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Conduct disorder
Disruptive behavior - child; Impulse control problem - child
Conduct disorder is a set of ongoing emotional and behavioral problems that occurs in children and teens. Problems may involve defiant or impulsive behavior, drug use, or criminal activity.
Causes
Conduct disorder has been linked to:
-
Child abuse
Child abuse
Physical child abuse is a serious problem. Here are some facts:Most children are abused at home or by someone they know. They often love this perso...
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Drug
or
alcohol
abuse in the parents
Drug
Substance use is the continued use of alcohol, illegal drugs, or the misuse of prescription or over-the-counter drugs with negative consequences. Th...
Read Article Now Book Mark ArticleAlcohol
Alcohol use disorder is when your drinking causes serious problems in your life, yet you keep drinking. You may also need more and more alcohol to f...
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- Genetic defects
- Poverty
The diagnosis is more common among boys.
It is hard to know how common the disorder is. This is because many of the qualities for diagnosis, such as "defiance" and "rule breaking," are hard to define. For a diagnosis of conduct disorder, the behavior must be much more extreme than is socially acceptable.
Conduct disorder is often linked to attention-deficit disorder . Conduct disorder also can be an early sign of depression or bipolar disorder .
Attention-deficit disorder
Attention deficit hyperactivity disorder (ADHD) is a problem caused by the presence of 1 or more of these findings: not being able to focus, being ov...
Depression
Depression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for shor...
Bipolar disorder
Bipolar disorder is a mental condition in which a person has wide or extreme swings in their mood. Periods of feeling sad and depressed may alternat...
Symptoms
Children with conduct disorder tend to be impulsive, hard to control, and not concerned about the feelings of other people.
Symptoms may include:
- Breaking rules without clear reason
- Cruel or aggressive behavior toward people or animals (for example: bullying, fighting, using dangerous weapons, forcing sexual activity, and stealing)
- Not going to school (truancy, beginning before age 13)
- Heavy drinking and/or heavy drug abuse
- Intentionally setting fires
- Lying to get a favor or avoid things they have to do
- Running away
- Vandalizing or destroying property
These children often make no effort to hide their aggressive behaviors. They may have a hard time making real friends.
Exams and Tests
There is no real test for diagnosing conduct disorder. The diagnosis is made when a child or teen has a history of conduct disorder behaviors.
A physical examination and blood tests can help rule out medical conditions that are similar to conduct disorder. In rare cases, a brain scan helps rule out other disorders.
Treatment
For treatment to be successful, it must be started early. The child's family also needs to be involved. Parents can learn techniques to help manage their child's problem behavior.
In cases of abuse, the child may need to be removed from the family and placed in a less chaotic home. Treatment with medicines or talk therapy may be used for depression and attention-deficit disorder.
Many "behavioral modification" schools, "wilderness programs," and "boot camps" are sold to parents as solutions for conduct disorder. There is no research to support these programs. Research does suggest that treating children at home, along with their families, is more effective.
Outloook (Prognosis)
Children who are diagnosed and treated early usually overcome their behavioral problems.
Children who have severe or frequent symptoms and who are not able to complete treatment tend to have the poorest outlook.
Possible Complications
Children with conduct disorder may go on to develop personality disorders as adults, particularly antisocial personality disorder . As their behaviors worsen, these individuals may also develop problems with drug abuse and the law.
Antisocial personality disorder
Antisocial personality disorder is a mental condition in which a person has a long-term pattern of manipulating, exploiting, or violating the rights ...
Depression and bipolar disorder may develop in the teen years and early adulthood. Suicide and violence toward others are also possible complications.
When to Contact a Medical Professional
See a health care provider if your child:
- Regularly gets in trouble
- Has mood swings
- Is bullying others or cruel to animals
- Is being victimized
- Seems to be overly aggressive
Early treatment may help.
Prevention
The sooner treatment is started, the more likely the child will learn adaptive behaviors and avoid potential complications.
References
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013.
Walter HJ, Rashid A, Moseley LR, DeMaso DR. Disruptive, impulse-control, and conduct disorders. In: Kliegman RM, Stanton BF, St. Geme, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 29.
Weissman AR, Gould CM, Sanders KM. Impulse-control disorders. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 23.
Review Date: 3/4/2015
Reviewed By: Timothy Rogge, MD, Medical Director, Family Medical Psychiatry Center, Kirkland, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
