Conduct disorder (CD)

Conduct disorder (CD) is a persistent pattern of behaviour in children and adolescents in which they violate the rights of others or basic social rules. These behaviour patterns are exhibited across different settings—home, school, and other social situations—and they significantly impair the individual’s social, academic and family functioning. CD can also have its onset as early as before age 10. 

 

Characteristics

  • Difficulty feeling and expressing empathy or remorse
  • Inability to read social cues
  • Misinterpretation of ambiguous actions as hostile or aggressive
  • Escalate situations into conflict

 

Behavioural Signs

  • Aggressive behavior that causes or threatens harm to other people or animals (ie. bullying, engaging in fights, or abusing animals)
  • Non-aggressive behaviours (ie. vandalism or arson)
  • Deceitfulness or theft (ie. burglary, lying, or scamming)
  • Serious rule violations (ie. school truancy, breaking curfew, and running away from home)
  • Risk-taking and impulsive behaviours

 

Causes

While it is easier to simply put the blame on the child or adolescent for these antisocial behaviours, it is important to remember that there are a range of genetic and environmental risk factors that contribute to CD. Understanding these factors enables the identification of youths who are at-risk of CD and help in preventing its onset. 


Genetic factors: 

  • Family members with or suspected of having CD
  • Parents with history of other mental illnesses like schizophrenia, depression and bipolar disorder
  • Impairments related to the brain frontal lobe lead to impulse controls and emotional regulation issues 

 

Environmental factors:

  • Disorganised environments (ie. alcohol and substance abuse, violence, and neglect at home)
  • At-risk neighbourhoods (ie. high crime rates and prevalence of violence and delinquency)

 

If you feel that your child is presenting some symptoms of CD, you should refer them to a mental health professional. They will make the appropriate assessments, diagnosis and treatment. Early diagnosis and intervention is especially important in this case as the condition could worsen without appropriate treatment. Mental health professionals will address problems faced in childhood and adolescence, equip them with skills that are essential to navigate developmental milestones, and guide the process of transition into adulthood.

Treatment 

  • Cognitive-behavioural therapy: Cognitive reframing of experiences and development of skills to emotionally regulate in more adaptive ways. 
  • Behavioural therapy: Unlearn inappropriate and antisocial behaviours and set appropriate behavioural expectations. 
  • Family therapy: Improve family relationships and dynamics and involve parents in developing a child's healthy self-image and self-esteem. 
  • Peer group therapy: Development and practice of interpersonal skills through interactions with others. 

 

How else can parents support their child?

  • Learn more about CD to understand what your child is going through
  • Increase parental monitoring and enforce stricter rules 
  • Remain patient and calm, even when your child is being defiant 
  • Be involved in their treatment and reinforce the skills they learnt
  • Be encouraging and supportive through treatment 

 

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Phoenix Park, Singapore 247974

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