By Blaise Dupont, Year 12
Conduct Disorder, or CD, is a behavioural disorder characterised by consistent patterns of negative behaviours in childhood and early adolescence. This disorder is often strongly associated with Antisocial Personality Disorder (ASPD) as it tends to appear as a preceding disorder in childhood, and thus a foreshadowing of antisocial habits in adolescence. CD is, in its technicality, the precursor disorder to ASPD. The behaviours linked to CD are reckless and impulsive rule-breaking, anger outbursts, disproportionately destructive responses, theft and deceiving of others, and troubles with relationships. Children with this disorder can be incredibly violent and cruel, especially when triggered.
Specific symptoms of this disorder include: malicious and machiavellistic attitudes, abusing and sadistic behaviours (including bullying), destructiveness and impulsivity, delinquency and deviance, and substance abuse. These symptoms are also notable in ASPD, which is why both disorders are strongly correlated and associated. The behaviours highlighted are typically due to maladaptive alterations of certain brain structures. These alterations include reduced volume of grey matter in the:
- Orbitofrontal cortex: This region of the brain is crucial in decision making and control of one’s impulses.
- Bilateral temporal lobes: These regions are key in sensory processing and memory encoding, along with processing of emotions and hormones.
- Amygdala: This almond-shaped region of the brain is particularly important in regulating autonomic and endocrine functions, it is known for triggering fight or flight responses and enforcing adaptations to environmental changes including decision making. It is essential in emotional processes.
- Hippocampus: This organ fulfils its role in memory processing whilst allowing the balancing of emotions, including stress, and optimising learning.
It is due to the grey matter deficiency in those areas that an individual with CD may have great difficulties with learning, decision making, self-regulation and processing of overwhelming emotions. These difficulties can arise from neurological factors, but also environmental. If a child’s needs are not met appropriately, and/or the child suffers any form of abuse, they are much less likely to develop proper mechanisms to cope with their feelings. In the long-term, the child may develop strong sadomasochistic tendencies and demonstrate sociopathy or psychopathy in adolescence. They may rely on substance abuse, crime and even self-injury to calm their extreme requirements for relief. A child with CD will require extended external support in order to relieve their overwhelmed states.
This disorder is also commonly seen in children with variant neurodivergence, particularly Attention Deficit Hyperactivity Disorder, or ADHD. This is due to the similarities in brain structures during the early stages of childhood. Neurodivergent individuals tend to ‘grow out’ of CD as they learn to understand themselves and cope.
There are other risks factors that can increase the risk of a child developing CD that include:
- Neurodivergence
- Schizophrenia
- Substance abuse, by the child of carrier of the child during pregnancy
- Foetal Alcohol Syndrome, when a child is exposed to alcohol through pregnancy
- Child abuse, verbal, physical, sexual, neglect, etc
- Sexual abuse in any form, molestation and bullying
Individuals with this disorder typically grow up and learn to manage their symptoms, hopefully with external support. However, this is not always the case and many individuals having dealt with conduct disorder find themselves dealing with graver dysfunctionalities in adolescence and adulthood. As mentioned previously, this disorder is strongly associated with ASPD, and other cluster B personality disorders, but it also comorbid with mood disorders and anxiety disorders. The risk factors that impact this disorder tend to halt the development of a child’s self-regulation and their relationship with the world around them. The disorder can be destructive to a child’s development in allowing them to forge their identity into something healthy and coherent. It is incredibly difficult to stabilise an individual who experiences great bounds of emotional reactivity, and lacks the neurological capacity to properly process it. It is why unhealthy coping mechanisms, such as self-harm and/or drugs, can appear so appealing because they offer an easy and incredibly efficient solution for a short amount of time. It works wonders to calm one’s impulses, but scars the brain in a way that it will never properly heal from, despite its plasticity.
Individuals with this disorder may also be isolated from others due to their destructive behaviours. This forges a deep-rooted sentiment of isolation and loneliness for most children who grow up to view themselves as unlovable and dangerous. This disorder, and its social implications, can cause great damage to one’s sense of self and self-esteem. It is important to understand these behaviours and demonstrate patience but also assertiveness. Children with aggressive tendencies may only be reflecting the behaviours that their caregivers display, or may mirror bad habits that they themselves have witnessed. In understanding individuals with antisocial tendencies, it is absolutely essential to highlight the roots of their behaviours that often stem from childhood. This is what allows individuals experiencing daily struggles in adulthood with antisocial behaviours to grasp the foundations of their behaviours and find alternative ways to deal with them. Understanding the early stages of more severe disorders can allow one to work through their behaviours before they turn into an illness that is increasingly difficult to cope with, and allow them to feel supported and, in fact, loved.
