Conduct Disorder

When children or adolescents show an ongoing pattern of aggressive or destructive behavior that violates the rights of others and the basic rules of society, they may be diagnosed as having conduct disorder.

Joe's Story

Joe always seems to pick fights on the school bus. He intimidates and bullies others and has few friends. Serving detention does not seem to help Joe learn to behave. Last year he was caught writing graffiti on school property, and he was suspended once for throwing rocks at a school bus. Although he was never caught, Joe stole money from the teachers' lounge, and he was suspected of setting a fire in the school dumpster. This year, he often cuts school and hangs out behind the local convenience store smoking cigarettes that he steals from his father.

What Is Conduct Disorder?

While all children and adolescents sometimes misbehave, some individuals seem to do more or most of the time. Conduct disorder refers to serious and frequent antisocial behavior * in young people. Conduct disorder involves any of four types of behaviors:

In the 1960s, social psychologist Albert Bandura (b. 1925) wanted to find out whether children would learn and perform aggressive behaviors simply by watching someone else behave in aggressive ways. Learning a certain behavior by watching someone else do it is called modeling or observational learning. Bandura conducted a series of experiments that demonstrated that aggressive behavior is indeed learned simply by observation. Whether a child actually went on to behave aggressively depended on what happened to the person the child observed. If a child saw that the other person was scolded or punished for acting aggressively, the child was not likely to perform the aggressive behavior, even though he or she had learned how. Children who saw that the other person's aggressive behavior was met with no consequence were more likely to perform the aggressive behavior they had observed as well as other aggressive behaviors.

Individuals with conduct disorder will have demonstrated three or more of these serious behaviors over the past year. In the United States, research studies have estimated that about 12 percent of males and 7 percent of females will have conduct disorder at some point in their lifetimes, although not everyone who has conduct disorder will be diagnosed with it.

Young people with conduct disorder may act alone or in groups. Many become involved in gang violence or other criminal or delinquent * behaviors. When caught violating rules of conduct, these young people often deny their guilt and may shift blame onto others, trying to make themselves look as if they are the victim of the unfairness of others. They often lack remorse for their actions and lack feeling or empathy * for people or animals they have hurt. Conduct disorder may be associated with other problems such as drug abuse, mood disorders (such as depression and bipolar disorder * ), attention deficit, post-traumatic stress disorder * , risky sexual behavior, and learning disabilities.

For some, conduct disordered behavior begins early in childhood. The earlier and more frequently the antisocial behavior occurs, the more likely it is to develop into a serious and difficult to solve problem. Other children do not develop antisocial behaviors until adolescence. Although still serious, their behavioral problems are sometimes more temporary and more successfully treated.

How Does Conduct Disorder Develop?

Many different theories exist about what causes conduct disorder, but there appears to be no one single cause; a number of factors seem to contribute to its development. However, conduct disorder and related antisocial behaviors tend to run in families, which may be due in part to inherited genes * that affect behavioral development, but there also is strong evidence that antisocial behavior is learned and modeled in the family environment.

Genetics and behavior

Many researchers have tried to determine how genetics and biology contribute to conduct disorder. Some studies found that youth with conduct disorder may crave an unusually high amount of stimulation. They also have trouble with self-awareness and goal setting, and lack skills for forethought and planning. Other studies found that youth with conduct disorder have problems with social learning, which includes the skills needed to learn social rules and to interact well with others. Young people with conduct disorder also appear to have less empathy than do others their age. Empathy is a type of emotional feeling for others; it involves the ability to see another person's point of view and to understand how someone else might feel in a given situation.

Children who have deficiencies in empathy, social learning, planning, and self-awareness may have a harder time developing behavioral controls, good problem-solving skills, and respect for others. Because they have fewer skills to solve problems in socially acceptable ways, they may be more likely to develop conduct problems. Children who have conditions that cause them to be impulsive * may have difficulty learning social rules and developing the behavior controls to follow these rules. However, to what extent these deficiencies are part of a person's genetic makeup or are tendencies that are learned by example and behavior in the family remains unclear.

