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Conduct disorder

Conduct Disorder

As immediately as infancy, children express individual characteristics that can be considered aggressive. The child can be aggressive in the way it cries, the way it plays and the way it attains attention. Parents of children that have a hard time sleeping through the night, trouble accepting affection and/or difficulties with hyperactivity are often so stressed and bothered by these behaviors that they resort to negative reinforcement techniques in their parenting. Examples of this can be seen in spanking, harsh reprimanding or even ignoring the child’s behaviors. By using negative reinforcement, the parents are unknowingly strengthening the prevalence of these behaviors, and therefore, the risk of these types of activities to continue through adolescence is also heightened (Patterson, 1982).

Children who tend to not comply with authority in infancy have a greater chance of having an aggressive temperament in adolescence (Kolvin, Nicol, Garside, Day & Tweedle, 1982; Olweus, 1980; Webster-Stratton & Eyberg, 1982). Therefore, as "difficult" children become adolescents, they present an even greater challenge for their parents, school officials, law enforcement and the community. Often ignored is the biggest challenge, which is the child dealing with this instability of his or her mental well-being. We will see in the research provided that conduct disorder is multifaceted, consisting of some components which are hard to conceptualize and of others that are common knowledge. However, each aspect is crucial in understanding the scope of this mental disorder, starting with its history of violence and ending with its lacking intervention.

Conduct Disorder is the most common psychiatric disorder in childhood, affecting approximately 7% of boys and 3 % of girls in the general population (Meltzer, Gatward, Goodman, Ford, 2000). Unlike most mental disorders, which afflict solely the diagnosed party, conduct disorder has serious implications for both the subject and the rest of society. Violence, over aggressiveness, and inappropriate behavior, such as stealing and drug and/or alcohol abuse, are all frequently expressed characteristics of the disorder, however, it is not, by far, limited to these three alone (Campbell, 1990). With an immense array of characteristics, from antisocial behaviors having to do with the violations of the rights of others and also those not having to do with the violations of the rights of others, it is not possible to touch on each.

This paper will focus almost entirely on studies involving antisocial behaviors that violate the rights of others because of their predominately violent nature. Also, this type has been exemplified as the necessary cause of school-aged offender’s malicious attacks, such as those at Columbine High School. However, we must understand that the prevalence of child offenders has not changed significantly in past years. What has changed is the gradual elevated seriousness of the crimes committed by children and adolescents over time and also the media’s over reaction to such offenses.

It is of great importance to create various subtypes in the classification of conduct disorder to facilitate personalized methods of studying and interceding these defiant behaviors. One example of these subtypes is childhood versus adolescent onset. The severity of crimes is reported to be directly associated with the age at which the disorder’s characteristics first emerge. Moffitt (1993) indicated that children afflicted in adolescence will commit offenses that exemplify their rebellion from authority largely because of societal and environmental factors. With even more severity, children with the childhood onset type will commit offenses that are violent and victim-oriented along with delinquent activities because of individual and family characteristics. In a study by McCabe, Hough, Wood and Yeb (2001), it was hypothesized that individuals with childhood onset disorder would commit more violent crimes than their adolescent-onset counterparts. More specifically, as theorized by Loeber (1990) and Tolan (1987), McCabe et al. (2001:2) it was predicted that, "the stability of conduct disorder is significantly related to the age of onset of the disorder, with earlier onset predicting greater persistence of the disorder over time". McCabe et al. (2001) also go on to confirm the hypotheses of Moffitt (1993), which claimed that early onset conduct disorder is rooted in neurological deficits and poor parenting, while adolescent-limited antisocial behavior is caused by the immediate urgency for adolescents to mature to an adult level and participate in adult activities before they are deemed appropriate in the view of society.

Conversely, evidence from McCabe et al. (2001) did not support Moffitt’s (1993) theory that individuals who began to show signs of conduct disorder in childhood were more likely to commit more violent acts than those surfacing in adolescence. Surprisingly, the two groups (child onset and adolescent onset) only differed in one aspect, more specifically, "youth with childhood onset disorder were more likely to have bullied or threatened others" (McCabe et al. 2001: 10.) In respect to other violent behaviors, such as animal abuse and use of weapons, the groups did not differ in any significant manner. Unfortunately, the data used in their study could not yield, as of yet, any new findings on the subject of the disorder’s consistency over time. However, the data is now being used longitudinally in follow-up interviews which will eventually shed some new light on Moffitt’s (1993) theory which states that child onset refers to a more stable degree of conduct disorder than adolescent onset.

To better understand the causes of conduct disorder, we must explore both biological and environmental factors. A growing body of evidence (Griest & Wells, 1983; Huesmann, Eron, Lebkowitz & Walder, 1984; Kazdin, 1987; Robins, 1981) supports that the existence of various psychiatric disorders, such as oppositional defiant disorder, attention deficit disorder, and antisocial personality disorder, among biological relatives of children with conduct disorder has great implications in the disorders incidence, suggesting a high rate of lifetime comorbidity (Keller, Lavori, Beardslee (1992). Furthermore, research has also exemplified how other variables, such as, family interactions, inadequacies in parenting and neurological abnormalities can have lasting affects on children’s aggressiveness (Breen & Altepeter, 1990). Child abuse, in particular, has been targeted as a likely predecessor for childhood psychopathologies, and especially for that of conduct disorder. According to Steiner, Garcia & Matthews (1997), about half of all incarcerated juveniles have experienced some level of traumatic abuse, unfortunately qualifying them for some criteria of Post Traumatic Stress Disorder.

