Conduct Disorder

Introduction

Conduct Disorder (CD) is a psychological problem that affects young children under the age of 10. CD is a disruptive-control disorder categorised by aggressive behaviour, lack of self-control and violation of societal norms and rules.
Read on to learn more about conduct disorder symptoms, conduct disorder treatment and types of conduct disorders. The article explains what is conduct disorder, what are the signs and symptoms of conduct disorder and what causes conduct disorder.

What is conduct disorder?

Conduct Disorder (CD) is a mental health condition among children and teens. This disorder is marked by persistently exhibiting aggressive behaviour like rule-breaking and having a disregard for societal norms.
CD often co-occurs with mental health conditions like Attention-Deficit Hypersensitivity Disorder (ADHD), depression or other learning disorders. This disorder also exists on a spectrum with other oppositional defiant disorder which may grow into Conduct Disorder.

Common Myths and Misconceptions

Myth 1: Conduct Disorder is mostly diagnosed among kids who are pampered.
Fact 1: False. Children with strict parents can also develop Conduct Disorder. This is a mental health issue that has nothing to do with strict parenting.

Myth 2: Patients suffering from psychological issues are dangerous.
Fact 2: False. Patients who are suffering from Conduct Disorder are not harmful but need immediate attention. Once therapy starts, it is crucial to behave normally with them to avoid exposing them to triggers.

Myth 3: Patients outgrow Conduct Disorder and it gets resolved with maturity.
Fact 3: False. Conduct disorder can only be treated by consulting a professional psychologist. Mental health experts can rightly diagnose the problem and start the treatment for the fastest recovery.

Statistics and Facts

Conduct Disorder is quite common in India. Maximum cases reported in the country are from the states of Bihar, Jharkhand, Uttar Pradesh and Delhi. 5.48% of the entire primary school-going student population is suffering from the problem.
Globally, 1 out of 7 adolescents suffers from mental health disorders like depression, anxiety and other behavioural issues.

What is the difference between Conduct Disorder and Personality Disorders?

Conduct Disorder refers to behavioural and emotional problems featuring a blatant disregard for others. This disorder is mostly diagnosed in children and teens. Patients find it difficult to follow rules and behave in a socially acceptable manner.
Personality Disorder, on the other hand, is a long-term mental health condition among adults that impacts mood and relationships. These disorders make a patient process emotions incorrectly and be more impulsive making it difficult to tolerate distress.
Antisocial Personality Disorder often stems from Conduct Disorder. The symptoms emerge at the age of 11 and are diagnosed in adulthood.

Types of Conduct Disorder

Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnoses CD based on specific behaviours. This categorisation depends on the number and intensity of the symptoms.

1. Childhood Onset
Patients suffering from Childhood-Onset Conduct Disorder display severe antisocial behaviours persistently. These patients are at a higher risk of developing long-term antisocial behaviours and symptoms usually appear before the age of 10.

2. Adolescent Onset
Patients suffering from Adolescent Onset start exhibiting their symptoms after they turn 10. These patients can indulge in rebellious behaviour but only in certain contexts or situations. This sub-type is less severe and may have a better prognosis.

3. Limited Prosocial Emotions
Patients suffering from Limited Prosocial Emotions show a lack of regret or remorse for their negative actions. They tend to manipulate others for their gain and lack a general sense of well-being for others. Considered as the most severe form of conduct disorder, patients need immediate psychological intervention.

What Causes Conduct Disorder?

Some patients are more genetically prone to suffering from conduct disorders. Families where ancestors have suffered from conduct disorders are likely to pass it onto the next generation.
Social Factors like living with people who have regressive ideas can make a child more susceptible to conduct disorders. Living in a violent society or getting exposed to the aggressive behaviour of parents can make a child susceptible to this disorder.
At certain times, patients suffering from a head injury can also feel incapable of behaving properly. Lack of appropriate cognitive processing can also make a child susceptible to conduct disorder.

What Are The Signs and Symptoms of Conduct Disorder?

Conduct disorder is characterised by a pattern of disruptive behaviours. Patients exhibit aggressive behaviour repeatedly that violates societal norms. Here are certain key symptoms:

- Patients exhibit aggressive behaviour towards animals. Patients are generally cruel to animals and try to harm them. These patients struggle to form relationships and are easily frustrated.

- Constantly indulging in physical violence towards elders and youngsters is a symptom. Bullying, abusing and physically hurting someone is common.

- Certain patients indulge in vandalising and destroying properties. They set fire to random objects and places without any reason. They stop fearing the authorities and openly display delinquent behaviour shamelessly.

- Social rule violation is another common habit. Constant lying, stealing items and even breaking into private properties can be observed among patients.

- Patients suffering from serious conduct disorder also indulge in aggressive alcoholism and substance abuse. They are sexually aggressive and generally show no remorse for their actions.

How is Conduct Disorder Diagnosed?

