Extreme Misbehavior – Conduct Disorder

Even before stepping into high school, John had already accumulated a laundry list of offenses. He had been involved in bullying, vandalism, fire setting, stealing, and fighting, among other aggressive or illegal activities. As if these antisocial behaviors weren’t enough, John also had other issues like abusing alcohol and prescription drugs, and threatening his parents with violence.  At 14, he was arrested for assault, and placed in a juvenile correction facility.

John has Conduct Disorder, a mental health condition believed to affect 3-10% of American children and adolescents. Conduct Disorder or CD is characterized by persistent patterns of antisocial behavior, behavior that violates the rights of others and breaks rules and laws. While most kids have natural tendencies towards episodes of lying, belligerence and aggression, children and teenagers with Conduct Disorder exhibit chronic and inflexible patterns of gross misbehavior and violence. Conduct Disorder is a serious disorder of behavior and not simply an overdose of the sort of ordinary mischief or misbehavior that all children get into. It is characterized by repetitive, consistent antisocial behavior that is not responsive to normal parenting interventions.

Conduct Disorder manifests in aggression to people and animals, destruction of property, deceitfulness or theft, and serious violations of rule such as running away, using dangerous weapons, skipping school and classes, ignoring curfews and so on. Symptoms cause severe impairment in the child’s personal, academic or social life. Conduct Disorder occurs more often among males than among females and usually coexists with other mental health conditions such as substance abuse, Attention Deficit Hyperactivity Disorder or ADHD, learning disorders, and depression.

What it’s Like for Parents
Conduct Disorder poses one of the greatest sources of grief and stress among parents. Symptoms can start out looking relatively normal, involving “misbehavior” such as chronic arguments with parents, disobedience and even hyperactivity. But as time goes by the gravity of the symptoms tend to escalate, alongside with their frequency. Temper tantrums can become actual episodes of violence and assault; lying to parents can become stealing from friends and classmates; and lack of respect for privacy at home can become breaking and entering somebody else’s home. Conduct Disorders can lead to cases of rape and sexual abuse, even homicide. If left untreated, Conduct Disorders can evolve into the adult disorder known as Antisocial Personality Disorder.

Receiving calls from teachers, principals and even the local police station, are common occurrences for parents of conduct disordered children and teens. Usually, there are many fruitless attempts to discipline or moderate a child’s behavior. Even counseling is insufficient because the biological nature of the disorder necessitates medical treatment as well. Because kids and teens with Conduct Disorder  suffer from a lack of empathy and emotional responsiveness, parents rarely get through to their child on their own.

What can Parents Do?
The good news is that there is hope for treating Conduct Disorders, and many programs have been found effective in both managing symptoms and restoring functionality. However, treatment is usually slow and complex. Indeed, Conduct Disorder is one of the most difficult behavioral disorders to treat. Recovery generally requires time and a combination of many different treatment approaches including different types of therapy, education, behavioral interventions and medications.

What can Help?
Early intervention helps increase the likelihood of successful treatment, which is why parents should act promptly when they notice antisocial behavior in their children. CD often begins as ODD or Oppositional Defiant Disorder, a condition characterized by lack of respect for authority. Lack of empathy is also a risk factor, alongside a family history of antisocial and/or criminal behavior.

As part of a comprehensive treatment program, traditional counseling and therapy interventions can go a long way, particularly those that aims to teach positive social skills such as communication, empathy and conflict management. Emotional management techniques, such as anger management interventions can also help. Sensitivity training, especially those at residential camps where kids and teens can interact with peers (and sometimes animals like horses), have also been known to be effective.

Parents are also encouraged to join family therapy sessions and Parent Management Training or PMT. Family therapy can surface systemic factors that cause and reinforce antisocial behavior in children. Family therapy can also help parents establish more effective forms of guidance and discipline, and teach parents how to respond to disruptive and defiant behaviors.

Because of the biological factor in Conduct Disorders, getting pharmacological help is important as well. A psychiatrist can help plan the appropriate drug therapy for a child or teenager with Conduct Disorder. In addition, a psychiatrist can help manage the child’s overall program of therapy and specific interventions. Sometimes the best source of help for children with Conduct Disorder is a specialized children’s mental health treatment center where many different types of professionals offer services under one roof and the child’s program can be coordinated through one department. Ask your doctor for a referral to such a center for diagnosis and treatment of your child.

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