Is your child behaving unruly? Is he breaking the rules? Let's talk about Conduct Disorder!

Does your child not listen to a word you say? Does he fight all the time? Does he bully other children, maybe even animals? Sometimes you might think, 'What's wrong with this child? Why is he behaving so badly?' In fact, if this kind of behavior continues for months, it's not just a simple mischief . It could be a symptom of a mental health condition called ``Conduct Disorder''. Let's talk about this simply, in a way that you can understand.

What is this (Conduct Disorder)?

Simply put, ``Conduct Disorder`` is a mental health condition that can be seen in children and young people (between the ages of 10 and 19). In this, the main thing is that the child constantly behaves in an aggressive manner without considering others and acts in a way that harms the well-being and rights of others. Also, these children often break the rules at home and school, and do not care about social norms at all.

Think of it like a group of behavioral disorders. You may have heard of a condition called Oppositional Defiant Disorder (ODD). In this condition, a child disobeys adults, argues frequently, and intentionally provokes others. Sometimes, this ODD can become more severe and become Conduct Disorder.

Another important thing is that children with ``Conduct Disorder`` are more likely to have other mental health conditions as well. For example:

• Depression .
• Attention-Deficit/Hyperactivity Disorder (ADHD) .
• Learning disorders .

What is the difference between Conduct Disorder and Personality Disorders?

Now you may be wondering, is this a personality disorder? A personality disorder is a long-term, severe problem with one's thoughts, behavior, mood, and relationships with others. Most of the time, these personality disorders begin in adolescence, when personality is still developing. Therefore, people over the age of 18 are usually diagnosed with a personality disorder.

However, there is one exception to this. That is a condition called `(Antisocial Personality Disorder - ASPD)`. About 80% of people with this condition can start showing symptoms as early as 11 years of age. In fact, there is not much difference between `(Conduct Disorder)` seen in childhood and `(ASPD)` seen in adulthood. However, `(Conduct Disorder)` is a diagnosis given to children. If an adult shows symptoms related to both of these conditions, a mental health counselor will give a diagnosis of `(ASPD)` instead of `(Conduct Disorder).

Who gets Conduct Disorder?

This condition affects children and young adults. It can sometimes start as early as age 10, which is called "early onset." However, it is most common in young adults (between the ages of 10 and 19).

Statistically, the condition is more common in boys than girls. Symptoms usually begin to appear between the ages of 10-12 in boys and 14-16 in girls.

How common is Conduct Disorder?

According to statistics in the United States, this condition affects between 2% and 10% of children and young adults. Similar conditions are seen in our country as well, but it is difficult to give exact statistics.

What are the symptoms of Conduct Disorder?

This is not something that happens overnight. The behaviors associated with ``Conduct Disorder`` develop gradually in a child. These children are stubborn, difficult to control, and do not seem to care about the feelings of others.

There are four basic types of conduct disorder :

1. Being aggressive towards people and animals and/or violating the fundamental rights of others.

2. Destruction of property.

3. Cheating, lying and/or stealing.

4. Serious violation of rules and regulations.

Now let's look at each of these behaviors in a little more detail.

1. Aggression towards others and animals

The following are the characteristics:

• Bullying other children.
• Physically assaulted (perhaps even using sharp weapons ).
• They are always fighting with words and threatening.
• They are forced into sexual acts.
• They blame others for their mistakes.
• Animals are hurt and tortured.

Imagine, there is a kid named 'Kasun' in school. He always hits other kids in class, steals their food, and makes fun of them. Sometimes he throws stones at dogs on the street. If he keeps doing things like this, it's something to be concerned about.

2. Destruction of property

This includes:

• Arson is intentional.
• Vandalizing or destroying other people's things. For example, breaking school desks and chairs, or writing graffiti on walls.

3. Cheating, lying and stealing

These characteristics are:

• They always lie to gain an advantage or to avoid responsibility.
• They steal from other people or from shops.
• They sneak into homes and businesses to steal goods.

