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The prevalence rate of some behavioral disorders in the United States is growing. Most concerning is that many of these conditions appear in early childhood and are linked with at-risk behaviors including dropping out of school, early sexual experiences, violence and drug use. Sustained behavioral problems are associated with a poorer long-term prognosis. Conduct Disorder, a condition in which there is a pervasive pattern of behavior wherein an individual repeatedly violates the rights of others, property or rules, is one such disorder. The Diagnostic and Statistical Manual of Mental Disorders IV (DSM IV-TR) suggests that this disorder has increased throughout the last few decades with some studies suggesting prevalence rates as high as 10% in the general population.
Conduct Disorder is diagnosed when an individual displays a number of behaviors in violation of age-appropriate societal norms. These behaviors fall into four general categories: Aggression to people and animals, destruction of property, deceitfulness or theft, and serious violations of the rules. In addition, the behaviors must cause significant impairments in school, social or occupational functioning. Conduct disorder tends to present before age 16 and is believed to be influenced by both genetic and environmental factors. Higher instances of the disorder are reported in urban environments and in males.
The proliferation of this disorder is cause for concern, especially for parents and educators. Afflicted children tend to experience significant problems both at home and at school. Boys with Conduct Disorder tend to fight, steal, vandalize property and break school rules. Girls with the same disorder are more likely to lie, run away from home, be truant, use drugs and become involved in prostitution. Features associated with Conduct Disorder for both boys and girls include little empathy and concern for others, callousness, lack of guilt and remorse, low self-esteem, irritability, poor frustration tolerance, recklessness and high levels of aggression. These children and adolescents are also more likely than their peers to engage in early sexual behaviors, smoking, drinking, drug use, fighting, reckless acts and gang related activity. They are more likely to contract sexually transmitted diseases, become pregnant or get injured from accidents or fighting. Suicidal ideation, intent and attempts are also higher for children with Conduct Disorder. Associated behaviors may also lead to significant problems with school including suspension and expulsion.
With this diagnosis, both genders are at a greater risk for Antisocial Personality Disorder as adults. Antisocial Personality is chronic and places individuals at a greater lifetime risk for legal problems and incarceration. It is also associated with work-related problems, financial irresponsibility, poor parenting practices and romantic infidelity.
Early intervention for Conduct Disorder may improve long-term outcome. Children and adolescents with externalizing behavior problems can benefit from a variety of treatments including individual and family therapy, psychoeducation and skill building exercises. They may also be helped from programs aimed at improving interpersonal skills, problem-solving skills, pro-social behavior and self-talk. Because children are a part of larger systems, i.e., classrooms, schools, families and communities, large systems-based approaches can be helpful in reducing prevalence rates of Conduct Disorder in communities. Examples may include service organizations, boys and girls clubs, volunteer organizations, and certain school policies.
