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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

Dr Sacrifice Chirisa Mental Health Matters
Conduct disorder is a serious behavioural and emotional disorder that can occur in children and teens. 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 teens 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.

It is estimated that 2-16 percent of children have conduct disorder. It is more common in boys than in girls and most often occurs in late childhood or the early teen years.

Symptoms of conduct disorder 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 (deliberate fire-setting) 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, skipping school, playing pranks, or being sexually active at a very young age.

In addition, many children with conduct disorder are irritable, have low self-esteem, and tend to throw frequent temper tantrums. Some may abuse 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.

Conduct disorder diagnosis is based on signs and symptoms that are suggestive of it. If symptoms of conduct disorder are present, parents and doctors must send the child for full psychiatric evaluation. The psychiatrist will also look for signs of other disorders that often occur along with conduct disorder, such as ADHD and depression.

Treatment for conduct disorder is based on many factors, including the child’s age, the severity of symptoms, as well as the child’s ability to participate in and tolerate specific therapies. Treatment usually consists of a combination of the following:

Psychotherapy: Psychotherapy is aimed at helping the child learn to express and control anger in more appropriate ways. Improving problem solving skills, anger management, moral reasoning skills and impulse control. Family therapy may be used to help improve family interactions and communication among family members.

Medication: Although there is no medication formally approved to treat conduct disorder, various drugs may be used to treat some of its distressing symptoms, as well as any other mental illnesses that may be present, such as ADHD, major depression and aggression.

DISCLAIMER: This column contains information about mental health-related issues. However, the information is not advice, and should not be treated as such. The writer accepts no responsibility for misuse and misrepresentation caused by the use or misunderstanding of this article. No warranties or assurances are made in relation to the safety and content of this article and attachments. Columnist accepts no liability for any damage caused by or contained in any attachments. No liability is accepted for any consequences arising from this article.

Dr S. M. Chirisa is a passionate mental health specialist who holds an undergraduate medical degree and postgraduate Master’s degree in psychiatry both from the University of Zimbabwe. He is currently working as a Senior Registrar in the Department of Psychiatry at Parirenyatwa Group of Hospitals and is also the current national treasurer of the Zimbabwe Medical association (ZiMA). He can be reached at [email protected]