Conduct disorder is a severe form of mental disorder that affects people under the age of 18. People with this disease do not hesitate to engage in aggressive, violent, deceitful and stealing behaviors to achieve their goals. Untreated conduct disorder leads to many other mental disorders and increases crime rates in the community.
What is conduct disorder?
Conduct disorder or conduct disorder is a mental disorder that occurs in children and adolescents. This disease is only diagnosed in people under the age of 18. If symptoms occur in an adult, an antisocial personality disorder is diagnosed.
People with conduct disorder always have seriously infringing behaviors on the physical and mental health of others, repetitive behaviors for a long enough time. In addition, this disease is also characterized by persistent violations of the rules and acts of deception to achieve goals (usually for self-interest).
According to statistics, about 3-8% of people under the age of 18 have behavioral disorders and the rate is higher in men (4 times more than women). The risk increases dramatically if you live in poverty and witness violence, conflict and conflict every day. Behavioral disorders can be co-existing with many mental disorders such as learning disorders, attention deficit hyperactivity disorder, and depression. The disease greatly affects the process of personality formation, so it needs to be treated early.
Manifestations of behavioral disorders
As mentioned, conduct disorder is a type of mental disorder characterized by repeated acts of severe aggression towards others. People with this disease do not hesitate to hurt other people, animals and have acts of deception and theft to achieve their goals. A special point is that the patient is completely unable to empathize, share and understand the pain of others. The insensitivity makes the patient unafraid of the somewhat brutal and reckless behavior.
Because conduct disorder mainly affects children and adolescents, families often confuse symptoms with rebellious or rebellious behavior. This is the reason why patients are not examined and treated in time.
Manifestations of conduct disorder are quite diverse, in which they are divided into 4 groups of symptoms as follows:
Aggressive behavior, hurting other people and animals:
- Aggression and fighting with classmates (not including family members)
- Lies or promises to get what the child wants, avoids obligations, or wants more special attention.
- Attacking and physically hurting another person through objects such as pens, shards of bottles, knives, bricks, or anything that can cause injury.
- Some children engage in very cruel behaviors such as tying, slitting hands, and setting others on fire. When the child has these behaviors, the parents can identify the child has a mental problem and take the initiative to take the child to see a doctor.
- In addition to behaviors that hurt others, children also abuse animals.
- Adolescents may engage in coercive behavior and rough sex with others.
- People with conduct disorder themselves do not feel the pain of others, do not know fear, understand and empathize. Therefore, the patient does not hesitate to commit acts of hurting those around him and is completely unrepentant and remorseful for his own sinful acts.
- When being coerced by authorities, patients often have aggressive and hostile behaviors.
- People with conduct disorder often join groups to carry out acts of bullying, exploitation, etc.
Violations of rules and regulations:
- Run away from home often overnight (at least twice a day) or run away from home once but leave for a long time.
- Frequent truancy (must appear before age 13).
- Going out at night despite parental prohibition and disapproval (starting before age 13)
- Breaking into a home, building, or illegally using someone else’s car
- Frequent bullying, threats and acts of violence towards others
- Pickpocketing, extortion, robbery, etc. friends of the same age or weaker people.
- Premature sex despite family prohibition and very thorough education.
- Using drugs, alcohol and smoking.
- Frequent violations of school rules even though the management board has taken strong handling measures.
Acts of destruction of property:
- Intentionally destroying the property of others or public property by arson
- Some people have other behaviors such as slashing bags, breaking personal items, using sharp objects to scratch cars, etc.
Deception and theft:
- Often lies to avoid having to do something or intentionally lies to get things from friends and relatives
- Stealing valuables in supermarkets, shops. Some people even fake valuables to swap with the real thing.
Conduct disorder in men characterized by aggressive, antagonistic, and deceitful behaviors. In particular, women with conduct disorder often cheat and violate the rules (especially sex before their age). Symptoms of conduct disorder can be mild to moderate and severe. Therefore, as soon as the first symptoms are noticed, the family should have early intervention measures to avoid the situation from worsening.
Causes of behavioral disorders
To date, experts have not been able to determine the cause of the conduct disorder. However, evidence has been obtained that this pathology is the result of an interplay between biological factors and environmental influences.
