Conduct disorder, a behavioral disorder in children and adolescents, characterized by aggressive or unacceptable behaviors that violate age appropriate social standards or rights of others. This may include delinquent behaviors (running away), irresponsibility, violating the rights of others (theft), and physical aggression, such as rape or assault. These factors can occur alone or in combination with the other factors.
The children suffering from Conduct Disorder (CD) seem difficult to control their anger and cannot act in socially acceptable ways. The frequency of occurrence of this disorder in the society is approximately 3-10 out of 100 children, and with boys is more to exhibit this behavior as compared to girls.
The Conduct Disorder Syndrome can also be grouped into Oppositional Defiance Disorder (ODD) which defines aggressive, negativistic and defiant behavior.
Symptoms of Conduct Disorder
The symptoms are usually the combination of behaviors, such as lying, stealing, running away from home, setting fires, vandalism, and cruelty to humans and animals, initiating fights and using weapons.
Causes of Conduct Disorder
Many factors contribute to the development and the origin of the Conduct Disorder.
• Neuropsychological testing has revealed that adolescents and children have impaired frontal lobe that interferes with their ability to avoid harm, plan, and learn from unpleasant experiences. The frontal lobe is considered for reasons or impulse control. So, children with frontal lobe dysfunction often act irresponsibly without thinking about the consequences.
• Genetics is also believed to be a predisposing factor for causing the Conduct Disorder.
• Anger management problems are also there, and they ought to strike at any easy target.
• Traumatic life experiences like physical or sexual abuse at young age also lead to the development of Conduct Disorder.
• Poor environmental influences like dysfunctional families children are inclined towards developing the Conduct Disorder. Children suffering from this disorder have no remorse or small empathy, which turns out, into an extremely dangerous adult.
Clinical Examination and tests
No real test, has been developed to detect the conduct disorder. If a child suffering, from such kind of negative behaviors has a family history of conduct disorders, then the diagnosis is made.
Blood tests and physical examination can help in ruling out the medical conditions, while a brain scan may sometime is useful in ruling out this disorder.
Treatments for Conduct Disorder in Children
To get the treatment successful and support in managing the child’s behavioral problems the child’s family has to be closely involved making them understand the techniques for treating their problem child.
• If the child has been abused at home, the child is kept in a quiet and less chaotic home. Some conditions, such as attention deficit disorder and depression also occur with CD, so talk therapy and treatment with medication is useful in such cases.
• Behavior modifications are for both the child and the parents and therapist teach them through the methods, such as, selective reinforcement, modeling and behavioral role playing.
• In the residential Community Based Programs children and parents, both are involved for tutoring, social skills training and reinforcement procedures.
• Boot camps and wilderness programs are also given to the parents, but they use confrontation or attack therapy which can prove to be harmful and it also does not have any research support.
• Research has suggested that children should be treated effectively at home with their family.
Let us take these treatments in detail:
Parent Management training- When parents can make changes in their behavior this type of practice has been found extremely helpful with the aggressive children. Parent’s cooperation is required to the fullest in order to make appropriate changes in the disciplined behavior of their children. When the relationship between parents and the child becomes healthy children can navigate in their academic and social field in a productive manner.
Family Therapy- With the help of this approach family is able to learn to develop a strong atmosphere at home which can foster positive reinforcement, direct communication, support, conflict resolution and problem solving in an effective way.
Trainings for Social Skills- Problem solving activities can be enhanced through these types of trainings. Difficult situations can be identified, recognized and handled in an effective way. By putting efforts in this approach youngsters become open and close with adults and that in turn helps in treating the children suffering from Conduct Disorder, as they seem somewhat alienated and distant from the adults.
Special school based residential training programs are extremely useful in integrating the child back into the regular school life as soon as the child’s behavior changes.
Psychotherapy- This treatment involves a consistent and loving relationship of youngsters with the older individual. This treatment when coupled with other treatments help in figuring out the exact cause behind the negative behavior of the child. As the child becomes older, the therapist is able to understand the actions and motions of the child and can the ways to deal with both.
Medication- The cause of Conduct Disorder is due to accumulation of emotional, biological and social stresses. No single line of medication is found useful other psychiatric problems, such as depression, hyperactivity, schizophrenia, and depressive illness can also alter the symptoms of chronic conduct disorder.
If a child is suffering from ADHD, use of stimulants can reduce the impulsiveness and negative behavior. Lithium, which is an, anticonvulsant, and mood stabilizer is quite useful in reducing impulsive aggression. Judicious use of medication according to the patient’s condition can be successful in the treatment of Conduct Disorder.
Prognosis
• There are chances that children suffering from conduct disorder may develop antisocial personality disorder as adults. The conditions will become worst if the individuals also develop legal and drug problems.
• Other complications that can occur are bipolar, and depression disorder, more violent behavior and suicidal tendencies are also been reported.
Medicines used for treating Conduct Disorder
Anti Anxiety Medicine: If the child feels nervous these drugs are given as a shot or by mouth.
Anti Depressants: This can prevent the depression and it is usually given by mouth.
Anti Convulsant: If the child is suffering from seizures, this medicine can control the aggression, irritability or the aggressive behavior. It is usually given by mouth or as a shot.
Anti Psycholtics: Severe or severe agitation is treated through these medicines and it is given by mouth, as a shot, or suppository in the anus.
Anti Parkinson’s: These medicines are used to control twitches, stiffness, and anxiety and are normally given my mouth.
Pshychostimulant : This medicine will help the child in improving concentration and attention; energy level of the child is also increased and is given by mouth.
Sedatives: The problem of insomnia in the child is treated through this medication, may be given as a shot, by mouth or as a suppository in the anus.
When to seek advice from Medical Professionals?
Parents need to seek advice of the doctor if the child has several mood swings, is cruel to animals, bullying others, or is overly aggressive.
Prevention of Conduct Disorder
As soon as treatment for CD is started, the child will learn the normal behaviors and complications will be prevented. Consistent treatment with dedication and regular follow up from parents is a must for treating the child suffering from Conduct Disorder.
If depression is stubbornly and severely persisting then merely courage cannot beat it. However, looking back into the time depression was not considered as a disease. People used to cheer up and move on with the situation to get out of their grief. Sometimes it helped and sometimes not!
