Children learn to shape their behaviors in accordance with the social environment and norms they are in from an early age. They learn how their own attitudes will affect others through social messages. Children who cannot regulate themselves according to the needs and emotions of others encounter problematic situations in later years. They have difficulty following rules, empathizing with others, cannot understand the other party’s emotions or make incorrect references. They get angry easily, can start fights, conflict with rules (authority), blame others or lie. They may exhibit behaviors that endanger their own safety and the safety of their environment (such as their circle of friends). This condition, called conduct disorder , is an important predictor of the picture seen as antisocial behavior disorder in the future.
For example, a child playing with his friends in primary school may feel angry when he “thinks” that he is being made fun of while others are joking around, and he may reflect this anger with an aggressive attitude or he may say something that will upset his friends or do something hurtful. While some may regret this behavior, others may not. These and similar examples may be examples of situations observed in conduct disorder. However, this picture may not be observed in the same way in every child.
What is Conduct Disorder?
Behavioral disorders observed in childhood can be observed as repetitive behaviors such as defiance, opposition, rebellion, hostility, as well as repetitive behavior patterns towards violating social norms and rules and/or the rights of others. Aggression towards humans or animals manifests itself with an angry reaction.
Frequency of Behavioral Disorder
According to scientific research , the prevalence in society is between 2.6% and 15%. However, in clinical practice, this rate is seen to be over 20%. The prevalence is higher in boys than in girls. The age of onset is 4-8, and there are cases where this condition is accompanied by diagnoses such as Attention Deficit Hyperactivity Disorder or Anxiety Disorder , Depression .
Behavioral Disorders are addressed under two separate headings: Oppositional Defiant Disorder and Conduct Disorder .
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Symptoms of Oppositional Defiant Disorder
The child gets angry easily, clashes with authority, complains about the rules set by authority, tends to deliberately irritate people, blames others for his own behavior, is often touchy, easily offended and easily angered by those around him, and shows himself in behaviors such as holding grudges and taking revenge. This situation leads to deterioration in both family and school life.
Symptoms of Conduct Disorder
Often, aggression towards people or animals manifests itself with an angry reaction: Bullying, intimidation, threats, starting a physical fight, using objects that can cause serious injuries ( such as sticks, glass bottles, broken objects, knives, pocket knives ), physically cruelty to people and animals, stealing, and destructive behaviors such as forcing someone to engage in sexual activity can be observed.
In addition to people and animals, behaviors that harm objects/properties are also observed: deliberately setting fires, damaging property, deliberately destroying someone’s belongings, etc. Lying, committing fraud/forgery, escaping school , engaging in illegal behaviors incompatible with age, substance use , and not feeling remorse after negative behaviors can be observed. This situation seriously disrupts social, academic, and out-of-school functionality. Observing such behaviors before the age of 13 is a serious risk factor, and is seen as an important predictor of Antisocial Personality Disorder in adulthood.
Causes of Conduct Disorder
In addition to research findings that it starts with temperamental differences (babies with difficult temperaments, difficult to soothe) from early childhood , continues with impulsive behaviors and/or difficulties in learning, and is caused by inadequate parental control (frequent changes in caregivers, neglect, abuse, etc.), genetic transmission (tendency to psychopathology) , parental attitudes (strict physical punishment, inconsistent understanding of discipline, etc.) and the triggering effect of psychological problems observed in the parent (depression, substance use, etc.) are mentioned. The tendency to associate with children involved in crime or criminal groups is observed as another environmental factor and also as a result of the reasons mentioned above.
Not feeling remorse after the behavior is another important symptom observed in Conduct Disorder . The tendency to think one is right and to put the blame on someone else is very common in such cases. Inability to empathize with the environment , disregarding the feelings and thoughts of others, reading social cues in a hostile manner or not being able to read them, lack of problem solving and social skills are frequently seen. In some cases, it is characterized by low performance in cognitive capacity/intelligence.
Treatment of Conduct Disorder
Psychotherapy and/or medical treatment are among the interventions applied in conduct disorder . During the psychotherapy process, cooperation is established with both parents and the school for behavioral change . Psychoeducation is provided to parents and other adults caring for the child, focusing on how to handle the behavior problem and inappropriate adult attitudes .
During the psychotherapy process , the child is observed, positive behavior is reinforced, and clear boundaries are created for unacceptable behaviors. The aim is for the child to recognize and express his/her own emotions, especially “anger,” and to establish a connection with the events and thoughts that trigger the feeling of anger. Social skills training is focused on problem-solving skills and establishing healthy relationships .
In addition to the psychotherapy process, in many cases, it is seen that medical treatment is also beneficial in order to increase the child’s functionality; psychotherapy and medical treatment are continued simultaneously.
