Conduct Disorders

“Conduct disorders” are a complicated group of behavioral and emotional problems in youngsters. Children and adolescents with these disorders have great difficulty following rules and behaving in a socially acceptable way. They are often viewed by other children, adults and social agencies as “bad” or delinquent, rather than mentally ill.

Children or adolescents with conduct problems may exhibit some of the following behaviors:

Aggression to people and animals

  • bullies, threatens or intimidates others
  • often initiates physical fights o uses weapon that could cause serious physical harm to others (e.g. a bat, brick, broken bottle, knife or gun)
  • is physically cruel to people or animals
  • steals from a victim while confronting them (e.g. assult)
  • forces someone into sexual activity

Destruction of Property

  • deliberately engages in fire setting with the intention to cause damage deliberately destroys other’s property

Deceitfulness, lying, or stealing

  • breaks into someone else’s building, house, or car
  • lies to obtain goods, or favors or to avoid obligations
  • steals items without confronting a victim (e.g. shoplifting, but without breaking and entering)

Serious violations of rules

  • often stays out at night despite parental objections
  • runs away from home
  • often truant from school

Research shows that the future of these youngsters is likely to be very unhappy if they and their families do not receive early, ongoing and comprehensive treatment. Without treatment, many youngsters with conduct disorders are unable to adapt to the demands of adulthood and continue to have problems with relationships and holding a job. They often break laws or behave antisocially. Many children with a conduct disorder may be diagnosed as also having a coexisting depression or an attention deficit disorder.

Many factors may lead to a child developing conduct disorders, including brain damage, child abuse, defects in growth, school failure and negative family and social experiences. The child’s “bad” behavior causes a negative reaction from others, which makes the child behave even worse.

Treatment of children with conduct disorders is difficult because the causes of the illness are complex and each youngster is unique. Treatment can be provided in a variety of different treatment settings depending on the severity of the behaviors. Adding to the challenge of treatment are the child’s uncooperative attitude, fear and distrust of adults. In order to form a comprehensive treatment plan, a child and adolescent psychiatrist may use information from other medical specialists such as a behavioral health expert, and from the child, family and teachers to understand the causes of the disorder.

Behavior therapy and psychotherapy are usually necessary to help the child appropriately express and control anger. Remedial education may be needed for youngsters with learning disabilities. Parents often need expert assistance in devising and carrying out special management and educational programs in the home and at school. Treatment may also include medication in some youngsters, such as those with difficulty paying attention and controlling movement or those having an associated depression.

Treatment is rarely brief since establishing new attitudes and behavior patterns takes time. However, treatment offers a good chance for considerable improvement in the present and hope for a more successful future.

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Copyright © 1997 by the American Academy of Child & Adolescent Psychiatry.

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