Tuesday, February 4, 2014

The Conduct Disorder Trio

The illnesses in what I call the Conduct Disorder Trio--Oppositional Defiant Disorder (ODD), Conduct Disorder (CD), and Antisocial Personal Personality Disorder (ASPD)--are becoming more common among children, teens, and adults. (You'll see why when I talk about the main causes of them.) I'm not just talking about bullying here; most bullies actually don't have a diagnose-able conduct problem. There are usually other negative things at work in their lives that can be easily resolved through proper guidance.

Conduct disorders are much worse.

Generally speaking, ODD is diagnosed in children, CD in teens, and ASPD in adults. However, if the symptoms are severe enough, one could be diagnosed with a disorder that's typically out of the normal age range.

FYI: All of the symptoms posted here come straight out of the DSM (the Diagnostic and Statistical Manual of Mental Disorders).

Childhood: Oppositional Defiant Disorder (ODD)
So, there's childhood moodiness, tantrum-throwing stages, general fussiness, and so on. But ODD is not your run-of-the-mill childhood crankiness. To start, the following four behaviors have to be going on for at least six months before a licensed professional can diagnose your child with ODD:

Negativity            Defiance            Disobedience            Hostility directed toward authority figures

Those four behaviors can lead to other things like...

...on a regular basis.

The child with ODD will also usually believe that his/her behavior is not defiant; the statement will usually be made that "unreasonable demands" are being placed on him/her...by adults, of course. This, along with the above mentioned behaviors, leads the child to have feelings of anger and resentment.

Adolescence: Conduct Disorder (CD)
As per the DSM: "Conduct Disorder is characterized by a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated." Like ODD, there is a time frame in which symptoms must be happening in order for diagnosis to be made. For CD, at least three of the following symptoms have to have happened within the past 12 months, with at least one of those three having happened within the past 6 months:

In addition, the DSM states that "the disturbance in behavior causes . . . significant impairment in social, academic, or occupational functioning."

One person describes this disorder perfectly. In fact, he's Psychology's poster-boy for it.

Source for textbook information

It's important to know that most kids/teens who act out don't have ODD or CD. They are just in a place in their lives where the frontal lobe of their brains (which controls things like logic) aren't developed enough to understand the concept of "Hey, this might not be the best idea."

Adulthood: Antisocial Personality Disorder (ASPD)
When psychologists talk about being antisocial, they're not talking about not wanting to go to parties. A diagnosis for ASPD is possible in people 18 years old and older and it can be quite disturbing. There are severe cases of this disorder in which an adult committed murder because someone was irritating him/her. The perpetrator (with ASPD) knew that it's against the law, but felt absolutely no guilt for it.

Here are the symptoms:

It is also important to understand that these symptoms may not be ASPD if the person has schizophrenia or bipolar disorder; the symptoms may be the same, but if it really is something like schizophrenia, the reason for the symptoms will be different and thus, so will treatment.

It's no secret that children need consistency in their lives. There are countless studies out there showing time and time again that, regardless of the type of family you come from (single parent, LGBT, working parents, etc.), consistency at home has the ability to prevent countless problems later in life. It's interesting to report that while there are many possible causal influences to ODD, CD, and ASPD, a majority of cases are caused by a lack of consistency and stability in the lives of those who have it. Here's are some examples:

Abuse or neglect
Inconsistent discipline
Lack of supervision
Lack of parental involvement
Parents in a troubled marriage
Family financial problems
A high-tension parental divorce
Changing schools frequently
Moving a lot, especially in the case of foster children in which they frequently move by themselves, without a family.

If the parents have a history of ADHD or other conduct problems that are not under control, that can also cause enough instability to activate the disorder in their child/children. It's harder to control your own children when you cannot control yourself.

In many cases of ASPD, MRIs have recorded various brain abnormalities that could very likely be a causal factor in the disorder.

Because ODD can evolve into CD and likewise into ASPD, the earlier the disorder is caught, the better and the easier it will be to treat.

Theoretically, treatment is simple. In real-life...not so much.

As with most disorders, therapy is a good start to helping the client (1) find alternate ways to resolve anger, (2) build moral reasoning skills, and (3) develop impulse control. Specialized therapy forms focus on other aspects of the clients' life. For example: Family therapy helps improve interaction and meaningful communication among family members; Parent Management Training gives the parents new techniques and skills to change their child's behavior in a positive way.

Responsibility and accountability are two principles tying the three above-mentioned things together; you must help the person understand that "what you're doing is actually wrong. Regardless of how you rationalize what you did or who you would like to blame your actions on, there is no place known to mankind where what you have done is acceptable. Things like this are against the rules everywhere; You can't say that 'nobody told me it was bad.' Your actions are your own and you need to take responsibility for them."

That's really hard to do when your client either feels no guilt for what he/she has done or honestly believes that it wasn't actually his/her fault. In fact, most who have ASPD and have committed a serious crime usually end up in prison. While aware that they have done something bad in the eyes of society, they still feel no guilt for their crimes.

In the case of conduct disorders, there's no medicinal fix--there's no medicine that will teach someone to have a basic moral compass and harness anger. Therapy and consistent application of said therapy outside of a session has to happen.


Knowledge is power. In a majority of cases, these disorders are 100% preventable. Consistency works wonders. Even if a child may have ODD, the sooner someone notices and reports it to someone who can help, the sooner the child will be back on his/her feet to lead a life free of detention centers and prison bars.

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