What is Conduct Disorder? From One Parent to Another
So, you’ve just Googled “What is Conduct Disorder” right? In which case, let me start by saying this: welcome to a club you never asked to join. It’s a tough situation, and I know you’re here searching for answers because you’re worried about your child and your family.
But let me tell you this: you’re not alone. There are countless parents out there navigating the challenges of living with a child with Conduct Disorder (CD).
What is Conduct Disorder: The Lived Experience vs. Textbooks
When learning about Conduct Disorder, most of the information you will find about it comes from mental health professionals, and rightly so. But here’s the thing: understanding Conduct Disorder from an intellectual level and living with it day-to-day are two entirely different things.
This reminds me of the movie Good Will Hunting. If you haven’t seen it, it’s about a young man who epitomises genius. He’s read countless books and knows just about everything about anything. In a very memorable scene, Robin Williams (who plays Sean, a professor of psychology and counsellor) states the following:
Sean: “You’re an orphan, right? You think I know the first thing about how hard your life has been, how you feel, who you are, because I read Oliver Twist? Does that encapsulate you?”
I am in no way minimising the importance of the knowledge of health professionals, I’m merely pointing out that no matter how much knowledge you gain on an intellectual level, it can only go so far in your depth of understanding.
The full scene illustrates this point much better, I’ve included it here if you want to enjoy Robin Williams’ brilliance (5 minutes):
I’m not a therapist or a doctor but I am the parent of a child with Conduct Disorder, just like you. I’ve actually walked in your shoes and can fully empathise with the rollercoaster of emotions you are probably feeling. That’s why I wanted to write this post. To share my lived experience knowledge about “What is Conduct Disorder?” from a parent’s perspective. Some personal insights, and maybe even a little hope. Because let’s face it, when you’re first hit with a diagnosis of Conduct Disorder, hope can feel like a distant dream.
So now let’s delve deeper into what Conduct Disorder looks like from a parent’s perspective.
What is Conduct Disorder – Through a Parent’s Eyes
Like many people I had never heard of Conduct Disorder until it touched our family, I’d learnt a lot about everything else my son had been misdiagnosed with, but this was something I had never imagined being possible.
When Googling certain behaviours, I actually remember coming across an article about it years before my son was finally correctly diagnosed. When I read it, I remember thinking “Wow my son is acting like that”. But despite all the checked boxes, in my mind, he was “acting” like he had Conduct Disorder – I was in complete denial that he actually had it.
As Kent Kiehl so aptly puts it when discussing psychopathy, “No parent wants to confront, much less accept, that fact.” – Kent Kiehl, The Psychopath Whisperer: The Science of Those Without Conscience.
In the years since, I have scoured the internet and consumed numerous books, podcasts and videos about everything related to Conduct Disorder. One of the best resources I have found is a video by Kati Morton, a licensed therapist who makes Mental Health videos.
It’s brilliant and well worth the 13 minutes if you want to learn more from the intellectual perspective about CD in a very easy-to-understand and straightforward manner. Below is a summary of key points and the video itself.
This is Conduct Disorder By Kati Morton: Summary of key points:
- DSM-5 Classification: CD belongs to the disruptive impulse control and conduct disorder category within the DSM-5 (a diagnostic manual for mental disorders).
- Symptoms: The hallmark of CD is violating the rights of others. This can manifest as aggression, physical cruelty to people or animals, destruction of property, stealing, or forcing someone into sexual activity.
- Diagnosis: A mental health professional diagnoses CD based on specific criteria. This includes how often these behaviours occur (at least 3 out of 15 listed criteria in the past year) and for how long (at least one in the past six months). Age of onset (before or after 10 years old) and presence of limited prosocial emotions (lack of remorse, empathy, etc.) are also considered.
- Prevalence: CD is statistically more common in boys, affecting 2-16% of children (though the true number is likely higher due to underdiagnosis).
- Causes: The exact causes of CD are unknown, but research suggests a combination of factors may be involved, including genetics, temperament, abusive upbringing, lower IQ, and brain structure differences.
- Treatment: While overcoming CD is challenging, there are treatment options. These include – CBT (Cognitive Behavioral Therapy): CBT helps identify and change unhelpful thinking patterns that might contribute to outbursts. Parent Training: Equipping parents with skills to manage negative behaviours and reward positive ones can be crucial for a child’s recovery. Some areas offer specialised parent management training programs. Anger Management Classes: Learning to recognise anger triggers and developing healthy ways to express anger can be very helpful for people with CD. School Support: Schools can play a role in providing a supportive environment and implementing strategies (like IEPs or 504 plans) to manage symptoms and promote success.