1. Clinical Interviews and Observations

Mental health professionals conduct thorough interviews with the patients to trace the cause of the problem. Parents and teachers are also interviewed extensively for a better understanding of the symptoms. Patients are observed under various circumstances and in diverse settings to analyse symptom consistency and severity.

2. Assessment Tools and Medical Evaluation

Assessment tools like standardised questionnaires offer additional insights into patient behaviour. A physical medical evaluation is conducted to rule out any other health problems that could be causing conductive disorder.

3. Collateral Information

Data from schools, tuition centres and even from home is collected. The therapist aims to learn about other people’s observations about basic behaviour. This also helps a therapist to rule out other mental health conditions with similar symptoms like ADHD, additional defiant disorder and so on.

How is Conduct Disorder Treated?

1. Psychotherapy

Cognitive Behavioural Therapy, Family Therapy and Individual Therapy are the most effective psychotherapies recommended for treating CD.

- Cognitive Behavioural Therapy (CBT)
CBT helps an individual to recognise negative thoughts and actions. Therapists recommend this therapy to develop the coping skills of patients so that they behave normally when exposed to triggers. Therapists also come up with various anger management techniques to control their behaviour. Patients are trained to use various problem-solving strategies that can control their aggression.

- Family Therapy
Therapists counsel members of a family through family therapy by explaining the disorder to them. The aim is to understand the circumstances of a patient and trace the cause of the problem. Communication between various members is enhanced which improves symptom management. A consistent routine is framed to create a nurturing environment at home. Parents are informed about the various triggers so that the environment in which a patient is living can be improved.

- Individual Therapy
Individual therapy is a treatment plan in which young patients are offered a safe space. The aim is to allow patients to address their unresolved emotional issues to improve their behaviour. Certain patients lose their sense of confidence and insulate themselves owing to their erratic behaviour. With individual therapy, healthy coping mechanisms are developed and a person feels confident enough to participate in social settings.

Behavioural Intervention

Behavioural intervention includes 3 strategies:

1. Positive Reinforcement
With positive reinforcement, patients are rewarded for exhibiting desired behaviour. Children who are diagnosed with conduct disorder are trained to behave normally and put in certain situations to check their progress. The aim is to reduce the frequency of negative episodes and encourage positive behaviour.

2. Time-Out and Consequences
Time-out and face consequences are another technique under behavioural intervention. While positive actions attract rewards, patients who exhibit negative actions are punished immediately. The purpose of the technique is to help children learn the concept of boundaries and develop better self-control.

3. Medication and Support
Therapists prescribe medication according to the symptoms exhibited by patients suffering from CD. There are medications available for treating impulsivity, depression and other mood disorders.
Additional support also helps patients to recover faster. Here are three main additional support therapies available for patients:

- Educational support is essential for young patients to train them. Constant tutoring and offering them an alternative learning environment helps them succeed in academics.
- Social skills training is important to train them to communicate properly. This homes their basic manners and also allows conflict resolution that improves relationships.
- Community support groups and other similar organizations offer resources to families. Young patients are encouraged to do community service which will improve their behaviour and make their lives better.

Living with Conduct Disorder

• Once diagnosed with conduct disorder, patients might feel uncomfortable and remain in a state of denial. However, it is essential to understand that mental health disorder is like any other physiological disorder.
• Patients must read about the disorder and learn management as much as possible. Patience is key as treatment is time-consuming and depends on the severity.
• Communicating thoughts and feelings is a must to learn about the effectiveness of the treatment. Patients can maintain a diary or talk to their friends and family whenever they feel emotional or overwhelmed.

How to Support Loved Ones Suffering from Conduct Disorder?

• Since conduct disorder is diagnosed among children under 10, being patient with them is essential.
• Encourage them to seek therapy as soon as possible. If delayed, the disorder can worsen the condition of the patient which may result in participating in any crime.
• Maintaining a positive attitude is essential for a faster recovery. Patients must be counseled that the disorder is like any other health problem which can be treated with therapy and medication.

Jagruti Treatment and Recovery

1. Customised Therapy
Customised treatment plans for patients make Jagruti Rehabilitation Centre an attractive option for many people. Patients suffering from Conduct Disorder are young and in an impressionable age. Therefore, the disorder varies according to the personality which needs individual attention.

2. Offline and Residential Treatment Options
Online and offline counselling sessions are held for patients at Jagruti Rehabilitation Centre. For patients who are exhibiting severe symptoms, online counselling can be helpful. However, patients who are extremely disturbed and need immediate medical attention must opt for offline therapy.

3. 24/7 Nursing Staff
Hygienic living conditions are maintained by nursing staff present there 24/7. Vitals of patients are monitored at all times and patients are encouraged to perform positive actions at all times. Healthy and nutritious meals are provided to patients which ensures complete recovery.

4. Expert Medical Help
Medical staff is also available for patients who need to manage their comorbidities. Moreover, patients who need medical emergency help can also do so. The rehabilitation centre has tied up with the best hospitals for immediate care and support.