Some of the identified causes of conduct disorder are:
Heredity is one of the important factors in the pathogenesis of behavioral disorders. Experts found that most people with this condition have damage to the frontal lobe of the brain.
The frontal lobe is the organ responsible for controlling emotions, memory, thinking ability, perception, and personality expression. Damage to the frontal lobe leads to a number of problems such as a lack of impulse control, a decreased ability to learn from life events, and a decreased ability to plan for the future. This is what causes the patient to behave aggressively, brutally and often seriously violate the rules.
Damage to the frontal lobe is determined to be genetically related or sometimes occurs after brain injury. However, there is a growing body of evidence that genetics do indeed play a role in the pathogenesis of behavioral disorders.
In addition, the amygdala in people with behavioral disorders also has a decrease in gray matter volume. As is known, this organ is responsible for controlling fear and anxiety. The phenomenon of reducing gray matter volume causes the amygdala to work poorly and the patient has absolutely no fear.
2. Perinatal complications
Perinatal complications have also been identified to be related to the pathogenesis of behavioral disorders and some other psychiatric disorders. Most people with this disease have mothers who used alcohol, tobacco and stimulants during pregnancy, leading to defects in neural development.
3. Neurotransmitter Disorders
Neurotransmitters are hormones that govern mood, thinking, behavior and regulate a number of organs in the body. In patients with behavioral disorders, experts noticed an increase in serotonin and a decrease in epinephrine. This leads to the patient’s absence of fear from aggressive, excitable, angry behaviors and does not hesitate to hurt others.
4. Impact from living environment
Personality is a genetic factor, but under the influence of the environment, personality will change in a positive or negative direction. Experts found that the risk of this disease increased significantly in people of African descent and people with a low quality of life. Therefore, it is possible to confirm the role of the living environment in the pathogenesis of behavioral disorders.
Environmental factors that can increase the risk of the disease include incomplete families, frequent parental conflicts, violent behaviors, and alcohol and drug use. In addition, frequent witnessing with violent acts from an early age also makes children develop aggressive, unwelcoming personalities, etc. Thereby increasing the risk of behavioral disorders and personality disorders. fight against government.
5. Factors that increase risk
In addition to the above factors, some of the following factors may also increase the risk of conduct disorder:
- Being male (4 times higher than female)
- Difficult family situation, frequent arguments, conflicts and violence
- Unhealthy family and learning environment
- Family history of conduct disorder, oppositional defiant disorder, attention deficit hyperactivity disorder, etc.
- There are other mental disorders such as depression, anxiety disorders, eating disorders, learning disorders, autism, etc.
- Have experienced severe traumatic events since childhood (abandonment, abuse, violence, assault, etc.)
Although the pathogenesis has not been determined, it can be confirmed that the behavioral disorder is related to genetics and environmental influences.
Behavioral disorders and unpredictable consequences
Conduct disorder is defined as a serious mental disorder. People with this disorder have aggressive, cruel behaviors with the aim of getting what they want without fear or empathy for the pain of others. Reckless behaviors due to conduct disorder seriously affect people around them, animals and sometimes cause physical harm to the person themselves.
If left untreated, behaviors can become progressively more severe because the person is completely fearless and compassionate. People with this disease are almost unable to maintain their studies, often run away from home, join thieves gangs. Women with conduct disorder are more likely to drop out of school early and work in sex-related jobs.
Most patients with conduct disorder use alcohol, drugs, and smoke. In case the family does not intervene in time, there is a high chance that the patient can contract infectious diseases due to sharing needles and unsafe sex. People with conduct disorder are more likely to develop antisocial personality disorder and become criminals, threatening social security.
Patients often do not have close relationships, live alone, indifferent and have a low life expectancy due to health problems. In addition, this disease also increases the risk of anxiety disorders, depression, delusional disorder, etc. Cases of co-morbid psychiatric disorders often have a high risk of suicide and a reduced quality of life.
The prognosis of conduct disorder is quite variable. Early-onset disease before the age of 8 years has a poor prognosis, with about 50% of cases having symptoms that persist into adulthood. In contrast, children with adolescent onset have a better prognosis. With active treatment, symptoms will be in almost complete remission by the age of 20.
