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Conduct Disorder | Dr. William Winter is a child and adolescent psychiatrist.
Will Winter, MD, FAAP
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Conduct Disorder describes an inability to function at home, school or in other places due to one's behavior.  It differs from Oppositional Defiant Disorder (ODD) in two ways.  Firstly, the disruptive symptoms are not meant to target authority figures only.  Secondly, it differs from ODD in the degree of violation done.  Whereas in ODD, one may hurt another with words, in conduct disorder, the acts of violation go beyond words.  This can include hurting/ beating up other kids, stealing, destruction of property, or what is considered "serious violation of rules" i.e. running away and truancy.

Why does this happen?
In order for these behaviors to happen 3 things need to be present.

Firstly, there must be anger. Anger fuels most of the 15 possible symptoms of conduct disorder listed in the DSM IV.

Secondly, there must be a lack of effective verbal communication. In general, when it comes to behavior, first comes talk. Then comes action. When a young person "acts out" he is communicating- loud and clear- with his actions.

Thirdly, there must be a lack of fear- that is, lack of fear of consequences.

It is extremely important to mention here that increasing severity of consequences does not increase their effectiveness. In fact, severe/ punitive consequences will increase anger in the young person with this disorder and further damage the relationship between parent and child. Also, it goes without saying that consequences should never be physical in nature.

Instead, consequences should be a part of a greater behavioral plan. Making a behavioral plan requires full participation of the young person and his parent(s). It also requires consistency and frequent follow up to make sure the plan is working. Often things do come up and the plan must be adjusted to fit the new realities on the ground. Consistent follow-up is also very important to work on improving verbal communication.

Designing an effective plan is an art and a science- and, although simple in theory, is not easy in reality. To do this and to maintain consistency in follow-up, it is strongly recommended that you find a specialist in this area. This is an area in which we can help.

Is Conduct Disorder also a diagnosis of childhood?
Yes.  Once one is considered an adult, i.e. over the age of 18, he no longer meets criteria for this diagnosis.

What happens to these kids after age 18?  What is the prognosis? 
If left untreated, most may not get better.  Many will ultimately meet criteria for antisocial personality disorder.  This type of person does not care about hurting others, regardless of how, so long as he gets what he wants.  Many of these young people may end up in jail in the future (or not so distant future).

Final thought- There is hope.
We must do talk therapy with the adolescent and with the family. It is crucial to do this work as the stakes are so high and there is so much to lose. Medication can be useful as an adjunct only.