4. Serious violation of rules and regulations

Things that come under this:

• Breaking the rules for no apparent reason.
• Truancy is the act of not going to school.
• Running away from home.
• They always break the rules set by their parents.

Other common symptoms of Conduct Disorder

In addition to these basic features, you can see other things:

• Excessive alcohol and/or drug use.
• Frequent risky sexual behavior.
• Gets angry quickly and gets agitated.
• They make no effort to hide their aggressive behavior.
• They show no remorse for their wrongdoings.
• It's hard to make friends and maintain friendships.

The important thing is that occasional stubborn and disobedient behavior is normal during childhood and adolescence. However, to be diagnosed as a ``Conduct Disorder'', these characteristics must be persistent, disruptive to others, and occur in a repetitive pattern.

Symptoms of Conduct Disorder in Adults

As children with Conduct Disorder grow up, they may have difficulty holding down a job or maintaining relationships. They may also engage in illegal or dangerous behavior. As mentioned earlier, if an adult exhibits these characteristics, it may be called Antisocial Personality Disorder (ASPD).

What are the causes of Conduct Disorder?

Now you're probably thinking, "Why on earth is this happening to my child?" It's really hard to pinpoint just one reason. Researchers say it's likely a complex combination of both genetic/biological factors and environmental factors .

Genetic/biological factors:

• Various studies have shown that some traits associated with ``Conduct Disorder'' (e.g. antisocial behavior, willfulness, quick temper, aggression, insensitivity to punishment) can be inherited .
• It has been found that increased levels of the hormone ``Testosterone`` in the body are linked to aggression.
• Traumatic brain injury, seizures, and damage to the nervous system can also cause aggressive behavior.

Parental, family and environmental factors:

• Parents of young children with Conduct Disorder may be involved in substance abuse or antisocial behavior. They may also have conditions such as ADHD, mood disorders, schizophrenia, or antisocial personality disorder.
• If the home environment is chaotic, there is no proper supervision, or there are frequent fights between parents , it can affect the child's behavior. These can lead to ``Conduct Disorder``.
• Children who are frequently exposed to domestic violence are more likely to develop ``Conduct Disorder''.
• Living in a low socio-economic status, having too many people in the household, and unemployment can lead to economic and social stress. This can make it difficult for parents to look after their children properly. This situation is more common among children living in low socio-economic status.
• If drugs are easily available in the environment where a child lives, and if there is a lot of crime , that child is at greater risk of developing a ``Conduct Disorder''.

But remember this: Even children from very well-functioning, healthy families can develop ``Conduct Disorder.'' So don't think, "There's nothing wrong with my family, so how did this happen?"

How to recognize (Conduct Disorder)?

This can only be diagnosed by a mental health professional. That means a ``Psychologist`` or a ``Psychiatrist``. They use criteria from the American Psychiatric Association's ``Diagnostic and Statistical Manual of Mental Disorders (DSM)`` guidebook.

According to that criteria, a child or young person must have exhibited three or more of the following behaviors within the past 12 months . Also, at least one of the symptoms must have been present within the past 6 months :

• Aggression towards people and/or animals.
• Destruction of property.
• Cheating, lying, or stealing.
• Serious violation of parental rules.

These behaviors must also have a significant impact on the child's relationships, home life, schoolwork, and/or work (if a young child) .

If your child is showing signs of Conduct Disorder, he or she may need to be referred to a Child and Adolescent Psychologist or Child and Adolescent Psychiatrist. These professionals use specially designed interviews and assessment tools to evaluate the child for a mental health condition.

Often, psychologists and psychiatrists obtain information from the child's parents, siblings, friends, and teachers to get a complete picture of the child's behavior.

How is Conduct Disorder treated?

The main treatment for Conduct Disorder is various types of psychotherapy . These need to be done with the child, the family, and sometimes at the community level.

