, symptoms of conduct disorder may begin to develop as a result.  Genetically speaking, it has been found that a lot of children and adolescents with conduct disorder have relatives who suffer from mood disorders, anxiety disorders, personality disorder, and substance use disorders; suggesting a possible genetic link.  Environmentally speaking, children and adolescents with a dysfunctional family life, history of childhood abuses, traumatic experiences, or inconsistent discipline by parents may contribute to the development of conduct disorder.  Psychologically speaking, some professionals believe that conduct disorders can reflect deficits in cognitive processing and problems with moral awareness.  Socially speaking, it has been found that children and adolescents with low socioeconomic status and/or not being accepted by their peers seem to be risk factors for the development of conduct disorder.

Furthermore, it has been found that many children and adolescents with conduct disorder typically suffer from other mental illnesses, such as depression, substance abuse, anxiety disorder, learning disorder, or attention-deficit/hyperactivity disorder (ADHD).

If you feel that your child or adolescent is displaying many of the symptoms discussed for conduct disorder, it is important to get help as soon as possible.  If left untreated, your child may be at an increased risk for failing or dropping out school, substance abuse, legal problems, injuries to self or others due to violent behaviors, incarceration, sexually transmitted diseases, depression, or suicide.

How common is conduct disorder?

Conduct disorder is more common in boys than in girls.  It typically begins in late childhood or in the early teen years.  Approximately 2% to 16% of children in the United States are believed to have conduct disorder.

FIVE TIPS if you think your child has conduct disorder.

As parents, we never expect to be faced with our own child’s intimidation or illegal behavior(s).  It’s tempting to rationalize or make excuses for our children’s behaviors.  However, by doing so, we may be making things worse.  Accepting the reality of our situation certainly does not mean we are accepting our child’s behaviors. 

Avoid putting yourself in situations where your child can physically intimidate you as much as possible.  This may sound like you are allowing your child to control you and your home, but instead it simply means that you are acknowledging the situation for what it is, not what you would like it to be.  Moreover, you are avoiding escalating the situation.  Often times, the physical intimidation is an attempt to control you through fear.  The moment your child recognizes that you are afraid of him or her is the moment the power in the relationship shifts to your child.  It’s important to reiterate that safety is difficult to achieve if you have not acknowledged the situation for what it is.  

Placing blame for your child’s behavior will not do anything to help.  Blaming yourself, your child’s other parent, friends/peers, or even your child is a waste of time.  It’s important to hold your child accountable, but blaming him or her will only leave you feeling angry and resentful; which in turn may keep you from responding effectively to the negative behaviors.  If you remember from earlier, children and adolescents with conduct disorder typically strive to manipulate others.  Getting you to take responsibility for negative behavior can be form of your child’s manipulation.

Although it may seem nearly impossible to control a child with conduct disorder, it is important to keep in mind that you do still have some area of control.  For instance, if your child is cutting class do not buy him or her all the clothes and shoes they want.  Simply put, a child who chooses to not attend class does not need new clothes for class.  If you feel that your child or adolescent is being violent toward you or another family member, call the police.  Yes, this sounds very harsh.  However, by doing so, you are showing that there are consequences for violating the rights of others. 

A mental health professional can help you get the help you need to deal effectively with conduct disorder.  Getting the support you need will you help bring control back in your life and ease the stress in parenting a child with conduct disorder.  Don’t try to do it on your own!  The support you need and deserve is available for you.

Treatment for Conduct Disorder

A professional mental health therapist can identify which treatment options would suit your family best based on your child’s age, the severity of symptoms displayed, and your child’s ability to participate in specific therapies.  Treatment for conduct disorder typically consists of counseling aimed at helping your child learn more adaptive ways to express and control anger.  The most common and effective form of therapy is cognitive-behavioral therapy (CBT), which aims to reshape your child’s thinking to better improve problem solving skills, moral reasoning skills, impulse control, and anger management.

Family therapy has also been shown to be effective in improving family interactions and communication.  Through family therapy, parents are able to learn techniques to positively help alter their child’s behaviors at home.  Family therapy may also help families create a more nurturing, supportive, and consistent home environment with an appropriate balance between love and discipline to decrease the frequency of symptoms related to conduct disorder.

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