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Conduct Disorder
Definition
A person with Conduct Disorder exhibits antisocial behavior that goes against societal rules or violates the rights of others. A person is diagnosed with Conduct Disorder if he or she violates three or more of the criteria stated in the DSM-IV within the last 12 months, with at least one of those criterion being present within the last 6 months. There are 4 major categories of criteria, with several behaviors within each category listed in the DSM-IV. These include:
· Aggression to people and animals
o The person with Conduct Disorder may often bully or threaten others and initiates fights. He/she may carry weapons or steal from others while the victim is present (such as mugging or committing armed robbery). This person is also physically cruel to people and/or animals.
· Destruction of property
o The person with Conduct Disorder may intentionally start a fire with the purpose of causing destruction, or purposely destroy property though means other than fire (for example, vandalism)
· Deceitfulness or theft
o The person with Conduct Disorder may have broken into someone’s house, car, etc. The person lies, or “cons” others. Also, he/she may have stolen items without contact with a victim (such as through shoplifting or forgery)
· Serious violation of rules
o The person with Conduct Disorder may often stay out late, despite parent rules, beginning before 13 years old. He/she may have run away from home at least twice. The person with Conduct Disorder may often skip school beginning before 13 years old.
The behavior has to occur on a frequent basis, not just a few times, in order for the person to be identified as someone with conduct disorder. The behavior that the person engages in also has to hurt the person’s social, academic, or occupational functioning. A person can also be diagnosed with conduct disorder if he or she is 18 or older and the criteria for Antisocial Personality Disorder were not met. (American Psychiatric Association, 68-69). Males with Conduct Disorder usually display aggression, such as fighting, stealing, and vandalism. Females are more likely to display truancy, running away, substance abuse, prostitution, or chronic lying (Sue, 509).
There are three code types of Conduct Disorder. Conduct Disorder, Childhood-Onset Type involves the onset of at least one of the problems occurring before 10 years old and Conduct Disorder, Adolescent-Onset Type is the diagnosis given to a person who did not display any characteristics before 10 years old. When the age of onset is not known, the person is diagnosed with Conduct Disorder, Unspecified Onset. A person who has a mild severity displays few problems beyond those that were necessary to make the diagnosis, and the person’s actions only cause minor harm to others (such as truancy or staying out at night). A person with moderate severity displays more conduct problems and a slighter increase of harm toward others (such as stealing with not in contact with the victim or vandalism). A person has a severe severity of Conduct Disorder when he/she exhibits many conduct problems beyond the amount necessary to make the diagnosis or the conduct problems cause great harm to others (such as physical cruelty, using a weapon, or breaking and entering) (American Psychiatric Association, 69).
Children and adolescents with Conduct Disorder are more likely to look for new situations and do not care as much about avoiding risk or harm. (Sue, 509). By six or seven years old, these children can start exhibiting less concern for others. (Bukatko, 456). Children are less likely to outgrow Conduct Disorder than they are other disorders. Besides exhibiting the behaviors necessary to diagnose conduct disorder, the person may also withdraw or depressed. (Sue, 509)
Prevalence
A range of one half to two thirds of the children and adolescents who are referred to mental health centers in the U.S. display Conduct Disorder (Bukatko, 455). Estimates of prevalence range from 1 to 10 percent of the population. Males are more likely to be diagnosed, along with a person living in an urban setting. Those with early onset usually have more chronic and more serious offenses, and are at a greater risk of adult Antisocial Personality Disorder (Sue, 508). This can be comorbid with children with ADHD hyperactive and combination subtypes. The rate of comorbid Conduct Disorders is 25 percent in boys and 8 percent in girls (Geffner, 21). Also, many children had Oppositional Defiant Disorder before being diagnosed with Childhood-Onset Conduct Disorder (Sue, 509).
Treatment
Psychotherapy has not always been very successful in helping those with Conduct Disorder. This is especially true for those beginning treatment later in life (Bukatko, 456) However, there have been some programs developed to try to help. These programs teach skills such as how to play cooperatively, developing verbal skills, developing problem solving skills, and teaching social skills through roll play and videos. Parent management training has also shown to be helpful. These programs help teach parents skills to establish rules, implement consequences, and reward positive behavior. (Sue, 511) Children and adolescents with Conduct Disorder can also be treated with stimulant medication. These help the person to be more attentive, less antisocial, and less aggressive. Combining medications, such as psychostimulants with antidepressants also can be effective. (Geffner, 21)
Outlook
Conduct Disorder often leads to criminal behavior, antisocial personality, and problems adjusting to marriage or jobs. People with Conduct Disorder start using drugs and alcohol early in life (Sue, 509).
Sources
American Psychiatric Association. (2000). Diagnostic and statistical manual of
mental disorders (4th ed., text revision). Arlington, VA: Author.
Bukatko, Danuta and Daehler, Marvin W. (2004). Child Development. Boston:
Houghton Mifflin.
Geffner, Donna (2005). Attention-Deficit/Hyperactivity Disorder: What
Professionals Need to Know. Eau Claire: Thinking Publications.
Sue, David, Derald Wing Sue, and Stanley Sue (2003). Understanding Abnormal
Behavior. Boston: Houghton Mifflin.