Conduct disorder Health Article

Definition

Conduct disorder is a childhood behavior disorder characterized by aggressive and destructive activities that cause disruptions in the child's natural environments such as home, school, church, or the neighborhood. The overriding feature of conduct disorder is the repetitive and persistent pattern of behaviors that violate societal norms and the rights of other people. It is one of the most prevalent categories of mental health problems of children in the United States, with rates estimated at 9% for males and 2% for females.

Description

The specific behaviors used to produce a diagnosisof conduct disorder fall into four groups: aggressive conduct that causes or threatens physical harm to other people or animals, nonaggressive behavior that causes property loss or damage, deceitfulness or theft, and serious violations of rules. Two subtypes of conduct disorder can be delineated based on the age that symptoms first appear. Childhood-onset type is appropriate for children showing at least one of the behaviors in question before the age of 10. Adolescent onset type is defined by the absence of any conduct disorder criteria before the age of 10. Severity may be described as mild, moderate or severe, depending on the number of problems exhibited and their impact on other people.

Youngsters who show symptoms (most often aggression) before age 10 may also exhibit oppositional behavior and peer relationship problems. When they also show persistent conduct disorder and then develop adult antisocial personality disorder, they should be distinguished from individuals who had no symptoms of conduct disorder before age 10. The childhood type is more highly associated with heightened aggression, male gender, oppositional defiant disorder, and a family history of antisocial behavior.

The individual behaviors that can be observed when conduct disorder is diagnosed may be both common, problematic, and chronic. They tend to occur frequently and are distressingly consistent across time, settings, and families. Not surprisingly, these children function poorly in a variety of places. In fact, the behaviors clustered within the term "conduct disorder" account for a majority of clinical referrals, classroom detentions or other sanctions, being asked to stop participating in numerous activities, and can be extremely difficult (even impossible) for parents to manage.

The negative consequences of conduct disorder, particularly childhood onset, may include illicit drug use, dropping out of school, violent behavior, severe family conflict, and frequent delinquent acts. Such behaviors often result in the child's eventual placement out of the home, in special education and/or the juvenile justice system. There is evidence that the rates of disruptive behavior disorders may be as high as 50% in youth in public sectors of care such as juvenile justice, alcohol and drug services, schools for youths with serious emotional disturbances, child welfare, and mental health.

The financial costs of crime and correction for repeated juvenile offenses by youth with conduct disorder are extensive. The social costs include citizens' fear of such behavior, loss of a sense of safety, and disruptions in classrooms that interfere with other children's opportunity to learn. The costs to the child and his or her family are enormous in terms of the emotional and other resources needed to address the consequences of the constellation of symptoms that define conduct disorder.