Conduct Disorder Flashcards
Define Conduct Disorder
Persistent (several months of longer) pattern of antisocial behaviour where a child or young person repeatedly carries out aggressive acts that may cause them distress and/or social impairment, and upset other people
What is oppositional defiant disorder
milder variation of conduct disorder seen in children <10yo
What differentiates early onset vs adolescent onset conduct disorder
Early onset = before 10yo
Adolescent onset = after 10yo
What are the risk factor for conduct disorder
Male (boys 2.5x more likely)
Lower than average intelligence
Learning/reading difficulties
Coexisting mental health problems e.g. ADHD
FHx (parent or sibling)
Physical or sexual abuse
Frequent changes in caregivers, or experience of early institutional living
Being rejected by parents or experiencing permissive neglectful, harsh, or inconsistent parenting
Family poverty
Being bullied
Involvement with other difficult young people
Use of recreational drugs
What is the estimated prevalence for conduct disorder in 5-16yo in England
5.6%
What are the symptoms of conduct disorder in 2-7yo
General defiance to adults’ wishes
Disobedience of instructions
Angry outbursts with temper tantrums
Physical aggression
Destruction of property
Arguing
Blaming others for things that have gone wrong
Annoying or provoking others
What are the symptoms of conduct disorder in 8-11yo
Swearing
Lying
Stealing outside the home
Persistent breaking of rules
Physical fights
Bullying
Cruelty to animals
Setting fires
What are the symptoms of conduct disorder in 12-17yo
Hurting others, fighting, bullying
Committing crimes (assault, robbery, vandalism, burglary)
Running away from home
Truancy from school
Misusing alcohol and drugs
Unusually severe temper tantrums
Defiant provocative behaviour
What are the differentials for conduct disorder
ADHD
Adjustment reaction to an external stressor (Divorce, bereavement, trauma, abuse, adoption)
Bipolar disorder
Depressive disorder
Autism spectrum disorder
Antisocial personality disorder
What questionnaires can be used for conduct disorder
Strengths and Difficulties Questionnaires
What is the management for conduct disorder
Refer to psychosocial intervention
<11yo: parent training (group training: modelling, rehearsal and feedback)
9-14yo: child focused programme (cognitive-behavioural problem solving model, rehearsal, feedback
11-17yo: multimodal: family education, psychological therapy, parent management training, family therapy, school support
When should a referral to CAMHS for conduct disorder be made
Coexisting mental health problems e.g. depression, ADHD
Neurodevelopmental condition e.g. ADHD, Autism
Learning difficulty or disability
Substance misuse
What are the complications of conduct disorder
May commit violent/ non-violent crimes
Poorer school performance, unemployment, relationship problems
Psychiatric problems
What is the prognosis for conduct disorder
Adolescent onset is associated with a better prognosis than early onset
Approximately 85% of people with adolescent onset will have stopped their antisocial behaviour by their early 20s
Approximately half of all children with early onset go on to have serious problems that continue into adulthood (delinquent) e.g. committing violent and non-violent crimes, antisocial personality disorder, drug abuse, depression, poor school performance, unemployment, relationship problems etc.
