Conduct disorder DSM-5* is a diagnosis that is usually given to children and adolescents under the age of 18. They repeatedly violate the rights of other people, and they refuse to conform their behavior according to the law, as well as to what is considered normal for their age in society. Often called juvenile delinquency, conduct disorder’s behavior patterns often cause disciplinary action from parents and teachers, in addition to the juvenile justice system.
The behaviors of conduct disorder are grouped into four sections, including:
- Hostile behavior conduct that results in bodily injury to others or animals.
- Nonaggressive conduct that causes a casualty or destruction of other people’s possessions.
- Dishonesty or theft.
- Severe and repeated rule violations.
According to the DSM-5, conduct disorder can appear as early as the preschool years with oppositional defiant disorder as a common premorbid condition that may progress to Conduct Disorder. Middle childhood to middle adolescence is the time period when Conduct Disorder symptoms are most likely shown.
Conduct disorder is broken down into two subtypes according to the age of onset of the disorder —childhood onset type and adolescent onset type. In each subtype, the disorder can be mild, moderate or severe. It’s important to note that, because many of the behaviors of individuals with conduct disorder are hidden, parents and caregivers may not have reported the symptoms and overestimate the year conduct disorder began.
In addition, there is a category titled unspecified onset, which means that the time when the conduct disorder began is unknown.
*Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, is published by the American Psychiatric Association.
Childhood Onset Type
Childhood onset type conduct disorder is typically found in males. Children prior to the age of 10 must have the minimum of a criterion in order to be diagnosed with the disorder:
- Show physical aggressiveness to others.
- Have disturbed relationships with peers.
- Had oppositional defiant disorder when he was a youngster.
- Symptoms usually meet the full criteria for conduct disorder before puberty.
These children are more apt to have continuous conduct disorder that develops into adult antisocial personality disorder than individuals with adolescent onset type.
Adolescent Onset Type
When compared to individuals with childhood onset type, the adolescents are less likely to show aggressive behaviors. They usually show the following:
- More normal peer relationships than that of childhood onset type.
- Often show conduct problems while they’re with others.
- Less likelihood of having persistent conduct disorder or developing adult antisocial personality disorder.
Specific Symptoms of Conduct Disorder
Conduct disorder is the repeated and continuous pattern of behavior that is present in the preceding year, and a minimum of a criterion being present in the last six months.
- Bullying, intimidating and threatening others often.
- Starts fights often.
- Has used a weapon that can result in severe harm to other people. (These items may include bat, knives, broken bottles or bricks.)
- Physically cruel to people or animals.
- Stealing, such as armed robbery, mugging.
- Forced another person into sexual activity.
- Setting fires, wanting to cause serious damage.
- Has destroyed other people’s possessions (other methods than setting fire).
- Has broken into another person’s house, a building or vehicle.
- Often lies to get something. (They are often known to con others.)
- Has stolen things without confronting the victim (shoplifting without breaking and entering and forgery).
- Many times will stay out at night, although it’s against the parents’ rules. This behavior usually begins prior to the age of 13.
- Has run away from home overnight at least two times while in the care of parents or caregiver’s home. This behavior may happen once; however, the individual doesn’t return home for a long period of time.
- Often skips school beginning prior to the age of 13.
- Prosocial behavior—intentions to help other people with no expectation for a reward—is limited. Shows an absence of remorse, guilt, empathy and may be shallow, unconcerned and callous.
- Rejection by more prosocial peers.
- Associating with delinquent peers.
People with these types of disturbances in their behavior encounter significant impairment socially, academically or in occupations.
What Causes Conduct Disorder?
Genetic factors may contribute to the development of conduct disorder.* Damage to the frontal lobe of the brain has been connected to conduct disorder. This part of the brain is what regulates cognitive skills, including problem-solving, memory and emotional expression. It is the “home” to an individual’s personality. The frontal lobe in an individual with Conduct Disorder may not work the way it should and can cause:
- A lack of impulse control
- Reduction in the ability to plan for the future
- Less ability to learn from past negative experiences
*Frontal lobe impairment may be genetic, inherited or caused by brain damage because of an injury. A child may inherit personality traits that are usually shown in conduct disorder.
In addition, there are also environmental factors that may contribute to conduct disorder. These include:
- Child abuse
- Dysfunction in the family
- Parents who abuse drugs or alcohol
- Being poor
Is There Treatment for Conduct Disorder?
While it’s difficult to overcome conduct disorder, it’s not a hopeless situation. When there is support from parents, teachers, and others, conduct disorder is able to be managed.
Individuals with conduct disorder are instilled with negative attitudes. Psychotherapy and behavioral therapy usually includes the family and others in the support system. Therapy is usually over a long period of time. The sooner the condition is diagnosed, the more successful therapy will be. A child can learn better ways to interact with family members, peers at school and in various situations. In addition, the family is taught the most effective ways to communicate with the child.
With younger children, treatment may include parent management training. A therapist will teach parents how to encourage positive behaviors in their children.
In addition, therapy for adolescents with conduct disorder may include interactions with teachers and other authorities at school.