Discussion #3: Identify and discuss the two types of conduct disorder that are commonly identified by therapists. Assess the similarities
Learning Goal: I’m working on a law question and need a sample draft to help me learn.
Answer Discussion question 250 words. Respond to 3 classmates 250 words each.
Discussion #3: Identify and discuss the two types of conduct disorder that are commonly identified by therapists. Assess the similarities and differences between the two. Discuss the prevalence of these disorders amongst the general population and treatment options. Identify and discuss the link to criminal behavior.
Objectives:
CO1: Summarize the link between mental illness and criminal behavior.
CO2: Debate how mental health issues influence behavior.
CO3: Synthesize the mental health diagnosis of conduct disorder.
Classmate 1 Angela: Two types of conduct disorders that immediately come to mind after this week’s reading are antisocial personality disorder and substance use disorder. Antisocial personality disorder is marked by aggressive behavior, rule-breaking, lack of concern for other people’s feelings, substance use or abuse, and according to the Mayo Clinic, tend to antagonize and manipulate those around them. Persons with antisocial personality disorder also tend to have little or no remorse for their actions. They lie easily and usually are quite effective, giving them an advantage when it comes to criminal behavior, as they feel no remorse about lying. The NCBI states that antisocial personality disorder has a 1-4% prevalence within the general population.
The second type of conduct disorder is one that is frequently seen in conjunction with antisocial personality disorder, and that is substance use disorder. Substance use, specifically alcohol use disorder affects 5.3% of the general population and is marked by a compulsion or need to continue drinking. Similarly, substance use disorder occurs in 14.8% of adults aged 18-25, and 6.4% of adults over the age of 25 (American Addiction Centers, 2021).
Similarities between the two disorders include a lack of remorse, the lack of concern for the consequences of their actions, and a continued pattern of law break despite law enforcement intervention. The differences between the two is that substance use disorder tends to have a higher treatment response than antisocial personality disorder.
Treatment options for antisocial personality disorder include cognitive behavioral therapy and medications for mood or antipsychotics. Treatments for substance use disorders include a variety of therapies and from medications such as Antabuse to prevent people from drinking.
The link between these disorders and criminal activity with substance use is the desire to continue using various illicit substances which are inherently illegal, and people may resort to further criminal behavior in an effort to continue to obtain the substances. With antisocial personality disorder, criminal behavior is due to the lack of remorse, the aggressive or violent behavior, and lack of inhibition. These tendencies lead to criminal behaviors such as destruction of property, assault, and other more serious crimes. Because these people find no difficulty or reluctance to lie to the police about these crimes, they often do not find punishment as much of a deterrent. With serious crimes such as serial killers, once they “get away with murder” they seem to have less and less fear of being caught.
American Addiction Center. (2021). Addiction statistics | Drug & substance abuse statistics. American Addiction Centers. https://americanaddictioncenters.org/rehab-guide/addiction-statistics
Mayo Clinic. (2019). Antisocial personality disorder – Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/antisocial-personality-disorder/symptoms-causes/syc-20353928
National Institute on Alcohol Abuse and Alcoholism. (2021). Alcohol facts and statistics. National Institute on Alcohol Abuse and Alcoholism (NIAAA)
National Institute on Alcohol Abuse and Alcoholism (NIAAA). https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics
Sher, K., & Trull, T. (1994). Personality and disinhibitory psychopathology: Alcoholism and antisocial personality disorder. https://www-proquest-com.ezproxy2.apus.edu/docview/614324011/fulltextPDF/2FECEE49D55F41BEPQ/1?accountid=8289
Werner, K. (2015). Epidemiology, comorbidity, and behavioral genetics of antisocial personality disorder and psychopathy. PubMed Central (PMC).https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4649950/
Classmate 2 Mark: Last week we wrote about Anti-social personality disorder, which is only diagnosable in young adults at least eighteen years of age. However, a similar disorder, known as conduct disorder, can be seen in childhood through adolescence. Since most children and teenagers have behavior problems at some point in their lives, it’s important to understand that not all kids who act up have a disorder. Conduct disorder is charactered as a long-term behavioral problem, which can be both disruptive and violent. This behavior can vary in severity but can be classified under four different categories. The categories of behavior are aggressive, destructive, deceitful, and rule breaking. People that suffer from conduct disorder often have accompanying illnesses such as ADHD and depression (Frick 1991).
