Conduct disorder is defined by the impact of the child’s behavior on people and surrounding and focuses on aggressive behaviors such as physical cruelty to people or animals, serious rule violations, property destruction, and deceitfulness. The diagnostic specifier is “limited prosocial emotions” where children who have callous and unemotional traits show a lack of remorse, empathy, and guilt, and shallow emotions which is associated with a more severe course, cognitive deficits, antisocial behavior, and poorer response to treatment.
The DSM-5 criteria for conduct disorder classifies patterns of repeated destructive and harmful behavior that can take different forms including aggressive behavior, destroying property, lying or stealing, and breaking rules. CD has Significant impairment in social, academic, or occupational functioning. Substance abuse is common but unclear whether it precedes or is concomitant with disorder. It is comorbid with anxiety and depression with comorbidity rates varying from 15 to 45% that also precedes depression and most anxiety disorders. 7% of preschool children exhibit the symptoms of conduct disorder with an importance of assessing conduct disorder early. Life-course persistent pattern of antisocial behavior is beginning to show conduct problems by age 3 and continuing into adulthood. Adolescence is limited as typical childhoods have engagement in high levels of antisocial behavior during adolescence and typical nonproblematic adulthoods. A maturity gap is. between the adolescent’s physical maturation and the opportunity to receive rewards for assuming adult responsibilities. There is continued troubles with substance use, impulsivity, crime, and overall mental health in their mid-20s. CD is fairly common with prevalence between 5 and 6% and is more common in boys than girls. Life-course-persistent type of conduct disorder will likely continue to have problems in adulthood, including violent and antisocial behavior. CD in childhood does not inevitably lead to antisocial behavior in adulthood. About half of boys with CD did not fully meet diagnostic criteria at a later assessment (1 to 4 years later) and almost all continued to demonstrate some conduct problems.
Conduct disorder is characterized by genetic influences, neurobiological influences, psychological influences, and peer influences. Heritability likely plays a part as some genetic influences are shared with other disorders and some are specific with the importance of gene X environment interactions. Deficits in regions of the brain that support emotion and empathetic responses show reduced activation of amygdala, ventral striatum, and prefrontal cortex. CD has deficient moral awareness, especially lack of remorse. Rejection by peers is causally related to aggressive behavior and predicts later aggressive behavior
A meta-analysis addressed the psychosocial interventions in the treatment of child and adolescent conduct disorder. The article examined various types of psychosocial intervention including child-oriented interventions, family-based interventions, and school-based interventions. Family based interventions used interaction-oriented parental education programs and behavioral-based education programs while school-based interventions used teacher-oriented interventions and non-teacher specialist-based interventions Community and institution level approaches are also used through community-level implementation of programs and residential programs. The overall findings of this article are how the combination of these treatment approaches in the most effective when treating conduct disorder in adolescents. However, some programs may be more effective alone based upon which treatment approach is the most suitable to each case.
Tonyali, A., Gok, Z., & Oneri, O. S. (2019). Psychosocial interventions in the treatment of child and adolescent conduct disorder. Current Approaches in Psychiatry / Psikiyatride Guncel Yaklasimlar . https://doi.org/ 10.188 10.18863/pgy.42522563/pgy.425225