Teenagers are going through a lot. Hormonal changes, questions of identity and sexuality, looming decisions about college and adulthood, peer pressure, and more can sometimes lead to behavior that drives their parents up a wall.
Many teens go through episodes of being destructive, aggressive, or deceitful. Sometimes they break the rules or act inappropriately. But when these kinds of behaviors escalate and happen regularly, causing disruption to the teen’s life and to the lives of everyone around them, a conduct disorder may be at play.
What is Conduct Disorder?
Conduct disorder typically begins between the ages of 10-14, is more frequently diagnosed in people assigned male at birth, and affects 2-10% of children in the United States. It is characterized by four core behaviors:
- Aggression toward people and animals
- Destruction of property
- Deceiving, lying and/or stealing
- Serious violations of rules
Children with conduct disorder are often seen as “bad” or delinquent, as they can act in particularly violent, cruel, and spiteful ways, seemingly without any remorse. These are the kids who get caught with weapons, start fights, steal and lie, set fires to property, run away from home, and are sexually aggressive.
Conduct disorder is diagnosed when children have demonstrated three or more of the above behaviors in the previous 12 months and at least one of those behaviors in the previous six months.
Adults who had untreated conduct disorder as teens and who continue to display similar behaviors are typically diagnosed with antisocial personality disorder.
What Causes Conduct Disorder?
While no one cause can yet be pinpointed, experts believe that conduct disorder generally arises from a combination of trauma, genetics, child abuse, social problems, and/or damage to the frontal lobe of the brain. Children who come from disadvantaged or dysfunctional homes, or whose parents have engaged in substance abuse or have antisocial personality disorder or other mental illnesses, are more at risk.
In addition, children who have mental health issues, such as mood disorders, PTSD, substance use disorder, ADHD, or learning problems are also more at risk for developing conduct disorder.
How is Conduct Disorder Treated?
Medication may be prescribed for any accompanying mental health disorder, like anxiety or ADHD. It may also be prescribed to address specific symptoms (for example, antidepressants might be used to help ease rigid or depressive behaviors). Otherwise, treatment for conduct disorder is primarily psychotherapy (talk therapy) and behavior therapy. Perhaps the hardest thing about treating a child with conduct disorder is working through their fear and distrust of adults so that they can allow a therapist to help.
Therapy can help the child learn how to control their anger and express it in a way that does not harm themselves or others. The family is crucial to helping a child manage conduct disorder. If the family is functional enough to work with a therapist, the AMA Journal of Ethics recommends that the therapist do the following:
- Help the family understand that long-term prognosis is poor without intervention
- Emphasize that the child needs structure and parental monitoring
- Encourage the child to become involved in supervised peer activities, such as organized sports or clubs
- Help the family practice ways to communicate effectively
- Stress the importance of positive attention – show family members how to reinforce positive behavior and to spend time with the child or teen every day, doing something fun
- Encourage consistent responses to behaviors and help the family establish boundaries and consequences they are willing to enforce
Chances are that if your teenager is struggling with conduct disorder, you already know about it. If you’ve tried therapy and found that the behaviors continue to escalate, it might be time to consider a more robust intervention.
Here at Miramont Behavioral Health in Middleton, WI, we can help. Our professional treatment team will work with you to determine the best level of treatment, whether that’s inpatient, outpatient, or some combination of the two. Conduct disorder is a difficult illness, but it can be treated, and your child can go on to become a stable, healthy, successful adult. Contact us today for more information.