Conduct Disorder: Symptoms, Causes, and Treatments

We are gregarious beings, and the fact of living in society makes it necessary to establish a series of basic rules to guarantee a healthy coexistence respectful of the basic rights of each fellow citizen, both legally and ethical. Most of us obey most of these rules, or at least the latter, often almost unconsciously having internalized them.

However, there are people who manifest a behavioral pattern characterized by consistent rejection of them and indifference to the basic rights of others.

Probably, after this description we can think that we are going to talk about adults with antisocial personality disorder. But the truth is that these patterns are also observed in childhood, in children with conduct disorder. It is this disorder that we are going to talk about throughout this article.

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Defining Conduct Disorder

conduct disorder, now called conduct disorder in the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), it is an alteration typical of subjects under the age of age (being able to start at different moments of child and adolescent development) that throughout their childhood present a pattern of ongoing behavior characterized by the presence of a systematic violation of social norms and the rights of others during at least twelve months.

Specifically, this behavior pattern is identified with the presence of aggressive behaviors against people (which may include the use of weapons) or animals (the torture and/or execution of small animals and pets being frequent), the use of fraud and theft of small objects or trespassing, serious breach of the general social norms of coexistence and/or vandalism.

Children with this disorder have Significant impairments in various areas such as social life and school. They tend to have low levels of empathy, ignoring the rights and feelings of others. It is also common for them to give a feeling of hardness of character, as well as to have preconceived ideas regarding society and rejection. They are also characterized, in general, by acting without thinking about the consequences and impulsively, with risky behaviors and with low capacity for delay of gratification and tolerance for frustration.

Generally, their actions do not go unnoticed by the environment, something that can also lead to who present socialization problems and have frequent problems at the school level and with the justice. Despite this, some behaviors tend to initially go unnoticed, being hidden or barely visible (such as the torture of animals). They may show insouciance about their performance, superficial affection, lack of empathy and a low or non-existent level of remorse for the consequences of their actions, although these characteristics do not occur in all cases.

Relationship with antisocial personality disorder

Conduct disorder has been considered throughout history, and in fact has sometimes been confused, with antisocial personality disorder. It should be noted that both are not synonymous, although in some cases there is syndromic continuity and the diagnostic criteria of both disorders have little divergence beyond the age of onset (antisocial disorder requires that the subject already have a formed personality, considering the turning point after the age of 18, although antisocial behavior patterns must appear before the fifteen).

In fact, although most of the disorder disappears upon reaching adulthood and developing more elaborate behaviors and abilities (especially in those cases in which the manifestation of the disorder has a rather adolescent onset), a considerable percentage of these children will end up developing an antisocial disorder of the personality. In this case, we find ourselves to a large extent with subjects who have had an earlier-onset conduct disorder, further fixing and limiting their behavioral repertoire and their way of seeing life.

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Possible causes associated with this psychological phenomenon

Since the conception of this disorder, the scientific community has tried to find an explanation for this type of behavioral disorder. It is considered that there is no single cause of this disorder, but There are multiple factors that influence its genesis..

From a biological perspective, the possible existence of behavioral inhibition problems derived from a lack of underdevelopment or underactivation of the frontal together with an excess activation of the limbic system and the reward system cerebral. The existence of a lack of moral development, the capacity for empathy and immaturity is also assessed, which may be due in part to intrinsic elements of their biology. and partly due to poor socialization.

At a more psychological and social level, it has been observed that many of these children leave homes where there are behavioral problems and marginality. The presence of continuous intra-family conflicts can be associated by minors as a natural way of proceeding, acting as a model, while It can condition that the child learns not to trust others. Social rejection has also been linked to the emergence of this disorder, observing that they often have problems relating to each other and solving problems.

The type of parenting pattern is also linked: authoritarian and critical parents with a punitive way of acting or excessively permissive parents whose instructions are unclear and do not allow learning discipline or the need to comply are more likely to teach their children to act covertly or to always do their part willpower. This does not necessarily imply a conduct disorder, but it can facilitate it.

Attempts have also been made to explain this problem as an aspect based on conditioning: throughout his life the minor has observed that performing aggressive acts helps them achieve their objectives, being the consequences of said acts appetitive initially and reinforcing the repetition of the same way of proceeding.

Treatment

Conduct disorder is a problem whose treatment is still not totally well established today. Various multimodal programs are frequently used, which include both the child and the parents and services in contact with the minor, and which require the collaboration of professionals from different disciplines and with an eclectic approach.

At the psychological level, a program that includes training in social and communication skills, as well as problem solving, is usually recommended. The reinforcement of prosocial behaviors, behavioral contracts, modeling and emotional expression. Generally, cognitive-behavioral programs are used, trying to teach positive ways to relate and generate alternative behaviors to those of the disorder.

parent training and psychoeducation They are also elements to take into account and that can help to reassure and teach patterns of action and learning for the child.

In very extreme cases and especially in those subjects whose behavioral alterations are due to the experimentation of emotional discomfort, in addition to a treatment dedicated to modifying the elements that generate discomfort or the perception of these the use of some drugs may be recommended Like the SSRIs.

Bibliographic references:

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Massón, Barcelona.
• thief, a. (2012). Child Clinical Psychology. CEDE PIR Preparation Manual, 0.. CEDE: Madrid.
• Perez, M.; Fernández, J.R,; Fernandez, I. (2006). Guide to Effective Psychological Treatments III. Childhood and adolescence. Pyramid: Madrid.