Conduct disorder is usually a disorder of childhood, according to the "Diagnostic and Statistical Manual of Mental Disorders." It can only be diagnosed in adults if the adult does not meet the criteria for antisocial personality disorder. Conduct disorder has a prevalence rate of about 5 percent, according to the manual. Using the DSM criteria, conduct disorder occurs more often in males than females.
Conduct Disorder's Main Feature.
Conduct disorder is defined by the person's repetitive pattern of violating the rights of others, or societal rules. In the DSM, many possible features are listed, but they result in conduct disorder diagnosis only if this pattern appears. Many times conduct disorder becomes antisocial personality disorder, APD, in adulthood; there are many convicted prisoners who have APD.
DSM Criteria
In addition to the pattern of behavior, the DSM requires three or more symptoms out of four groups of behaviors that have occurred within the last year, with at least one occurring during the last six months. The four groups of behavior are: 1) Aggression to people and animals; 2) Destruction of property; 3) Deceitfulness or theft; 4) Serious violations of rules. Most of the criteria within these four groups involve unlawful activity.
Aggression
People with CD may do things like bullying others, fighting, using weapons like bats, being physically cruel to other people or animals, stealing, or forcing sex on someone. If the person with CD also has attention deficit hyperactivity disorder, ADHD, he will tend to perform more severe acts than someone without co-occurring ADHD.
Property Destruction
CD is likely if the person deliberately destroys someone's property. A feature found with many CD patients is deliberate fire-setting. Children as young as 5 years have burned down structures with people in them purposely, sometimes killing those inside.
Deceitfulness And Theft
Stealing by those with CD is common, by breaking into a car or other property. The deceitfulness usually appears as the CD person lying to get what she wants, or avoiding work, like a con artist.
Rules Violations
Basically, for a person with CD, rules do not apply. Many children begin staying out at night, running away from home, or being truant from school by age 13. The CD person acts entitled, as if the world owes him what he takes.
Causes of CD
No single cause has been identified for CD, according to "Dulcan's Textbook of Child and Adolescent Psychiatry". Several factors appear likely to affect whether a child develops CD, which appears, on average, at six years. Attachment problems may elevate a person's chance of developing CD. Attachment is the initial bond between the child and main caretaker, from birth. If the attachment is insecure, it is more likely the child will have problems with authority. Lower socioeconomic status raises the level of risk for CD. The family environment is important if the family experiences domestic violence, child abuse, parental mental disorder, substance abuse, poor parenting skills and harsh discipline, CD is more likely to develop in a child. Some genetic links with CD suggest the possibility of inheriting the disorder.
References
- "Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Text Revision"; American Psychiatric Association; 2000
- "Synopsis of Psychiatry, 9th ed."; Benjamin J. Sadock, Virginia A. Sadock; 2003.
- "Dulcan's Texbook of Child and Adolescent Psychiatry"; Mina K. Dulcan, ed.; American Psychiatric Publishing, Inc.; 2010
