Conduct Disorder Is That What My Teen Has?

So what you may ask is adolescent conduct disorder? You might even be thinking “Don’t all teens have some sort of conduct disorder?

No, conduct disorder as a mental health diagnosable disorder is more severe than just everyday adolescent misbehavior, difficult teens or rebellion.

Here is a working definition.

Children and adolescents with conduct disorder repeatedly violate the personal or property rights of others and the basic expectations of society. In order for a diagnosis of conduct disorder to be made these symptoms need to continue for 6 months or longer.

Now take a look at this definition again. This doesn’t imply that any teen with a bad attitude or a difficult few months has a mental disorder. Put the emphasis on ‘violates… basic expectations of society’ and on the part that says 6 months or longer.

An example of bad behavior not conduct disorder:

One night when my son was a teenager a police officer showed up at my door. My son and his friend had been caught stealing hood ornaments off local cars. He came down very hard on my son and my son and his friend were required to repair and pay for the damage to the cars they had damaged.

I think he even had to pay for ones other kids had damaged that night but didn’t get caught. Of course he received discipline at home as well.

The officer reminded me in private that my son wasn’t doing anything more than the rest of the kids his age at the time. He was just dumb enough to get caught. I know my son never tried that again.

Now was that conduct disorder or teen peer pressure and rebellion?

They had a contest at school amongst the kids to see who could steal the most. My son didn’t win.

Now back to conduct disorder…

Conduct disorder is also known as a “disruptive behavior disorder” because of its negative impact on teenagers, their families, neighbors, and schools.

There is another disruptive behavior disorder, called oppositional defiant disorder, which may be a precursor of conduct disorder. A child is diagnosed with oppositional defiant disorder when he or she shows signs of being hostile and defiant for at least 6 months. (There’s that 6 month criteria again.)

Oppositional defiant disorder may start as early as the preschool years, while conduct disorder generally appears when children are older. Oppositional defiant disorder and conduct disorder are not co-occurring conditions but oppositional defiant behavior can lead to conduct disorder especially when left untreated.

I do hope this hasn’t totally confused you.

Okay, so what are the signs of conduct disorder, you may be asking next?

Symptoms of conduct disorder can include:

  • Aggressive behavior that harms or threatens other people or animals
  • Destructive behavior that damages or destroys property
  • Lying or theft
  • Truancy or other serious violations of rules
  • Early tobacco, alcohol, and substance use and abuse
  • Precocious sexual activity

Children with conduct disorder or oppositional defiant disorder also may experience:

  • Higher rates of depression, suicidal thoughts, suicide attempts, and suicide
  • Academic difficulties
  • Poor relationships with peers or adults
  • Sexually transmitted diseases
  • Difficulty staying in adoptive, foster, or group homes
  • Higher rates of injuries, school expulsions, and problems with the law

Remember these are symptoms that are over and above what would be considered normal rebellious behavior for average difficult teens. And there needs to be several of these symptoms that continue for long periods of time. In other words you’re looking for extremes in behavior.

How common is conduct disorder? (That is another good question.)

Conduct disorder affects 1 to 4 percent of 9 to 17 year olds, depending on exactly how the disorder is defined (U.S. Department of Health and Human Services, 1999).

The disorder appears to be more common in boys than in girls (I’ll bet you could have guessed that one.) and more common in cities than in rural areas.

So,who is actually more at risk for conduct disorder?

Research shows that some cases of conduct disorder begin in early childhood, often by the preschool years. In fact, some infants who are especially “fussy” appear to be at risk for developing conduct disorder.

Other factors that may make a child more likely to develop conduct disorder include:

  • Early maternal rejection
  • Separation from parents, without an adequate alternative caregiver
  • Early institutionalization
  • Family neglect
  • Abuse or violence
  • Parental mental illness
  • Parental marital discord
  • Large family size
  • Over Crowding
  • Poverty

Is there help available for families?

Although conduct disorder is one of the most difficult teen behavior disorders to treat, young people often benefit from a range of services that include:

  • Training for parents on how to handle child or adolescent behavior
  • Family therapy
  • Training in problem solving skills for children or adolescents
  • Community-based services that focus on the young person within the context of family and community influences

What can you as parents do when your child is diagnosed with conduct disorder?

Some child and adolescent behaviors are hard to change after they have become ingrained. Therefore, the earlier the conduct disorder is identified and treated, the better the chance for success.

Most children or adolescents with conduct disorder are probably reacting to events and situations in their lives. Some recent studies have focused on promising ways to prevent conduct disorder among at-risk children and adolescents. In addition, more research is needed to determine if biology is a factor in conduct disorder.

Parents or other caregivers who notice signs of conduct disorder or oppositional defiant disorder in a child or adolescent should:

  • Pay careful attention to the signs, try to understand the underlying reasons, and then try to improve the situation
  • If necessary, talk with a mental health or social services professional, such as a teacher, counselor, psychiatrist, or psychologist specializing in childhood and adolescent disorders

  • Get accurate information from libraries, hot lines, or other sources
  • Talk to other families in their communities
  • Find family network organizations

Here are some helpful resources:

Substance Abuse and Mental Health Services Administration
http://www.mentalhealth.gov/

National Institute of Mental Health
www.nimh.nih.gov

For information about children’s mental health, contact SAMHSA’s National Mental Health Information Center:
Toll-free: 800-789-2647
Fax: 240-747-5470
TDD: 866-889-2647