Conduct Disorder

Conduct Disorder (CD) is a severe emotional and behavioural disorder that is diagnosed in children and adolescents. It is characterized by a consistent pattern of behaviour in which they violate the basic rights of others or major age-appropriate societal norms or rules. This may include behaviours such as aggression, destruction of property, deceitfulness, theft, or serious rule-breaking. Early diagnosis and intervention are vital, as the disorder can progress and lead to problems in adulthood.

If you suspect you or someone else is experiencing Conduct Disorder, it is crucial to seek immediate medical attention by calling emergency services or consult with a Psychologist.

Causes

• Biological: Some studies suggest a difference in brain development or function may be at play in those with CD. Brain imaging studies have identified structural and functional differences in areas associated with impulse control, emotional regulation, and moral reasoning. • Environmental: Experiencing abuse, neglect, or trauma, growing up in a chaotic household, or having a history of parental substance abuse or mental illness can contribute to the development of CD. • Genetics: Family history can play a role. Children with a parent or sibling with CD or other mental health disorders might be at a higher risk.

Risk Factors

The following factors may increase the risk of developing or triggering conduct disorder: • History of child abuse or neglect • Family history of mental health disorders • Parental substance abuse or criminal behaviour • Family conflict and instability • Early institutional living or frequent changes in caregivers Complications from untreated or inadequately treated conduct disorder may include: • Poor academic performance • Substance use disorder • Problems at work or with relationships • Co-existing mental health disorders • Legal problems and incarceration

Symptoms

• Aggressive Behaviour: This is characterized by bullying, cruelty towards animals, initiating physical fights, using a weapon in fights, and physically harming someone with the intent to do so. • Destructive Behaviour: Children and adolescents with CD may deliberately engage in acts of arson or other intentional destruction of property. • Deceitfulness: This can manifest as frequent lying, conning others for personal gain or pleasure, and theft (breaking into someone's house, car, or other properties). • Violating Rules: Individuals with CD may often break rules without clear reason. This includes staying out at night despite parental objections, running away from home, and truancy before the age of 13. • Lack of Empathy: They might have a blatant disregard for others' feelings, an inability to maintain relationships, or a lack of guilt after misbehaving.

Diagnosis

• Clinical Evaluation: A mental health professional will typically conduct a comprehensive evaluation. This might involve direct observation, obtaining a detailed family history, and using standard scoring questionnaires that assess behaviour. • Physical Examination: This ensures that a physical ailment isn't causing the behaviours. Certain medical conditions, medications, or substances can cause behavioural issues that might mimic CD. • Interviews: Teachers, family members, or other adults who have frequent interactions with the child can provide valuable information.

Treatments

• Psychotherapy: Individual therapy can address the emotional issues that contribute to CD. Cognitive-behavioural therapy (CBT) can help the child recognize and change their negative behaviour patterns. • Family Therapy: This treatment can improve overall family dynamics and communication. It often teaches families how to employ positive reinforcement and consistent discipline techniques. • Group Therapy: Sometimes, being in therapy with peers can provide additional insights and coping mechanisms. However, care needs to be taken to ensure the group reinforces positive behaviour and not negative patterns. • Medication: While no drug is FDA-approved specifically for its treatment, some medications may be used to address specific symptoms or co-existing conditions. For example, ADHD medication might be prescribed if the child has co-existing ADHD, or mood stabilizers/antipsychotic medications for severe aggression. • Parent Management Training: This educates parents on how to change or manage their child's behaviour.

Preventive Measures

• Early Intervention: Recognizing and addressing the symptoms early on can prevent them from worsening. If a child shows signs of CD, it's essential to seek professional guidance immediately. • Consistent Parenting: Children thrive on consistency. Predictable consequences (both rewards and punishments) for actions can help reinforce behavioural norms. • Promotion of School-based Programs: Schools can play an integral role in promoting positive behaviours. Programs that foster social and emotional learning can be beneficial. • Avoiding Drug or Alcohol Abuse: Substance abuse can exacerbate symptoms and increase the risk of CD. Educating kids and teens about the risks is crucial. • Therapy: Regular sessions with a therapist, even if no symptoms are present, can be a way to check in, address minor issues before they become major, and equip the child with coping skills.

Do's & Don’t's

If you suspect you or someone else is experiencing Conduct Disorder, it is crucial to seek immediate medical attention by calling emergency services or consult with a Psychologist.