Conduct Disorder
A conduct disorder is characterized by a repetitive pattern of behavior in which the basic rights of others are violated.
Although some children are better behaved than others, children who repeatedly and persistently violate rules and the rights of others in ways inappropriate for their age have a conduct disorder. The problem usually begins in late childhood or early adolescence and is more common among boys than girls. Evaluation of conduct must take the child's social environment into account. Misconduct developed by children as an adaptation to life in war-torn areas, settings of civil unrest, or other highly stressed environments is not a conduct disorder.
In general, children with a conduct disorder are selfish, do not relate well to others, and lack an appropriate sense of guilt. They tend to misperceive the behavior of others as threatening and react aggressively. They may engage in bullying, threatening, and frequent fights and may be cruel to animals. Other children with conduct disorder damage property, especially by setting fires. They may be deceitful or engage in theft. Seriously violating rules is common and includes running away from home and frequent truancy from school. Girls with conduct disorder are less likely than boys to be physically aggressive; they typically run away, lie, abuse substances, and sometimes engage in prostitution.
About half of the children with conduct disorder stop such behaviors by adulthood. The younger the child is when the conduct disorder began, the more likely the behavior is to continue. Adults in whom such behaviors persist often encounter legal trouble, chronically violate the rights of others, and are often diagnosed with antisocial personality disorder (see Section 7, Chapter 105).
Treatment
Treatment is very difficult because children with conduct disorder rarely perceive anything wrong with their behavior. Often the most successful treatment is to separate the child from a troubled environment and to provide a strictly structured setting, in either a mental health or a juvenile justice setting.
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