We have all known bullies and troublemakers all through our school days. However, a small number of children engage in other serious transgressions of societal norms for behaviour and demonstrate a chronic pattern of unconcern for the basic rights of others.
The Diagnostic and Statistical Manual of Mental Disorders, Text Revision-IV (DSM-IV-TR) provides the framework of the criteria of Conduct Disorder
A) Repetitive and persistent pattern of behavior in which the basic rights of others or societal norms are violated. This is demonstrated by the presence of three or more of the following characteristics in the past 12 months, with atleast one in the past 6 months.
- Aggression to people and/or animals
1. Often bullies, threatens, or intimidates others and initiates physical fights
2. Has used a weapon that can cause serious physical harm to others
3. Has been physically cruel to animals
- Destruction of property
1. Has deliberately engaged in fire setting with the intention of causing serious damage
2. Has deliberately destroyed others’ property (other than by fire setting)
- Deceitfulness or theft
1. Has broken into someone else’s house, building, or car
2. Often lies to obtain goods or favors or to avoid obligations
3. Has stolen items of crucial value without confronting the victim (e.g., shoplifting but without breaking and entering; forgery)
- Serious violations of rules
1. Often stays out at night despite parental prohibitions, beginning before age 13 years.
2. Has run away from home overnight at least twice while living in a parental home.
3. Is often Truant from school.
Truancy, also called skipping school, is defined as “unexcused absences from school without the knowledge of a parent or guardian”. There are several factors contributing to truancy which are broadly classified in two categories namely:
- School and its facilities-When students feel unsafe, unchallenged, or unimportant at school, they may decide not to attend. School-related factors contributing to truancy include poor supervision and maintenance of school facilities, Teachers and school officials failing to address behavioral problems, harsh punishments for minor infractions, such as automatic suspensions etc., lack of notification to parents when a child is not attending or performing as expected.
- Student’s home life and personal related factors: Abuse or neglect by the child’s parents or guardian, substance abuse by family members or self, parents’ lack of interest in education, financial issues, such as single parents working multiple jobs to make ends meet, low self-esteem, often due to poor grades and undiagnosed or untreated mental health issues.
B) These disturbances in behavior cause clinically significant impairment in social, academic, or occupational functioning.
Let us look at the potential causes for conduct disorder in children.
- Biological factors: Genetics and neurological problems are implicated in the development of conduct disorder.
- Children with conduct disorder tend to have parents who are harsh and inconsistent in their discipline practices and model aggressive, antisocial behaviour. Psychologically, children with conduct disorder tend to process information in ways likely to lead to aggressive reactions to the behaviours of others.
The conduct problems of some children diminish with age, a pattern called adolescent-limited antisocial behavior.
Unfortunately, many children with conduct disorder continue to violate social norms in adolescence and adulthood. This pattern is called life-course-persistent antisocial behaviour.
Looking at the treatment plan;
- Cognitive-behavioral therapy- focuses on building smooth interpersonal relationships and help them control their angry impulses.
- Truancy prevention programs include increased parental involvement, usually through notification of a child’s truancy, joint counseling with the child and his or her parents, family mediation and mentorship.