What is conduct disorder?

Definition: A repetitive pattern of behaviour in which the basic rights of others or major age appropriate societal norms or rules are violated. (DSM-IV)

Children or young people with exhibit some of the following behaviours.

1. aggression to people and animals

Identification of the presence of a conduct disorder is a specific diagnosis on the basis of specific symptoms. Diagnosis must be made by a trained mental health professional, and is done on the basis of extensive assessment of symptoms and other contributory factors. Thus it is important to recognise that not all young people who misbehave have a conduct disorder. Judgements concerning the presence of conduct disorder should take into account the child’s developmental level. For example, temper tantrums are a normal part of a 3 year olds development, so their presence alone would not be a grounds for diagnosis. Equally, one outburst of aggressive or destructive behaviour does not mean a child has a conduct disorder. However sometimes the child continues to behave badly for several months or longer, and the behaviour is out of the ordinary and seriously breaks the rules accepted by family and community. This behaviour is more than ordinary childhood mischief or adolescent rebellion. This sort of behaviour affects a child’s development and their ability to lead a normal life.

There are a number of sub-varieties of conduct disorder. Primarily these are differentiated by the age at which the behaviour first begins. Childhood-onset type requires the onset of at least one defining characteristic of conduct disorder before the age of 10 years. Adolescent onset type requires the absence of any defining characteristic of conduct disorder prior to 10 years of age.

Many factors may contribute to a child developing a conduct disorder. Recent theoretical models have proposed multiple, interacting risk factors including biological and neurological vulnerabilities, child abuse, negative family and social experiences and parent-child relationship problems including poor management and monitoring of child behaviour and the lack of a positive affective bond between parent and child.

Treatment of Conduct Disorder.

Research shows that children with conduct disorder are likely to have ongoing problems if they and their families do not receive early and comprehensive treatment. Without treatment, children are unlikely to adapt to the demands of adulthood, continue to have problems with relationships and holding a job, they often break the law and behave in an antisocial manner. Treatment is complex and challenging, and each young person is unique. Treatment of conduct disorder often consists of group, individual and/or family therapy and education about the disorder, behavioural management – structure, support, limit setting, consistent rules, identification with healthy role models, social skills training, behavioural modification, and sometimes residential or day treatment or medicine.

It is common for conduct disorder to exist with other disorders. The most common combination is conduct disorder and ADHD. Also common is conduct disorder with depression or anxiety, with substance abuse, with learning disabilities and bipolar disorder.

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