- Medication: No medication is specifically approved for CD, but some doctors may prescribe medications (SSRIs, SNRIs, or antipsychotics) off-label to manage co-occurring symptoms like depression or aggression. It’s important to consult with a medical doctor to determine if medication is right for you or your child.
Symptoms of Conduct Disorder: A Spectrum of Chaos
Just like all mental disorders, Conduct Disorder exists on a spectrum. It manifests differently in every child. Some may display explosive anger and aggression, while others might be more manipulative and deceitful. The severity can vary greatly, making it difficult to predict what each day will bring. This unpredictability can be incredibly stressful for parents, leaving them feeling constantly on edge.
This constant state of tension can be even more amplified when parents enter online support groups and see the vast array of challenges others face. It can be a double-edged sword – finding connection, but also feeling overwhelmed by the spectrum of difficulties. When I first found online support groups, it was disheartening to see many parents comparing their situations. Some parents might be facing physical aggression, while others deal with constant lying or manipulation. This might lead some parents to downplay their own experiences because they feel “lucky” they aren’t facing the same severity.
This is where it’s crucial to remember that all of the behaviours and their consequences, whether physical or emotional, have lasting negative effects. While the specifics might differ, the impact on a parent’s well-being is undeniable. Constant defiance, lying, or manipulation can be just as damaging as physical violence.
The key takeaway here is that every parent’s journey with CD is valid. The specific challenges might differ, but the underlying struggle of raising a child with Conduct Disorder is a shared experience. Support groups are so valuable, but navigating them requires sensitivity to the spectrum of challenges each family faces.
Causes Of Conduct Disorder
The internet can be a confusing place when searching for information on Conduct Disorder, particularly when it comes to “Causes of Conduct Disorder”. Much of the literature varies from expert to expert on this subject, which can be confusing, and misleading, and often leaves parents with more questions than answers.
On top of that, some resources can come across in a way that places blame solely on the parents. When you’re already emotionally fragile, and probably copping some finger-pointing from other places already, this can be devastating.
Here’s what I do know for sure: Conduct Disorder is a complex issue with a combination of potential contributing factors, including genetics and environment. There is no definitive answer to the question of “why did this happen?” So do yourself a favour and try to let that go.
It is what it is.
Our psychologist said this to us and I didn’t accept this statement at first and certainly wasn’t happy with its bluntness. But I do now. Whilst devasting, I can’t change it, I can only control what is within my control. It sux, but… it is what it is.
More importantly, regardless of how and why it happened, the very fact that you’re here, actively seeking information and support, speaks volumes about you as a person and your commitment to your child. You’re a good parent, and that’s what matters most. Read that again if you need to!
Diagnosis and Treatment of Conduct Disorder
When it comes to diagnosis & treatment, one thing I have read over and over is that early intervention and long-term support are critical in the management of Conduct Disorder. I completely agree with this, however, in reality, it’s easier said than done.
In our case, for example, my son was misdiagnosed for years, making early intervention impossible. Then, when he was finally diagnosed, he wouldn’t participate effectively in treatment and eventually began refusing it altogether (in Australia a minor who has the capacity to consent to treatment may also refuse it). In his mind, there was nothing wrong with him. Everything was our fault (well let’s be honest, mostly mine), and the world was to blame. This is just our story, but I’ve heard plenty that are similar.
Some Barriers to Diagnosing Conduct Disorder:
- CD shares some symptoms with other disorders like ADHD, Oppositional Defiant Disorder (ODD), and Autism. This overlap can make it difficult for clinicians to pinpoint the exact issue. Moreso, as the child is still developing, so their presentation is constantly evolving.
- Mental health professionals, especially in under-resourced areas, may not have extensive training or experience with CD. This can make it difficult to recognise the specific signs and symptoms.
- Many families don’t have access to qualified mental health professionals, especially those specialising in childhood behavioural disorders.
- There can be a stigma associated with mental health conditions, especially those like CD. This can lead to parents being hesitant to seek help or children presenting a facade of normalcy to avoid being labelled.
- Children with milder presentations may fly under the radar, especially if they function well in certain settings and have become adept at masking… A real-life Jekyll and Hyde scenario.
