Aman is a 6th std student. He was always quite awkward at making friends but recently, there had been some complains coming from his school regarding his behavior. He broke 3 benches in classroom over the period of 1 month. He was also found guilty for beating a classmate up. Aggression in his behavior was increasing and at times, he did not adhere to punishment given by his classroom teacher either. Not long ago, he was found hurting a stray puppy and did not seem to be bothered by its screams; on the contrary, he seemed to be enjoying it.
What is Conduct Disorder?
Conduct disorder is a prevalent disorder, which often goes untreated, if not unnoticed. The symptoms of Aman are mere part of this. This disorder is known by a repetitive pattern of behavior, which violates basic human rights of others and does not comply with societal norms.
Such children are often egotist and easily hurt with criticism. They are impulsive and acts more on emotions than on reason. They create a false sense of superiority whereas their self-esteem is extremely low. Aggressive, deceitful and destructiveness are the words, which define them. Children affected with CD, perceive emotions intensely which is why it is difficult for them to understand and process situations otherwise, and they end up handling situations in a rough and socially unacceptable way.
There are two types of aggression in CD, Proactive aggression, where aggression is methodically planned, controlled and accomplished with a desired goal in the mind, on the contrary Reactive aggression is triggered in response to real or perceived provocation and is emotionally charged in nature. Children often exhibits reactive aggression generally. CD occurs in children and adolescents and to be diagnosable, the symptoms should persist from at least 6 months to 1 year. It is also known to be more common in boys than in girls. Following are some symptoms you should look out for in your children –
- Unnecessarily indulging or provoking physical fights.
- Bullying and threatening peers.
- Destructing anyone’s property (breaking in, ruining garden, burning stuffs etc.)
- Has forced someone into some or the other kind of sexual activity.
- Has been cruel to animals (kicking, pinching, skinning, smashing etc.)
- Stealing, mugging, blackmailing, manipulating with complete lack of remorse.
- Does not respect or adhere to authority figures. Rules and regulation are often taken for granted by them.
- Liar, Liar, Liar. A pervasive liar.
- Exhibits behavior that is not age appropriate.
What are the causes?
Genetics are partially responsible for conduct disorder. If anyone in the family and blood relatives are suffering from mood disorders, substance abuse disorders or even personality disorders; it raises the chances and makes kids more vulnerable and prone to be affected.
- Psychosocial factors
Inability to understand their emotions can lead in impaired way of managing them. Traumatic experiences, neglected parenting, criminal background of people around, all of them are contributing factors. Such children have many cognitive distortions, which needs to be assessed and treated as soon as possible. Children who belong to lower socio-economic status are more susceptible to CD as their basic needs are barely fulfilled, and dignity is often compromised. A more compassionate and helpful behavior can decrease the probability of this disorder.
- Environmental factors
In multiple researches, it has been found that children who are often physically, sexually or emotionally abused at home or school, are more at risk of developing conduct disorder. Similarly, parents who are addicted to alcohol or drugs are often the key reasons for their condition. Therefore, dysfunctional and emotionally unavailable parents unintentionally sows the seed.
- Neurobiological factors
Recent neuroimaging studies have also shown the relation of different brain structure and brain injuries as a dynamic factor, especially if the injuries are in areas where emotions and impulses are regulated. Such resemblance to brain structure has also been observed in adults diagnosed with Anti-social Personality Disorder.
- Lack of Moral Education
As plain as it may sound but lack of moral education plays a vital role. Guilt and empathy are the core emotions on which moral education can develop. Imagine, how you would have survived in the world where you cannot differentiate between right and wrong. Unimaginable, isn’t it? In many cases of juvenile offenders, it has been found that the guilty party did not know what they were doing was wrong. In their mind, it was acceptable. For example, if a kid grows up with a physically abusive father who beats his wife and mother also obliges, such kids are going to grow up into thinking that wife beating is a part of a normal marriage. Now if this kid gets good exposure of society and moral education which defines what is right and what is wrong; what is socially acceptable and what is not, he will come to understand his father’s actions as don’ts and morally wrong. This is why moral education is mandatory in schools. Keep an eye on your kids’ moral education classes and discuss it regularly on parents-teacher meetings.
How is it Diagnosed?
This article is only written for your information and awareness purpose. Do not use it as a mean to ‘diagnose’ your child. Although, if you suspect his/her behavior and the symptoms seems to match, please consider meeting a good psychologist. A psychologist will use standardized tests, behavioral observation, parental observation, interview the kid etc. and in some scenarios, refer your child for neuroimaging examinations to assess any brain abnormalities. The procedures are completely safe, and a positive diagnosis will help you in preparing for suitable therapy approaches, to ensure your child’s safe and productive future.
- PMT (Parent Management Training) or Family Therapy
It is especially designed for children with disruptive disorders like conduct, ODD etc. It includes educating parents about clear communication and rewarding good behaviour frequently. This can be done under a therapist’s supervision. The therapist will teach you what to say, what not to say, how to communicate, when to reward, how to set a goal and track progress of their behaviour etc.
Conduct disorder has 3 levels, mild, moderate and severe. If diagnosed with severe, medicines are involved. Medicines are not harmful but can have some side effects which are completely normal. Still, if they are too bothersome in nature, should be consulted with the prescribing psychiatrist.
- CBT (Cognitive Behaviour Therapy)
CBT works better with teenagers, as they understand the relation of thoughts and feelings better than young children do. Techniques to identify moral dilemma, problem solving, anger management, healthy communication with peers, severity of consequences etc. will be taught here.
What if it’s left Untreated?
- Involvement in substance abuse.
- Developing Personality disorders.
- Turning into a criminal, which can involve crimes like rape, theft, robberies, physical damage, ruthless actions, property destruction etc.
- Resulting in Mood disorders like Depression or Mania. In addition, children with Conduct disorder often graduates to Anti-social personality disorder, which can also lead into adapting psycho-sociopathic tendencies.
- Pathological liar.
Children with Conduct disorder often develops other disorders like ADD, ODD, ADHD, pyromania (setting things on fire), kleptomania (stealing things for no particular reason) and learning disorders.
A good loving family environment and responsible parents can lessen the probability. Affection, discipline, boundaries, identifying early signs etc. can decrease the intensity and likelihood of the toxic condition we call conduct disorder.