Conduct Disorder | Research & Encyclopedia Articles

Conduct disorder refers to a behavioral disturbance in children. Children with the disorder behave repeatedly in ways that violate the basic rights of others and that society does not consider appropriate for their age. The behavior is different from general misbehavior, which occurs among nearly all children: usually it lasts longer, is more severe, and involves different kinds of actions. It also has more serious consequences than typical childhood mischief. Conduct disorder is the behavioral problem that child psychiatrists most often treat. Reports of the number of children who have conduct disorder range from less than 1 percent to more than 10 percent of all children. These children are often called antisocial, and one-quarter to one-half of such children will have antisocial personality disorder as adults.

The behaviors that characterize conduct disorder include:

• theft
• vandalism
• physical fights—sometimes with weapons
• fire setting
• running away from home
• truancy
• repetitive lying
• forcing sexual activity on others
• physical cruelty to animals and to people
• substance abuse

Law enforcement may become involved when children commit these acts.

Conduct disorder appears to be more common in boys than in girls and more common in urban areas than in rural areas. Girls with a conduct disorder are likely to run away from home and/or become involved in prostitution. Children with this disorder rarely perform at an academic level in keeping with their intelligence or age, and they often have poor relationships with peers. They are more likely than other children to suffer from depression, to have suicidal thoughts, to make suicidal attempts, and to commit suicide.

Some of the factors that contribute to conduct disorder have to do with biology, while others have to do with the family and social life of the child. Social factors include:

• a family history of antisocial personality disorder or alcohol dependence (or both)
• parents who have poor parenting skills
• early rejection by the mother
• early institutionalization (placement at a young age in a group home or institutions)
• large family size and crowding in the home
• a chaotic home environment
• lower economic status

Biological factors that contribute to conduct disorder include:

• mild abnormalities of the central nervous system (the brain and spinal cord)
• neurological damage during the birth process
• insensitivity to physical pain

Often, children with conduct disorder are also diagnosed with attention deficit disorder or attention-deficit/hyperactivity disorder and some developmental disorders.

As adults, these children frequently have psychiatric problems. They are less likely to do well in higher education and hold on to jobs, and more likely to commit crimes, to smoke, to abuse alcohol,and to use illegal drugs. Many will have problems with dependence and will seek treatment many times in their lives for drug abuse.

In individuals with both conduct disorder and substance abuse, a common combination, the conduct disorder usually appears before the drug abuse. Many individuals have a genetic predisposition to both substance abuse and conduct disorder. This means that they have inherited a trait that makes it likely they will both use drugs and behave in antisocial and violent ways.

Drug use during adolescence almost always involves illegal behavior plus a deviant peer group. As a result, drug use increases the risk for violent assault as well as getting arrested and convicted for drug possession or selling. The use of drugs in early to mid-adolescence sets up a pattern of antisocial behaviors that may last into adulthood.

Conduct disorder in children and adolescents can be treated through family therapy, individual therapy, and residential treatment programs. The most promising treatment, however, appears to be a training program for parents in which they learn skills for managing their children and encouraging them to behave in positive ways. The children also receive training in the use of problem-solving strategies.

Four drugs have been tested as treatments for conduct disorder in children. One test showed that lithium and methylphenidate (Ritalin) can reduce aggressiveness in children. Tests of the other two drugs, carbamazepine (Tegretol) and clonidine (Catapres), showed they were also effective in reducing aggressiveness but had many side effects.

Conduct disorder is a very difficult condition that presents risks to individuals, families, and society. More research into conduct disorder may eventually reveal ways to prevent it or to treat it effectively once it is diagnosed.

Antisocial Personality; Attention-Deficit/Hyperactivity Disorder; Crime and Drugs; Families and Drug Use; Risk Factors for Substance Abuse; Ritalin.

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