" Mrs Smith's son has been expelled from three schools and has just been suspended from the fourth because of his behaviour. Dave is unable to follow the school rules, he gets into fights, bullies others, and is often caught smoking on school premises. Why can't Dave just do the right thing?"
Conduct disorder is characterized by a series of emotional and behavioural problems that first arise during childhood or adolescence and may persist until adulthood. Children with conduct disorder often find it difficult to follow rules and act in socially acceptable ways.
Conduct disorder can be classified into three categories based on when the disorder first appears.
- Childhood onset conduct disorder: the signs of a conduct disorder manifest before the age of 10.
- Adolescent onset conduct disorder: the conduct disorder begins during the teenage years (10-19). This is the most common type.
- Unspecified onset conduct disorder: the age at which the conduct disorder first began is unknown.
What are the symptoms of conduct disorder?
Children with conduct disorder are usually aggressive, impulsive, and unconcerned with the needs and feelings of others. Here are some of the symptoms, a child with conduct disorder will exhibit:
Aggressive behaviour: this may include bullying and/or intimidating others, harmful actions towards animals and people with or without a weapon.
- Lying and stealing
- Destructive behaviour such as vandalism, arson, breaking and entering, and intentional destruction of property.
- Drug and alcohol use
- Truancy: this includes skipping school and running away from home.
- Early sexual behaviour
- Deviant sexual behaviour such as forcing others into sexual acts
- Impulsivity: acting without considering the consequences of their actions.
- Unwilling to follow rules
- Disobedient and difficult to control
- Limited emotional expression: the child appears unemotional, heartless, has difficulty showing empathy or remorse, unable to understand the emotions of others.
The symptoms of a conduct disorder are often displayed by other children, but the frequency, duration, and intensity of the behaviour will be significantly different in children with conduct disorders. The extent to which it impacts their daily functioning must also be considered.
What puts a child at risk for a conduct disorder?
Conduct disorder has been linked to biological and environmental factors.
Biological: researchers have linked damage to the frontal lobe of the brain to this disorder. The frontal lobe of the brain is responsible for essential functions and behaviours such as decision-making, critical thinking, problem-solving, personality, emotional expression, and memory. Consequently, symptoms such as lack of future planning, poor impulse control, and inability to learn from past negative events may arise from damage to this area of the brain.
People who have other psychological/psychiatric disorders also have a higher chance of developing a conduct disorder.
Environmental: several environmental risk factors that may increase the risk of developing a conduct disorder have been identified. Some of them are:
- Being abused or neglected
- Living in an urban environment
- Living with parents who abuse alcohol/drugs.
- Having a family history of conduct disorder or other psychiatric disorder.
- Living in a troubled home environment
- A history of traumatic experiences
Being male is also identified as a risk factors for conduct disorder. Males have a higher chance of developing conduct disorders than females. Males are more likely to exhibit destructive and aggressive behaviour while females tend to lean towards rule violation and deceitful behaviours such as lying and stealing.
Children with conduct disorders often go undiagnosed and do not get the help they need. Instead, they may be categorized as delinquents or troublemakers. Children with conduct disorder often act from a place of insecurity, or based on an inaccurate sense of what is considered threatening.
If you notice any of these signs occurring frequently for an extended period of time in your child, you should see a mental health professional to guide you on the next steps.