Behavioural and Emotional Disorders

Conduct Disorder (CD)

What is Conduct Disorder?

Conduct Disorder (CD) is an emotional disorder associated with patterns of aggressive, destructive and deceitful tendencies. A precursor to Antisocial Personality Disorder (ASPD), CD is commonly diagnosed in children and teenagers.

Symptoms of Conduct Disorder

While CD is almost twice as common in boys than girls, both genders can be diagnosed with CD.

Ψ Aggressive behaviour: Use of physical measures (e.g., weapons or force) to cause harm to others or animals
Ψ Destructive tendencies:  Any form of destruction of property (e.g., vandalism or arson)
Ψ Violation of rules: Engage in non-age appropriate behaviours (e.g., underage smoking or drinking), running away from home
Ψ Deceitful behaviours: Shoplift, lying, cheating

What Makes Conduct Disorder Different From Typical Teenage Behaviours?

Unlike the emotional and behavioural problems in childhood and the teenage years, individuals diagnosed with CD engage in activities that violate age-appropriate societal rules and standards, and engage in activities that may potentially put others in danger, such as aggressive acts towards others and animals and destroying property.  

Risk Factors of Conduct Disorder:

While it may be easier to blame these destructive behaviours on the child or teenager, a more compassionate response would be to understand the factors that lead to these behaviours.

Genetic factors:

Ψ Children with parents or siblings with, or suspected of having, CD are more likely to have the disorder as well.
Ψ CD is more common in children with a parental history of other mental health disorders such as schizophrenia, depressive disorders and bipolar disorder.  
Ψ The brain plays a role – particularly the frontal lobe, which determines are most important executive functions such as controlling impulses and emotion regulation. Damage to the frontal lobe leads to impairments in social behaviors, increasing the risk of children or teens developing conduct disorder.  

Environmental factors:

Ψ The environment in which children grow up in play an important role in a child’s development.
Ψ Children who grow up in disorganised environments, such as in homes where alcohol and substance abuse, violence and neglect occur, are more susceptible to the development of CD.
Ψ If the neighbourhood in which the children reside in have high crime rates and/or high prevalence of violence and delinquency, they are also more likely to develop CD.

How Does ASPD Differ From CD?

Both conduct disorder and ASPD are similar in terms of aggressive tendencies and their intertwining nature with the legal system. A diagnosis for ASPD is only given when the individual is at least 18 years old, and shows symptoms of CD before the age of 15. Hence, if left unaddressed, CD can progress to ASPD. As a result, early intervention is important for children and adolescents who exhibit CD behaviours to prevent its progression into ASPD. The earlier intervention for CD begins, the better the intervention outlook.

Can Conduct Disorder be Managed?

Here are some therapeutic plans, and their objectives, for children with conduct disorder:

Ψ Cognitive-behavioral therapy: Involves cognitive reframing of stressful events. Help children to inculcate skills to help people resolve negative emotions in alternative ways that are more adaptive.    
Ψ Behavioral therapy: Help children unlearn inappropriate and antisocial behaviors. Lay out stricter rules and reinforce parental supervision so that the children are aware of what is expected of them.
Ψ Family therapy: Improve family relationships and dynamics. Allow the child to develop a healthy self-image, self-esteem, and internalise appropriate behaviours with the help of parents.  
Ψ Peer group therapy: Children can develop and practice adaptive interpersonal skills through interaction with other people.

What else can I do to support my child? 

Other than sending children for therapy sessions, parents can support children at home as well. Of course, it is not easy to handle a child who displays defiant and aggressive behaviours. But parents play a huge role in helping the child to understand societal rules and improve. 

Here are some helpful tips for parents: 

Ψ Read up more about conduct disorder so they can understand what their children is going through and why they may act in a certain way 
Ψ Increase parental monitoring and reinforce stricter rules 
Ψ Learn to be patient and calm, especially when your child acts up
Ψ Help your child to practice the skills they have learnt in therapy
Ψ Be encouraging and supportive throughout their therapy