Division of Child and Adolescent

Psychiatry

Hanna Garza, MS, LPC

TCHATT
(Texas Child Health Through Telemedicine)
 What is Conduct Disorder?
 Conduct disorder is a severe condition characterized by
hostile and sometimes physically violent behavior and a
disregard for others. Children with CD exhibit cruelty,
from early pushing, hitting and biting to, later, more than
normal teasing and bullying, hurting animals, picking
fights, theft, vandalism, and arson. Since childhood and
adolescent conduct disorder often develops into the adult
antisocial personality disorder, it should be addressed
with treatment as early as possible; early treatment offers
a child a better chance for considerable improvement and
hope for a more successful future.
 Symptoms of CD
 Symptoms of conduct disorder vary depending on the age of the child and whether
the disorder is mild, moderate, or severe. In general, symptoms of conduct disorder
fall into four general categories:
 Aggressive behavior such as threaten or cause physical harm (fighting, bullying,
being cruel to others or animals, using weapons, etc.)
 Destructive behavior such as intentional destruction of property such as arson
(deliberate fire-setting) and vandalism (harming another person's property).
 Deceitful behavior such as lying, shoplifting, or breaking into homes or cars to
steal.
 Violation of rules such as going against social rules or engaging in behavior that is
not appropriate for the person's age. These behaviors may include running away,
skipping school, etc.
 In addition, many children with conduct disorder experience irritability, have low
self-esteem, tend to throw frequent temper tantrums, abuse drugs and alcohol, and
are unable to appreciate how their behavior can hurt others and generally have little
guilt or remorse about hurting others.
 Causes of CD
 The exact cause of conduct disorder is not known, but it is believed that a
combination of biological, genetic, environmental, psychological, and
social factors play a role.
 Biological such as brain injury and having other mental illnesses, such as
ADHD, learning disorders, depression, substance abuse, or an anxiety
disorder.
 Genetics such as having close family members with mental illnesses.
 Environmental such as a dysfunctional family dynamics, childhood abuse,
traumatic experiences, a family history of substance abuse, and inconsistent
discipline by parents.
 Psychological such as problems with moral awareness (notably, lack of
guilt and remorse) and deficits in cognitive processing.
 Social such as low socioeconomic status and not being accepted by their
peers.
 Risk Factors
 Without treatment, your child is likely to have ongoing
problems. Children may be unable to adapt to the
demands of adulthood, which can cause problems with
relationships, school, and holding a job. They are also at
an increased risk for substance abuse and problems with
law enforcement. Your child may even develop a
personality disorder, such as antisocial personality
disorder, when they reach adulthood. This is why early
diagnosis and treatment are critical.
 Diagnosis
 If symptoms of conduct disorder are present, the doctor may conduct
complete medical and psychiatric evaluation. A physical exam and blood
work may be appropriate if there is concern that a physical illness might be
causing the symptoms. The doctor will also look for signs of other
disorders that often occur along with conduct disorder, such as ADHD and
depression.
 If a physical cause for the symptoms cannot be found, referral to a
psychiatrist or a mental health professional who is trained to diagnose and
treat mental illnesses in children and teens may be appropriate. Mental
health professionals use different assessment tools to evaluate a child for a
mental disorder. The diagnosis is based on reports of the child's symptoms,
observation of the child's attitudes and behavior, reports from the child's
parents, teachers, and other adults because children may withhold
information or otherwise have trouble explaining their problems or
understanding their symptoms.
 Treatment
 Treatment for conduct disorder is based on many factors, including
the child's age, the severity of symptoms, as well as the child's
ability to participate in and tolerate specific therapies. Treatment
usually consists of a combination of therapy and medication.
 Therapy that is aimed at helping the child learn to express and
control anger in more appropriate ways. Cognitive-behavioral
therapy (CBT) aims to reshape the child's thinking (cognition) to
improve problem solving skills, anger management, moral reasoning
skills, and impulse control. Family therapy may be used to help
improve family interactions and communication among family
members.
 Medication although there is no medication formally approved to
treat conduct disorder, various medications may be used to treat
some of its distressing symptoms (impulsivity, aggression), as well
as any other mental illnesses that may be present, such
as ADHD or depression.
Questions