Some of the main treatment methods are:

• Parent Management Training: This involves training the child's parents on how to discipline their child, set consistent rules, reward and encourage good behavior, and control bad behavior. Simply put, they teach them how to 'manage' their child.
• Psychotherapy: Psychotherapy is a group of treatment techniques that help a person identify and change their distressing feelings, thoughts, and behaviors. Working with a mental health counselor, the child and family receive support, education, and guidance. Psychotherapy for conduct disorder usually focuses on family life and school life, helping to improve family relationships, academic success, and the child's behavior in various environments.
• Anger Management Training: The goal of this is to reduce the emotional and physical arousal that a child experiences due to anger. Since it is impossible to completely avoid people or things that make them angry, this training teaches the child how to control their reactions.
• Individual psychotherapy, such as cognitive behavioral therapy (CBT): Individual therapy for a child with conduct disorder focuses on developing problem-solving skills, resolving conflicts and strengthening relationships, and developing skills to reject negative influences in the environment.
• Community-based Treatment: This includes therapeutic schools and residential treatment centers. These can provide a structured program to reduce a child's disruptive behaviors.

Doctors do not usually prescribe medication directly for Conduct Disorder. However, since this condition can be accompanied by other mental health conditions (e.g. ADHD, Depression), the child may benefit from medication to manage those conditions.

Can Conduct Disorder be prevented?

As far as we know, there is no specific way to prevent `(Conduct Disorder)`. This is because it is caused by a complex combination of factors. However, if treatment is started as soon as symptoms appear , many of the problems associated with it can be reduced. Seeking help early can reduce the disruption to the child's life, family, and friendships.

What is the prognosis of Conduct Disorder?

The outlook for this condition depends on how early it develops and whether it is treated.

Typically, the disruptive behaviors associated with Conduct Disorder resolve by early adulthood. However, in about one-third of cases, these behaviors persist. Many of these cases meet the criteria for Antisocial Personality Disorder (ASPD).

Early onset of the condition before the age of 10 is associated with poorer vision. It is also strongly associated with significant impairment in school performance.

Some children and young people with Conduct Disorder may also have other mental health conditions. Examples include:

• Mood or anxiety disorders.
• Somatic symptom disorder.
• Alcohol use disorder and/or substance use disorder.
• Early adult-onset psychotic disorders.

Conditions such as depression and bipolar disorder can develop during adolescence and early adulthood. Suicidal ideation can be a complication of these conditions. If your child is talking about or threatening suicide, it is extremely important to seek medical help immediately.

How do I take care of my child with conduct disorder?

If your child has a ``Conduct Disorder,'' in addition to seeking professional help, here are some ways you can help yourself and your child:

• Learn about `(Conduct Disorder)` and stay informed about the latest research on effective treatments.
• Talk to a mental health counselor . If possible, find someone who is trained in diagnosing and treating Conduct Disorder.
• Explore available treatment options. Treatment should be tailored to the child's needs and be family-centered.
• Find a family support group or organization in your community.

When should I see a doctor about my child's (Conduct Disorder)?

If your child has been diagnosed with a ``Conduct Disorder'' and their behavior is getting worse, or is interfering with family life or schoolwork, talk to their mental health professional.

Most importantly: If your child exhibits dangerous behaviors that could harm themselves, others, or animals, seek medical help immediately.

Disobedient, aggressive children can be a big challenge for parents. While it is normal for toddlers and young children to occasionally display disobedient behavior, persistent, disruptive, aggressive behavior can be a sign of a ``Conduct Disorder.''

It is very important to start treatment for Conduct Disorder early . The first step in treatment is to talk to a doctor or mental health counselor . Don't be afraid to ask your doctor questions. They are there to help you.

Take-Home Message

• Conduct Disorder is a serious behavioral pattern seen in children and adolescents. This is not a simple mischief.
• If symptoms such as aggression, breaking the law, cheating, and property destruction persist , be sure to seek professional advice .
• This is caused by a combination of genetic, biological, and environmental factors.
• Early identification and appropriate treatment (especially psychotherapy and parent training) can bring great relief to the child and family.
• You are not alone. Don't be afraid to ask for help. With the right support, this situation can be managed.

` Conduct Disorder, Children's Behavior Problems, Mental Health, Child Psychiatry, Parenting Advice, Aggressive Children, Behavioral Disorders