- Some parents report that professionals were hesitant to diagnose CD because it might restrict access to certain programs or services. This can be a significant barrier for families who need extra support.
- There’s a worry that an incorrect CD diagnosis can become a self-fulfilling prophecy. Some parents and clinicians fear the label itself might limit a child’s potential or create negative expectations.
Do any of these relate to your journey to getting a diagnosis? I would love to know in the comments!
Treatment of Conduct Disorder
There are several obstacles when it comes to treatment also:
- Children with CD often struggle with motivation and low frustration tolerance. Engaging in therapy and consistently practicing learned skills can be difficult.
- Effective treatment for CD often requires significant involvement from parents or caregivers. This can be challenging for families with complex dynamics, limited time, or a lack of support.
- Treatment for CD is a marathon, not a sprint. It can take time to see significant improvements, and maintaining consistent interventions over time can be a challenge. More so for these kids as they often struggle with long-term goals and planning.
- Qualified mental health professionals specialising in CD, especially in rural areas, can be scarce. This limits treatment options and can lead to delays in getting the right kind of help.
- Effective treatment can be expensive, including therapy sessions, medication (if prescribed), and potential schooling modifications. This can be a significant barrier for families with limited financial resources.
- Not all treatment approaches work for everyone. Finding the right “fit” between the therapist, treatment modality, and the specific needs of the child can be a process of trial and error. This can be costly both financially and in time and energy.
- Children with CD can be very manipulative. They may learn to tell therapists what they want to hear in order to get out of sessions or avoid consequences. This can make therapy progress difficult and frustrating.
- Many children with CD also don’t believe they have a problem. They may see their behaviour as normal or justified. This can make them resistant to treatment altogether.
- Despite their outward defiance, children with CD often struggle with low self-esteem. This can make them less receptive to feedback or motivated to change.
- Another hallmark feature of CD is impulsivity. This can make it difficult for them to follow through with treatment plans or resist engaging in problematic behaviours.
Finding Strength Through Challenges
I realise this all sounds pretty bleak, but I would be doing you a disservice if I sugarcoated the situation. I’m not intentionally trying to paint a picture of treatments not working because that’s not true. Multiple factors impact outcomes – age of onset, severity, and so on. In some cases, treatment does result in the child “aging out” of the condition, or at the very least, helps to minimise harm.
Dealing with and trying to effectively treat CD is probably one of the hardest things you will ever do. It’s a constant emotional rollercoaster, filled with worry, frustration, and moments where you feel like you’re at your breaking point… again and again and again.
That’s why self-care and support is SO IMPORTANT. You need to look after yourself to be able to continue doing what you can to help your child (and family as a whole) and give them the best chance possible. I often equated the situation for myself to being a phoenix – I would burn and die and have to start again over and over.
As mentioned, for some families things will work out, but the reality for others is that it won’t and they may progress into AntiSocial Personality Disorder, amongst other conditions and problems. Either way, this journey will be hard, and you need must look after yourself. Please be sure to look at other articles, resources and support options we have to help you with self-care.
I don’t want to end this section on such a bad note. So, remember, there is always a silver lining. To quote Good Will Hunting again:
Finding Hope and Support: You’re Not Alone
When my son was first diagnosed, I felt lost and helpless. There weren’t any local or formal online support groups available to turn to, just a few communities on Facebook. The Facebook groups had their limitations in terms of organisation of information, privacy, anonymity, and so on but they were still a lifeline for us. Primarily because they offered a space where other parents who were going through similar struggles “got it” and we didn’t feel so alone anymore.
Part of creating Conduct Disorder Support (CDS) was taking that sense of community and support to a whole new level. The platform aims to empower individuals with the knowledge and resources necessary to navigate CD’s complexities while fostering a sense of community and belonging. Essentially, I wanted it to be everything I needed but couldn’t find when my son was first diagnosed.
Take the Next Step
While the journey with Conduct Disorder is a challenging one, there is hope. There are resources available, and there is strength to be found in connection with others who understand. You are not alone.
At CDS, we recognise the unique challenges parents of children with Conduct Disorder face. As a platform created by a parent who’s walked that path too, we’ve curated a range of resources to offer you the support, guidance, and community you deserve.
Remember, even though you may be facing a difficult situation, you’re taking the most important step: seeking help and support. And that’s something to be proud of.
Click here to explore how we can help you navigate this journey.
