Conduct disorder

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Conduct disorder
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Readings

• Wenar, C. Kerig, P. (2000) Conduct disorder
  and the devlopment of antisocial behaviour in
  Developmental Psychopathology (pp. 189-210).
  Singapore McGraw-Hill

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Lecture Questions

• What is Conduct Disorder and how does it affect
  children/adolescents lives?
• What are the diagnostic issues related to Conduct
  Disorder?
• What is the developmental picture and course in
  Conduct Disorder?
• What are some of the social issues related to
  Conduct Disorder?

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Conduct Disorder in Popular Culture
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Overview

• Another externalising problem
• Impacts on all rings of the social context web-
  young person, family, school, community
• NZ prevalence 3.4 age 11, 7.3 age 15, 5.5 age
  18
• More prevalent in clinical samples, around a
  third to a half of all child and adolescent cases
• Comorbidity with ADHD, ODD, learning disorders,
  depression

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Gender issues

• Ratio 31, more diagnosed in boys
• Research biased to study of boys
• DSM criteria differences and presentation
  differences
• Girls CD patterns more likely to begin in
  adolescence
• Girls gtcomorbidity-depression, anxiety
• Influence of developmental factors
• Influence of how gender constructed

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Factors in drawing the line

• Context for the behaviour, adaptation or mental
  disorder?
• Seriousness of rule violations
• Frequency, intensity, endurability, pervasiveness
• Age appropriateness of rule violations

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Rule violation developmental picture

• Pre-school aggression to other children,
  disobedient to parents
• School age classroom disruption, unco-operative
  in playground, defiant at home
• Adolescence delinquent peers, violating the law,
  ignoring parental discipline, failing in school
• Rule violation normal in adolescence
• Childhood behaviour better predictor of adult
  antisocial behaviour than adolescent behaviour

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DSM Criteria

• Aggression to people and animals (cruelty,
  bullying, fights, forced sex, mugging)
• Destruction of property (fire-setting and other
  ways)
• Deceitfulness or theft (breaking entering,
  conning, stealing
• Serious rule violations (staying out at night,
  running away, truanting)
• Repetitive, persistent, violation of others
  rights or social norms, at least three in each
  category

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Types of Conduct Disorder

• Childhood onset
• Overt aggression
• Physical violence
• Multiple problems
• More common in males
• Persistent
• Better predictor of antisocial behaviour in
  adulthood
  
  
  

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Types of Conduct Disorder

• Adolescent onset
• Less severe behaviour problems
• Less complex problems
• Less violent crime
• Different childhood temperaments (difficult for
  child type, emotional detachment for adolescent

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sub-types

• Two behavioural dimensions
• Destructiveness- (a)those that harm others and
  (b)those that violate rules
• Overtness- (c) those that lie, steal (covert) and
  (d)those that bully, fight
• Subtypes- oppositional (bd), aggressive (ad),
  property violations (ac), status violations (bc)

Frick et al. (1993)
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Children who kill

• 1950s Heavenly Creatures
• Mark and Luke Reihana
• Bailey Junior Kurariki

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Children who kill-psychopaths?

• Antisocial behaviour-associated with impulsivity
  and conduct problems
• Psychopathy associated with callousness, lack of
  empathy and emotion
• Psychopathy linked with violence of offending
• Different pathways

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Developmental course

• At age 3, aggressive, temper tantrums, torturing
  the family cat, destroying property, no playmates
• In the school years, academic deficiencies
• As a teenager, poor interpersonal skills, high
  peer rejection
• 50 of children diagnosed with CD will develop
  anti-social personality as adults (Kazdin)

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Risk factors-child/adolescent

• Prematurity, low birth weight, anoxia, medical
  stresses at birth (interact with family factors)
• No substantial evidence for genetic factors
• Temperament (emotionality, activity level,
  sociability) difficult
• Frontal lobe deficits-inability to plan or
  redirect potentially harmful behaviour and learn
  from negative consequences
• Problems with self-control

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Risk factors-parents

• Alcoholism/substance abuse
• history of parent criminality
• psychiatric problems, especially antisocial
  personality disorder

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Risk factors- family system

• harsh parenting or lax parenting, poor
  supervision, inconsistency, coercion
• low attachment, warmth
• less supportive and more defensive communication
• dominance of one family member
• low stress threshold, stress related to
  significant other
• exposure to violence, abuse, neglect- increase
  risk from 5 to 20

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Risk factors-social

• large family size, overcrowding, untoward living
  conditions
• poor housing
• disadvantaged school setting
• financial hardship
• adversarial contact with an outside agency

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NZ data

• Fergusson et al. (Christchurch Development Study)
  social and material disadvantage
• parental criminality, substance abuse and other
  adjustment problems
• impaired parenting and lower standards of child
  care
• family instability, change and marital conflict
• One risk factor in itself not predictive, the
  greater the number, the more likely anti-social
  career from early age escalating in seriousness

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Peers factors

• Peer rejection in early childhood
• Association with deviant or antisocial peer
  group (especially adolescence)
• Girls with older boyfriends

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Societal factors

• Media violence and tolerance for violence
• Neighbourhood violence
• School climates
• Constructions of gender

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Buffers or protective factors

• Being a girl
• Being very intelligent
• Having a positive social orientation
• Having a resilient temperament
• Having warm, supportive affective
• relationships with family or other adults
• Being committed to values of school or
• other social institution
• Family and community norms opposed to
• crime and violence supportive of
• educational success and healthy development