Table of contents:

1. Causes of conduct disorders
2. Conduct disorders: symptoms
3. Recognition of conduct disorders
4. Treatment of conduct disorders
5. Prognosis of children and adolescents with conduct disorders

Conductdisorders are a problem encountered by specialists in child psychiatry - this entity is only diagnosed in children and adolescents. Behavioural disorders are difficult to define, primarily because they are a complex group of problems - one explanation is that it is often difficult to determine which behaviour of a young person is still considered normal and which behaviour is considered to be far above the norm.

Apart from the aspects related to the definition of behavioural disorders themselves, one thing can definitely be said about them - their occurrence in a child poses significant problems for both the child's carers and other people who come into contact with the child, e.g. teachers. The prevalence of conduct disorders may even be regarded as surprising - according to statistics, there may be more than 50 million children and adolescents worldwide struggling with these problems. In terms of the prevalence of this pathology in the paediatric population as a whole, abnormalities corresponding to conduct dis orders may be found in up to 10% of children and in more than 20% of adolescents. The problem is more common in boys.

Causes of conduct disorders

In fact, the causes of conduct disorders in children and adolescents are still not clear. The predominant view today is that two groups of factors are involved in the development of this type of pathology: the first is genetic and other organic factors, and the second is various environmental problems.

The role of genes in the aetiology of behavioural disorders is suggested by the fact that it has been observed that the problem is more frequent in those children whose families had already been diagnosed. Attention is also drawn to the involvement of various defects in the central nervous system. In particular, damage to the frontal lobes of the brain is suspected of influencing the appearance of behavioural disorders in children. Centres located in this part of the nervous system are responsible, among other things, for problem-solving skills or the expression of emotions, and therefore various defects that appear in this region of the brain would be linked to behavioural disorders. Defects of this kind could result from a variety of problems - they could occur both as a result of head trauma and the defects could result from various pathologies during the perinatal period.

Children are considered to be at particularly high risk of developing conduct disorders if they have a 'genetic predisposition' to the problem and are exposed to environmental factors that favour conduct disorders. These can be a variety of events - insufficient attention from caregivers, experiencing violence (both physical and psychological) or having experienced a traumatic event (e.g. rape).

Behavioural disorders in children, photo: panthermedia

Conduct disorders: symptoms

Behavioural disorders in children include a wide variety of behaviours that are generally regarded as simply abnormal and unacceptable. Indeed, in the criteria for the diagnosis of conduct disorders, problems such as:

• extremely frequent and totally inadequate outbursts of anger and aggression,
• frequent altercations with parents, other family members and other people with whom the child comes into contact,
• a tendency to be oversensitive and easily offended,
• engaging in inappropriate behaviour and then blaming it on others,
• vindictiveness,
• tendency to lie,
• running away from home,
• truancy,
• deliberately damaging things,
• frequent defiance of adults,
• cruelty to both people and animals,
• picking fights,
• intentionally hurting other people.

Recognition of conduct disorders

Conductdisorders are diagnosed on the basis of several different criteria. According to the ICD-10 classification, these problems can be diagnosed when the duration of the conduct disorder symptoms is at least six months. The diagnostic criteria also state that the diagnosis cannot be made if the child is suffering from other mental disorders - such as schizophrenia or pervasive developmental disorders, for example - and therefore other psychiatric problems must be ruled out before a conduct disorder is diagnosed.

It is also worth mentioning here that there are several different varieties of conduct disorder. These are:

• conduct disorders confined to the family environment,
• conduct disorders with normal socialisation (i.e. where the child functions well in a peer group),
• conduct disorders with abnormal socialisation (the opposite form to that described above),
• oppositional defiant disorder.

Treatment of conduct disorders

Therapeutic interventions play the greatest role in the treatment of conduct disorders. Of the many different psychotherapeutic methods in operation, therapies that affect not only the child, but also the entire environment, such as systemic therapy, are most often recommended for the problem at hand.

It is rare, but children with conduct disorders are sometimes offered pharmacological treatment. This does not eliminate the cause of the problem, but medication can reduce the frequency of aggressive outbursts in patients. For example, neuroleptics (antipsychotics) may be recommended to reduce the frequency of such attacks in patients with conduct disorders .

Prognosis of children and adolescents with conduct disorders

Achieving improvement in a child with conduct disorder may not be easy - therapy sometimes takes a very long time. Nevertheless, it is worthwhile trying to help your child, because the onset of a behavioural disorder, whether in a child or adolescent, increases the risk that he or she will develop further disorders in the future - these may be, in particular, various types of personality disorders in adulthood.