Diagnosing behavioral disorders
Behavioral disorders have very serious consequences. Therefore, the family should bring the patient to the doctor as soon as possible. Similar to other mental disorders, this disorder is diagnosed primarily by clinical presentation and risk screening. Currently, Psychiatrists use the ICD-10 or DSM-5 criteria to diagnose conduct disorder.
In case people over 18 years of age have symptoms of conduct disorder, they will be diagnosed with antisocial personality disorder (ASDP) – one of the severe personality disorders, with a poor prognosis and difficult treatment. Symptoms are defined as behavioral disturbances only when they persist for at least 6 months and cause significant life-threatening effects.
Behavioral disorder treatments
Treatment for conduct disorder should be done as soon as possible. Because the pathogenesis is related to biological and environmental factors, it requires close cooperation from the family. Most patients need to be treated with a combination of methods to get positive results.
Behavioral disorder treatments may be used:
1. Building a healthy living environment
Most people with conduct disorder live in incomplete families or are sometimes influenced by aggressive, brutal behavior by friends. Therefore, the first step in the treatment process is to build a healthy living environment to avoid the formation of aggressive, fierce, lack of goodwill, etc. A healthy living environment directs children to good characters. and reduce cruel and brutal acts.
How to build a healthy living environment to support behavior disorder treatment:
- If parents often quarrel and conflict, both should discuss to find a solution. It is best to yield to each other to create a healthy living environment for children and a happy family. In the event that they cannot find a common voice, both should separate or divorce, avoiding the situation where children see their parents arguing every day.
- Review the educational environment to determine if your child has been influenced by bad friends. If necessary, the child should be transferred to another school to ensure that he or she learns in the healthiest environment. In case the child lacks the ability to adapt and is isolated, the child should be sent to special education centers.
- Talk to your child’s siblings about their health so that everyone can support the child through it. Encourage your children to show care and love to inspire love, empathy, and compassion in the person with the behavior disorder.
- Sometimes violent, aggressive behaviors are caused by children learning from those around them. Therefore, families should consider moving so that their children can grow up in the healthiest environment.
2. Psychotherapeutic intervention
Psychotherapy is the mainstay of treatment for behavioral disorders. According to experts, the state of indifference, fearlessness and compassion is the source of violent, aggressive, reckless behavior, etc. If the patient himself has deep feelings for others, the This behavior will gradually decrease. Therefore, psychotherapy is considered the main intervention in the treatment process.
Psychological methods used in the treatment of behavioral disorders:
- Functional family therapy: This therapy is carried out for both the patient and the family with the goal of helping the family understand the characteristics of the disease, thereby consciously supporting and encouraging the patient to intervene in treatment. In addition, functional family therapy also helps relatives to form good qualities and have the right method of educating their children. Only in this way can patients change their behavior and form a positive personality.
- Multi-system therapy: In addition to functional family therapy, multi-system therapy is also an effective method in the treatment of behavioral disorders. This therapy helps to reduce aggressive behaviors and form correct, socially appropriate behaviors. This method is often applied long-term to help patients control their disease and form a healthy personality.
The process of psychotherapy for patients with behavioral disorders needs to be carried out over a long period of time. It also requires close coordination between families, schools and medical staff.
In addition to psychotherapy, chemotherapy is also considered in the treatment of behavioral disorders. Medications are often used to reduce aggressive behavior and improve symptoms of certain mental disorders such as depression, epilepsy, attention deficit hyperactivity disorder, anxiety disorders, etc.
Medications used in the treatment of conduct disorder include:
- Alpha Blocker (Clonidine)
- Antipsychotics (Risperidone, Haloperidol, Quetiapine, Olanzapine, etc.)
- Selective serotonin reuptake inhibitors (SSRIs)
- Combined psychiatric medications
Pharmacotherapy is only considered in cases of necessity. Because this method can only control symptoms temporarily. The most important is still the living environment, the education of the family and the school. If actively treated, mental function will be restored and the patient can stabilize a long life.
Conduct disorder is a severe mental disorder seen in children and adolescents. This disease causes a lot of consequences and complications if not diagnosed and treated promptly. More than anyone else, family is an important factor to help patients have early access to health care measures and faster recovery.