As more and more adolescents with conduct disorder slip through the cracks of the criminal justice system, their disorders are often left untreated, particularly in ethnic minorities, and ultimately they lose faith in themselves as persons incapable peaceful life. More often than not, they are misled by the punishments they face and have conflicting thoughts about the reasons for their institutionalization. It is of crucial importance to those working in the behavioral health services field to investigate the rate at which individuals who are diagnosed with conduct disorder are arrested for crimes. Behavioral health services can provide much needed help for such cases, often enabling "problem" adolescents to become non-violent, socially-functional citizens.

In one study, youth who were referred by mental health services were compared to youth with no history of mental health disorders (Rosenblatt, Rosenblatt & Biggs, 2000). Arrest rates for these groups of youths was the dependent variable. The differences between the two groups was outstanding. "Results indicated that 31% of all the children and adolescents in the county who had committed crimes had received public mental health services" (Rosenblatt et al., 2000: 6). However, the severity of their crimes was less than those not serviced by the mental health field. In terms of ethnicity, juvenile minorities had more incidences of arrest than their Caucasian counterparts, even though ethnic minorities are not serviced by mental health units as frequently (Rosenblatt et al., 2000). "It has been suggested that Caucasian youth who commit delinquent acts tend to be served by mental health agencies, whereas minority youth are relegated to the juvenile justice system for the sam!

e acts" (Rosenblatt et al., 2000: 7).

There are a number of studies that have shown that conduct disorder in children has a significant effect in placing children at a higher risk for adult criminal activity, still

beginnings of a life of "cumulative disadvantage". Also, Sampson and Laub (1997) found that isolating criminal behavior as being caused by conduct disorder does not allow for the array of influences and associations that lead a difficult child to criminal activity later in life.

Sampson and Laub (1997) contest that the very act of labeling a child with conduct disorder can have demoralizing effects on the their self esteem and can escalate negative reactions from others. Poor social bonds and negative life changes are also key features in their assessment of the risks in becoming a criminal. Intervention can succeed if it is understood that treating conduct disorder solely while neglecting other possibilities is inadequate. A full scale program tackling issues of substance abuse, antisocial personality, social class, history of abuse and individual characteristics would explore the array of potentials whose foundation is conduct disorder.

Bibliography:

Breen, M. J. & Altepeter, T. S. (1990). Situational variability in boys and girls identified as ADHD. Journal of Clinical Psychology, 14, 256-278.

Campbell, S. B. (1990). Behavioral problems in preschool children: Developmental and clinical issues. New York: Guilford.

Griest, D. L., & Wells, K. C., (1983). Behavioral family therapy with conduct disorders in children. Behavior Therapy, 14, 37-53.

Huesman, L. R., Eron, L. D., Lefkowitz, M. M., & Walder, L. O. (1984). Stability of aggression over time and generations. Developmental Psychology, 20, 1120-1134.

Kazdin, A. E. (1987). Treatment of antisocial behavior in children: Current status and future directions. Psychological Bulletin, 102, 187-203.

Keller, M. B., Lavori, P. W., & Beardslee, W. R. (1992). The disruptive behavioral disorders in children and adolescents: Comorbidity and clinical course. American Academy of Child and Adolescent Psychiatry, 31, 204-209.

Kolvin, I., Nicol, A. R., Garside, R. F., Day, K. A., & Tweedle, E. G., (1982). Temperamental patterns in aggressive boys. In R. Porter & G. M. Collins (Eds.). Temperamental differences in infants and young children. (CIBA Foundation Symposium No. 89) (pp. 252-255). London: Pitman.

Loeber, R. (1990). Development and risk factors of juvenile antisocial behavior and delinquency. Clinical Psychology Review, 10, 1-41.

McCabe, K. M., Hough, R., Wood, P. A. & Yeb, M. (2001). Childhood and adolescent onset conduct disorder: A test of the developmental taxonomy. Journal of Abnormal Child Psychology, 29, 305-316.

Meltzer, H., Gatward, R., Goodman, R. & Ford, T. (2000). The mental health of children and adolescents in Great Britain. London: Office for National Statistics.

Moffitt, T. E., (1993). Adolescence-limited and life-course-persistent antisocial behavior: A developmental taxonomy. Psychological Review, 4, 674-701.

Olweus, D. (1980). Familial and temperamental determinants of aggressive behavior in adolescent boys: A causal analysis. Developmental Psychology, 16, 644-660.

Patterson, G. (1982). Coercive Family Process. Eugene, OR: Castalia.

Robins, L. N. (1981). Epidemiological approaches to natural history research: Antisocial disorders in children. Journal of the American Academy of Child Psychiatry, 20, 566-680.

Rosenblatt, J. A., Rosenblatt, A., & Biggs, E. E. (2000). Criminal behavior and emotional disorder: Comparing youth served by the mental health and juvenile systems. The Journal of Behavioral Health Services and Research, 27, 227-237.

Sampson, R. J., & Laub, J. H. (1997). A life-course theory of cumulative disadvantage and the stability of delinquency. In T. P. Thornberry (Ed.), Developmental theories of crime and delinquency. New Jersey: Transaction. (pp. 133-161).

Steiner, H., Garcia, I., & Matthews, Z. (1997). Posttraumatic stress disorder in incarcerated juvenile delinquents. Journal of American Academy for Child Adolescent Psychiatry, 36, 357-365.

Tolan, P. H. (1987). Implications of age of onset delinquency risk. Journal of Abnormal Child Psychology, 15, 47-65.

Webster-Stratton, C., & Eyeberg, S.M. (1982). Child temperament:Relationship with child behavior problems and parent-child interactions. Journal of Clinical Child Psychology, 11, 123-129.



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