conduct disorder

Conduct disorder criteria A

Repetitive and persistent behavior where the basic rights or others or major age appropriate societal norms or rules are violated and 3 of the 15 symptoms are present for 12 months and one criterion present for 6 months

Criteria A symptoms

Aggression towards people and animals

• Often bullies, threatens, or intimidates others

• Often initiates physical fights

• Used a weapon to case serious harm to others

• Physically cruel to people

• Physically cruel to animals

• Stolen while confronting a victim

• Forced someone into a sexual activity

Destruction of property

• Deliberately engaged in fire setting with the intention to do serious damage

• Deliberately destroyed others property

Deceitfulness or theft

• Broken into someone else’s property

• Lies to obtain goods or favors

• Stolen items of nontrivial value from others

Serious violation of rules

• Stays out at night past curfew deliberately beginning before age 13

• Runs away from home overnight at least twice or for a few days at least once

• Truant from school

Criteria B

Behaviors cause clinically significant impairment

Criteria C

If individual is 18 or older criteria for antisocial personality disorder must not be met

Childhood onset

At least one symptom characteristic is shown prior to age 10

Adolescent onset

No symptoms is shown prior to age 10

Limited prosocial emotions

At least two of the fallowing characteristics are shown for over 12 months persistently in multiple relationships and settings

• Lack or remorse or guilt

• Callous lack of empathy

• Unconcerned about performance

• Shallow affect

Lack of remorse or guilt

Does not feel bad or guilty when they do something wrong

Callous lack of empathy

Disregards and is unconcerned about the feelings of others. May be described as cold and uncaring

Unconcerned about performance

Does not show concern about poor/problematic performance at school, work, etc

Shallow affect

Does not express feelings or show emotion others except in ways that seem shallow or superficial

Severity

Mild: few if any conduct problems to meet diagnostic requirements and relatively minor harm to others

Moderate: number of conduct problems and effects on others are intermediate between mild and severe

Severe: many conduct problems in excess of those required by diagnostic or causes considerable harm to others

Development and course

• First significant symptoms typically occur in middle childhood through middle adolescence

• May be diagnosed in adults

• Onset is rare after age 16

• Early onset prior to age 10 typically predicts a worse prognosis and increased risk of criminal behavior and substance use in adulthood

• At risk for developing mood disorders and anxiety disorders later on

Environmental risk factors

• Often prenatal rejection and neglect occurs

• Inconsistent childbearing practices

• Harsh discipline

• Physical and sexual abuse

• Lack of supervision

• Large family size

Temperamental risk factors

If the infant has an uncontrollable temperament it can impact the primary caregivers ability to form a secure attachment

Interventions

• Parent training

• Risperdon is prescribed to help reduce aggression