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Conduct and Oppositional Disorders are the most frequently occurring behavioral disorder in the general population. It also represents the greatest percentage of referrals for treatment of children. Conduct disorders occur at a rate of approximately 3 to 10 children out of 100. Boys are 3 to 4 times more likely to have this disorder than girls. Children with severe conduct disorders are likely to exhibit similar patterns of behavior later in life. As adults, they have a greater risk to show more serious psychological/psychiatric impairments.
Environmental factors which influence the development of conduct disorders include family systems, educational systems and the impact of friends and peer relationships. Repeated noncompliance with appropriate parental expectations is a key factor in the development of these disorders (i.e. excessive disobedience of adults).
Conflict and distress between parents, parents and the child, as well as conflict between the family system and others have been shown to lead to acting out and conduct disordered behaviors. Parents of aggressive children tend to be excessively commanding and coercive. Parents of children who steal tend to be more distant and less involved with their children.
Discipline in the families of these children is often excessive, lacking, inconsistent or inappropriate. Mothers are often rejecting and fathers tend to be excessive or inconsistent in discipline practices. There is clear evidence that these families do not adequately monitor the child’s behaviors. Substance abuse strongly influences the occurrence of Conduct and Oppositional Disordered behavior. In addition, substance abuse often follows as a result of the progression of these disorders.
As for behaviors that characterize these disorders they are as follows:
Conduct Disorder. A persistent pattern in which the basic rights of others and important social norms and rules are violated.
- running away from home;
- lying;
- stealing without confronting a victim;
- use of a weapon;
- initiating physical fights;
- physical cruelty to animals;
- physical cruelty to people;
- forcing someone into sexual activity;
- setting fires;
- truancy from school;
- breaking into someone's house, building or car.
Oppositional Defiant Disorder. A pattern of negativistic, hostile and defiant behavior without the more serious violations of the basic rights of others that are seen in conduct disorders.
- angry or resentful;
- blames others for his or her own mistakes;
- swears;
- argues with adults;
- actively defies of refuses the requests of adults;
- deliberately does things to annoy people;
- spiteful or vindictive;
- loses temper;
- touchy or easily annoyed by others.
A large number of treatment strategies have been developed to deal with conduct disorders. The chance of a successful treatment outcome is best when early interventions are made and when children are young. Family based approaches are more effective than individual approaches which focus on the child while excluding the parents and family. Parent training and behavioral interventions are crucial when working with younger preadolescent children.
As children reach adolescence, the use of peer group as well as an individual focus can be effective. Family based interventions which emphasize parent training are often more difficult with older children since the problems may have been going on for some time, and children are often beginning to individuate and separate from the family. Outdoor based interventions are often effective when all other approaches have failed and there is a high or extremely high risk that the problem behavior will continue or escalate.
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