Conduct Disorder

Addressing Childhood and

Adolescent Behavioral Problems:

Diagnosis Criteria and the Role of the School Psychologist

Introduction

This paper shall examine the field of child psychology in respect to the topic of conduct disorder (CD). In child psychology, conduct disorder is an extremely difficult subject to accurately address and clarify, due primarily to the need to distinguish between normal childhood behaviors and the onset or development of an actual disorder. Once a child matures to the stage where he or she is allowed into the school system, however, it becomes pressing to identify and clarify the presence of CD in order to better assess the behaviors of that child.

This paper shall investigate the issues and the psychological development of conduct disorder in both the childhood and the adolescent years. The diagnosis of conduct disorder shall be compared and contrasted against oppositional defiant disorder (ODD) and the correlation that conduct disorder has with attention deficit hyperactivity disorder (ADHD). Standard medical definitions for these disorders, as well as the growing body of literature on this field, shall be included to better round out the discussion and to signify the impact of such disorders on children and adolescents.

Conduct Disorder

Conduct disorder (CD) is defined by the American Association of Child and Adolescent Psychology (AACA) as: “’Conduct disorder’ is a complicated group of behavioral and emotional problems in youngsters. Children and adolescents with this disorder have great difficulty following rules and behaving in a socially acceptable way. They are often viewed by other children, adults and social agencies as "bad" or delinquent, rather than mentally ill.” (AACA: 2000) The AACA then classifies the disorder through providing a list of behaviors that children suffering from CD often manifest in their daily activities, which includes:

- Aggression to people and animals

- Destruction of Property

- Deceitfulness, lying, or stealing

- Serious violations of rules

The AACA defines and describes the extent and impact of such behaviors, but then continues in suggesting that the primary hazard found in CD is not primarily due to the CD itself, but rather due to the additional disorders that frequently accompany a manifestation of CD. The AACA states:

“Many children with a conduct disorder may have coexisting conditions such as mood disorders, anxiety, PTSD, substance abuse, ADHD, learning problems, or thought disorders which can also be treated. Research shows that youngsters with conduct disorder are likely to have ongoing problems if they and their families do not receive early and comprehensive treatment. Without treatment, many youngsters with conduct disorder are unable to adapt to the demands of adulthood and continue to have problems with relationships and holding a job. They often break laws or behave in an antisocial manner.

“Many factors may contribute to a child developing conduct disorder, including brain damage, child abuse, genetic vulnerability, school failure, and traumatic life experiences.” (AACA: 2000)

The research on conduct disorder strongly cautions that the problems found within CD are not strictly manifested by the child, but rather can be triggered from external or internal causes and вЂ" more importantly вЂ" promoted through the presence of other diseases and the lack of sufficient or timely treatment to keep the disorder in check. This, researchers caution, is the primary reason why CD among adolescents can be seen as a much more problematic manifestation of the disease than among children, for the initial form of conduct disorder has been allowed to run unchecked and therefore has had the opportunity to take on more dangerous attributes. One source suggests that CD in children is less serious than in adolescents because of the lack of exposure to stimulus that can promote social development problems, like excessive contact with video games and television.

There are many forms of psychological disorders that are found in conjunction with conduct disorder. Two of the most common types of these associated disorders are oppositional defiant disorder and attention deficit hyperactivity disorder. These disorders shall now be examined to clarify their impact on children and adolescents.

- Oppositional Defiant Disorder (ODD)

Where conduct disorder is classified as behavioral and emotional problems in both children and adolescents, oppositional defiant disorder (ODD) is classified as a combination of aggression and a tendency to purposefully bother others. This combination is psychologically effective for the afflicted individual: A child suffering from ODD will be “rewarded” in terms of attention for his or her socially- negative behaviors, while an adolescent can use the motivation from ODD to act out against authority in a psychologically gratifying manner.

Statistically, it is believed that approximately 5 % of all children and adolescents in the United States manifest some form of ODD. Child psychologists find that ODD is almost always associated with CD, indicating that there is a strong correlation between CD and ODD. Research also indicates that adolescents are more likely to have manifested this disorder than children, which in turn suggests that CD is a precursor to ODD. However, there is mounting evidence that suggests that there are potential outside instigators for both CD and ODD, such as prenatal smoking. One source reports that: “Women who smoke more than half- a- pack of cigarettes a day during pregnancy are significantly more likely to have a son with conduct disorder than mothers who did not smoke during pregnancy.” (CQS: 1999)

Similar to CD, those afflicted with ODD manifest the following symptoms, where there are two definite facets of the disorder:

- [First] A pattern of negativistic, hostile, and defiant behavior lasting at least six months during which four or more of the following are present:

1. Often loses temper

2. often argues with adults

3. often actively defies or refuses to comply with adults' requests or rules