What is Conduct Disorder?

Conduct Disorder is a persistent pattern of behavior in which a child or adolescent ignores the basic rights of others and breaks major norms or rules of society.

What are the symptoms of Conduct Disorder?

Symptoms may include:

• Stealing
• Running away
• Lying
• Fire-setting
• Truancy
• Breaking and entering
• Destruction of property
• Physical cruelty to animals or people
• Forcing sexual activity on others
• Using weapons in fights
• Frequent physical fights
• Drug or alcohol abuse
• Cheating in games and/or at school
• Manipulating or taking advantage of others
• Verbally or physically bullying
• Intimidating or threatening others
• Frequent outbursts
• Impairment in social, school or occupational functioning
• Staying out late at night despite parental prohibition (under age 13)
• Disobeying rules

What causes Conduct Disorder?

The cause of conduct disorder is unknown at this time. The following are some of the theories:

• It may be related to the child's temperament and the family's response to that temperament.
• It may be inherited in some families.
• There may be physical causes.
• It may be caused by a chemical imbalance in the brain.

What happens to people who have Conduct Disorder?

The course of Conduct Disorder is variable. Mild forms tend to improve over time. More severe forms (those that require hospitalization or day hospital treatment) are more likely to be prolonged. Without treatment, the severe forms can lead to illegal or criminal activity and can be complicated by drug abuse or dependence; school suspension; sexually transmitted diseases; unwanted pregnancy; or high rates of physical injury from accidents, imprisonment, fights and suicidal behaviors. With treatment, reasonable social and work adjustment can be made in adulthood.

What is the treatment of Conduct Disorder?

Treatment of Conduct Disorder often consists of group, individual and/or family therapy and education about the disorder; structure; support; limit-setting; discipline; consistent rules; identification with healthy role models; social skills training; behavior modification; remedial education (when needed); and sometimes residential or day treatment or medicine.

What can I do to deal with my Conduct Disorder?

• Attend therapy sessions.
• Use time-outs.
• Identify what increases anxiety.
• Talk about feelings instead of acting on them.
• Find and use ways to calm yourself.
• Frequently remind yourself of your goals.
• Get involved in tasks and activities that direct your energy.
• Learn communication skills.
• Develop a predictable daily schedule of activity.
• Develop ways to get pleasure that do not interfere with the rights of others.
• Learn social skills.
• Establish mutually acceptable limits of behavior and consistently reinforce those limits.

What can I do to keep the symptoms from returning once I have them under control?

When symptoms return, you are said to be having a relapse. During a period of good adjustment, the patient, his family and the therapist should make a plan for what steps to take if signs of relapse appear. The plan should include what specific symptoms are important warning signs that immediate steps must be taken to prevent relapse. An agreement should be made to call the therapist at once when those specific symptoms occur, and at the same time to notify friends and other people who can help. Concrete ways to limit stress and stimulation and to provide structure should be planned in advance.

Where can I learn more about Conduct Disorder?

There are several good books about Conduct Disorder and its treatment:

Russell Barkley
Defiant Children, second edition. Guilford Press, 1997.

Rex Forehand and Nicholas Long
Parenting the Strong-Willed Child. NTC Publishing Group, 1996.

Ross W. Greene
The Explosive Child. Harper Collins, 1998.

Robert L. Hendren (editor)
"Disruptive Behavior Disorders in Children and Adolescents." In Review of Psychiatry, vol. 18, American Psychiatric Press, 1999

Harold Koplewicz
It's Nobody's Fault: New Hope and Help for Difficult Children and Their Parents. Random House, 1997.

Carol W Peschel et. al., (editors)
Neurobiological Disorders in Children and Adolescents. Jossey-Bass, 1992.

The following organizations can provide help, information and support:

American Academy of Child and Adolescent Psychiatry
A professional organization that provides many publications for the layperson. Call 202-966-7300 or reach them online at www.aacap.org

Family Self-Help Group for Parents of Children and Adolescents
Sponsored by the National Alliance for the Mentally Ill (NAMI). Offers support, information and advice for parents of children with psychiatric disorders. To see if there is a group in your area, call NAMI at 1-800-950-NAMI or reach them online at www.nami.org

Family Ties:
A self-help group for parents of children with psychiatric or behavior problems. Call your local self-help clearinghouse for information about meetings near you, or call the National Self-Help Clearinghouse at 1-212-817-1822. Not available in all areas.

Toughlove:
Provides mutual support for parents whose children are having trouble. A self-help group. You can find their number in your local telephone book, or reach them online at www.toughlove.com