Learned behavior

There is evidence that aggression, a major trait in people with conduct disorder, can be a learned behavior. People who observe others behaving in aggressive ways (and this includes watching aggression and violence on television, movies, and video games) are more likely to demonstrate the aggressive behaviors they have witnessed. Children who witness aggressive behaviors at home, such as physical fighting, pushing, and shoving, and other forms of domestic violence are at increased risk for developing conduct disorder. Children with conduct disorder often live in families in which there is a high level of conflict that takes physical form.




Trends in the prevalence of behaviors that contribute to violence on school property in the United States, 2013





Trends in the prevalence of behaviors that contribute to violence on school property in the United States, 2013
SOURCE: Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance—United States, 2013. Surveillance Summaries, June 13, 2014. Available online at: http://www.cdc.gov/healthyyouth/yrbs/pdf/trends/us_violenceschool_trend_yrbs.pdf (accessed August 18, 2015). Table by Lumina Datamatics Ltd. © 2016 Cengage Learning®.

Certain parenting practices increase the risk that a child will develop conduct disorder. For example, parents who do not provide adequate supervision, do not consistently enforce rules for behavior, and do not administer age-appropriate discipline contribute to conduct disorder. Parents who use overly harsh or abusive discipline may contribute to the development of conduct disorder.

Peers can also influence a child's behavior. Many young people with conduct disorder are rejected by their peers, which may make their conduct problems worse, particularly when conduct disorder is associated with other mental health or learning problems. Social rejection may cause these children to associate with others like themselves who have social and behavioral conduct problems, a choice that tends to reinforce unacceptable behaviors.

How Is Conduct Disorder Treated?

See also Antisocial Personality Disorder • Bullying • Oppositional Defiant Disorder • Personality and Personality Disorders

Resources

Books and Articles

Hong, Ji, Rebecca Tillman, and Joan Luby. “Disruptive Behavior in Preschool Children: Distinguishing Normal Misbehavior From Markers of Current and Later Childhood Conduct Disorder.” The Journal of Pediatrics 166, no. 3 (March 2015): 723–730.

Lindhiem, Oliver, et al. “Beyond Symptom Counts for Diagnosing Oppositional Defiant Disorder and Conduct Disorder?” Journal of Abnormal Child Psychology 43 no. 7 (October 2015): 1379–1387.

Poole, Hilary. Disruptive Behavior Disorders. Broomall, PA: Mason Crest, 2016.

Websites

American Academy of Child and Adolescent Psychiatry. “Conduct Disorder.” http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Conduct-Disorder-033.aspx (accessed March 3, 2016).

WebMD. “Mental Health and Conduct Disorder.” http://www.webmd.com/mental-health/mental-health-conduct-disorder (accessed March 3, 2016).

Organizations

American Academy of Child and Adolescent Psychiatry. 3615 Wisconsin Avenue, N.W., Washington DC 20016. Telephone: 202-966-7300. Fax: 202-464-0131. Website: http://www.aacap.org (accessed March 3, 2016).

* antisocial behavior is behavior that differs significantly from the norms of society and is considered harmful to society.

* bullying is when a person repeatedly intimidates or acts aggressively toward those with less power or ability to defend themselves.

* truancy is staying out of school without permission.

* delinquent is a legal term that refers to a juvenile (someone under the age of 18) who has committed an illegal act. Delinquent behavior includes any behavior that would be illegal or considered a crime if committed by an adult as well as specific youth, such as school truancy, violating curfew, or running away.

* empathy is the action of being aware or understanding the feelings of others without having those feelings explained.

* bipolar disorder is a group of mood disorders that are characterized by alternating episodes of depression and mania.

* post-traumatic stress disorder (post-traw-MAT-ik STRES dis-ORder) is a mental disorder that interferes with everyday living and occurs in people who survive a terrifying event, such as school violence, military combat, or a natural disaster.

* genes (JEENS) are chemical structures composed of deoxyribonucleic acid (DNA) that help determine a person's body structure and physical characteristics. Inherited from a person's parents, genes are contained in the chromosomes found in the body's cells.

* impulsive means acting quickly before thinking about the effect of a certain action or behavior.

Disclaimer:   This information is not a tool for self-diagnosis or a substitute for professional care.

(MLA 8th Edition)