CONDUCT DISORDERS

"Conduct disorders" are a complicated group of behavioral and emotional
problems in youngsters. Children and adolescents with these disorders have
great difficulty following rules and behaving in a socially acceptable way.
They are often viewed by other children, adults and social agencies as "bad"
or delinquent, rather than mentally ill.

Their expression of anger is the major problem. They are often aggressive,
both physically and verbally, with other children and to adults. They may
lie, steal, destroy property and misbehave sexually.

Research shows that the future of these youngsters is likely to be very
unhappy if they and their families do not receive early, ongoing and
comprehensive treatment. Without treatment, many youngsters with conduct
disorders are unable to adapt to the demands of adulthood and continue to
have problems with relationships and holding a job. They often break laws or
behave antisocially. Many children with a conduct disorder may be diagnosed
as also having a coexisting depression or an attention deficit disorder.

Many factors may lead to a child developing conduct disorders, including
brain damage, child abuse, defects in growth, school failure and negative
family and social experiences. The child's "bad" behavior causes a negative
reaction from others, which makes the child behave even worse.

Treatment of children with conduct disorders is difficult because the causes
of the illness are complex and each youngster is unique. Adding to the
challenge of treatment are the child's uncooperative attitude, fear and
distrust of adults.

A child and adolescent psychiatrist uses information from other medical
specialists, and from the child, family and teachers to understand the causes
of the disorder and then organize a comprehensive treatment plan.

Behavior therapy and psychotherapy are usually necessary to help the child
appropriately express and control anger. Remedial education may be needed for
youngsters with learning disabilities. Parents often need expert assistance
in devising and carrying out special management and educational programs in
the home and at school. Treatment may also include medication in some
youngsters, such as those with difficulty paying attention and controlling
movement or those having an associated depression.

Treatment is rarely brief since establishing new attitudes and behavior
patterns takes time. However, treatment offers a good chance for considerable
improvement in the present and hope for a more successful
future.


Facts for families: the American Academy of Child and Adolescent Psychiatry.