Mental health: conduct disorder

Conduct disorder

Conduct disorder is a serious behavioural and emotional disorder that can occur in children and teenagers. A child with this disorder may display a pattern of disruptive and violent behaviour and have problems following rules.

It is not uncommon for children and teenagers to have behaviour-related problems at some time during their development. However the behaviour is considered to be a conduct disorder when it is long-lasting and when it violates the rights of others, goes against accepted norms of behaviour and disrupts the child's or family's everyday life.

What are the symptoms of conduct disorder?

Symptoms 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 behaviour. These are behaviours that threaten or cause physical harm and may include fighting, bullying, being cruel to others or animals, using weapons and forcing another into sexual activity.
• Destructive behaviour. This involves intentional destruction of property such as arson and vandalism (harming another person's property).
• Deceitful behaviour. This may include repeated lying, shoplifting or breaking into homes or cars in order to steal.
• Violation of rules. This involves going against accepted rules of society or engaging in behaviour that is not appropriate for the person's age. These behaviours may include running away, playing truant, playing pranks or being sexually active at a very young age.

Many children with conduct disorder are also irritable, have low self-esteem and tend to throw frequent "temper tantrums". Some may use drugs and alcohol. Children with conduct disorder often are unable to appreciate how their behaviour can hurt others and generally have little guilt or remorse about hurting others.

What causes conduct disorder?

The exact cause of conduct disorder is not known, but it is believed that a combination of biological, genetic, environmental and social factors play a role.

• Biological. Some studies suggest that defects or injuries to certain areas of the brain can lead to behaviour disorders. Conduct disorder has also been linked to special chemicals in the brain called neurotransmitters. Neurotransmitters help nerve cells in the brain communicate with each other. If these chemicals are out of balance or not working properly, messages may not make it through the brain correctly, leading to symptoms. Many children and teenagers with conduct disorder also have other mental illnesses such as attention-deficit/hyperactivity disorder (ADHD), learning disorders, depression, substance use or an anxiety disorder, which may contribute to the conduct disorder.
• Genetics. Many children and teenagers with conduct disorder have close family members with mental illnesses, including mood disorders, anxiety disorders, substance use disorders and personality disorders. This suggests that a vulnerability to conduct disorder may be inherited.
• Environmental. Factors such as a dysfunctional family life, childhood abuse, traumatic experiences, a family history of substance use and inconsistent discipline by parents may contribute to the development of conduct disorder.
• Social. Low socioeconomic status and not being accepted by their peers appear to be risk factors for the development of conduct disorder.