Teen Conduct Disorder – Understanding Abnormally Bad Behavior

Children and teens with conduct disorder are at greatly increased risk to develop drug and alcohol abuse problems, and without treatment, they are at greater risk for lifetime substance abuse, legal, mental health, social and academic/vocational problems.

If you have a child with conduct disorder, the earlier you can initiate treatment, the better their ultimate prognosis and the better your chances of minimizing problems to come.

What Are the Symptoms of Conduct Disorder?

Teens with conduct disorder show extreme defiance and a willingness to break the rules of the family and of society at large.

For a diagnosis of conduct disorder, the defiant, deceitful, violent or rule breaking behaviors must be chronic, must infringe on the rights of others and must contravene the rules of society or the family.

While most children and teens will go through developmental stages of poor behavior, what sets those with conduct disorder apart is their willingness to engage in more extreme acts, their more callous disregard for the feelings of others and the enduring nature of their anti-social behaviors.

The symptoms of conduct disorder are broken into 4 categories:

1. Aggression targeted at animals or people

• Frequently getting in physical fights
  
• Bullying or intimidating others
  
• Using weapons that could cause severe harm (knife, gun, bat, etc.)
  
• Forcing sexual activity
  
• Being cruel to animals
  
• Extorting money or objects by threat of violence

2. Destroying property

Examples could include:

• Vandalism
  
• Setting fires with the intent of causing destruction of property
  
• General intentional destruction of other’s property
  

3. Stealing, lying or other serious deceitfulness

Examples include:

• Shoplifting
  
• Breaking and entering
  
• Lying to manipulate or to get out of obligations
  

4. Rule Breaking

Examples include: ¹

• Breaking rules for no real reason
  
• Heavy Drinking or drug use
  
• Skipping school (younger than 13)
  
• Ignoring curfew
  
• Staying out all night

Conduct Disorder Age of Onset

There are 2 forms of conduct disorder:

1. Early Onset
   
2. Adolescent Onset

Children who begin to show conduct disorder symptoms prior to the age of 10 are considered to have the early onset form of the condition, but when symptoms don’t emerge until after the age of ten, the child has adolescent onset conduct disorder.

Adolescent onset conduct disorder is much more common. Children who have early onset conduct disorder often also have ADHD² and conduct disorder at any age is associated with an increased likelihood of oppositional defiance disorder, ADHD, anxiety, depression, communication disorders and Tourettes syndrome.

What Causes Conduct Disorder?

Researchers suspect a combination of environmental and biological factors contribute to the development of conduct disorder.

While genetic causes remain elusive, some hypothesized environmental causes include:³

• Living in a dysfunctional family home
  
• Living with parents who display poor parenting skills
  
• Living with aggressive or violent parents
  
• Experiencing maltreatment in the home*
  
• Living with alcoholic parents or with a depressed mother
  
• Living in a family experiencing major life stressors, (such as major illness, poverty, overcrowding, etc.)
  

Conduct Disorder Treatment

Conduct disorder is treatable, although treatment is generally long running or on-going. With this disorder, what is most important is rapid initiation of treatment – the prognosis for a that child receives prompt and on-going treatment soon after displaying conduct disorder behaviors is far more positive than the prognosis for a child who receives treatment only after negative behaviors are long entrenched.⁴

Some possible treatments include:

• Family Therapy – Especially training parents how to effectively handle and control a conduct disorder child.
  
• Cognitive Behavioral Therapy – Which can help children to learn more effective and non-aggressive ways to interact with others
  
• Skills Training – increasing a child’s competency in areas such as communication and interactions with others can reduce incidences of serious problems
  
• Anger Management Training
  
• Medication – In some cases, medication for co-occurring disorders, such as depression or ADHD - can also help to alleviate symptoms of conduct disorder
  

In general, adolescents with conduct disorder have a better overall prognosis if: They have no other disorders, such as AHDH or substance abuse They exhibit relatively few symptoms of conduct disorder, or exhibit only mild symptoms.⁵