Like many mental illnesses, the cause of conduct disorder is not known. However, there are many factors that experts believe increase the risk of a child developing conduct disorder. Perhaps the most common factor is the role that genetics play. Studies have shown that many children who have conduct disorder also have close family members who suffer from mental illnesses. Environmental factors can also play a role, since children tend to mimic behaviors that they see while growing up. For example, if a child’s father has anger issues, and often loses his temper, a child may think this is acceptable behavior. Parenting can have a huge impact on a child’s mental well-being and is linked to several mental illnesses which affect kids. Child neglect/abuse, absent parents, and harsh or inconsistent discipline can all negatively affect a child’s development. In a small portion of cases, children with conduct disorder were found to have injuries or birth defects to the brain (Roisman 2010).
Conduct disorder can be broken down into two subtypes. The subtype which a person falls under depends on when they started showing symptoms. If a child begins to show symptoms before the age of 10, they fall under the “child-onset type”. If they show symptoms after age 10, they fall under the “adolescent-onset type”. Both types have similar symptoms, but the adolescent-onset is said to be less severe. Many children who develop the child-onset type typically have more family problems, and experience more related conditions such as depression or anxiety. Children suffering from the adolescent-onset type have been shown to have better success with therapy (Raine 2011).
Roughly 8% of the children in the US suffer from varying levels of conduct disorder. Although difficult to treat, the best option is cognitive behavioral therapy. This therapy can help a child communicate better, and deal with anger in a healthy way. In more extreme cases, a child may be prescribed medication to help treat depression and anxiety, so that therapy is more effective. Family therapy can also be a great tool when the disruptive behavior is affecting more than just the child. Plus, this can give parents the proper education and tools to help deal with the illness inside the home (Murrihy 2010). Many parents who live with out-of-control kids often call the police because they do not know what to do. At work, I have personally responded to hundreds of calls over the years where parents were completely lost about how to handle their child’s behavior. A lot of them do not have health insurance and are very poor. They have very little resources and are often times single parent households. These kids will skip school, join gangs, commit crimes, and physically assault their parent. I can’t tell you how many times I have seen a 6ft tall teenager assault his 5ft tall 100-pound mother, because she tried to implement new rules in an effort to reign in their child. The juvenile justice system here in California is supposed to focus more on helping troubled youth who suffer from mental illnesses, rather than punish them. I think sometimes the system is quick to label a child with a mental illness, even though they simply may just need to be disciplined. I also think the opposite is true. I think some juvenile halls are quick to discipline children, rather than screen them for mental illnesses.
References:
Frick P. J.; Kamphaus R. W.; Lahey B. B.; Christ M. A.; Hart E. L.; Tannenbaum T. E. (1991). “the vast majority of these have ADHD. Academic underachievement and the disruptive behavior disorders”. Journal of Consulting and Clinical Psychology.
Raine A (2011). “An amygdale structural abnormality common to two subtypes of conduct disorder: A neurodevelopmental conundrum”. American Journal of Psychiatry. 168 (6): 569–571.
Roisman G. I.; Monahan K. C.; Campbell S. B.; Steinberg L.; Cauffman E.; Early Child Care Research Network (2010). “Is adolescence-onset antisocial behavior developmentally normative?”. Development and Psychopathology. 22 (2): 295–311.
Murrihy, R., Kidman, A., & Ollendick, T (2010). Clinical Handbook of Assessing and Treating Conduct Problems in Youth. Springer: New York.
Classmate 3 Allen: Behavioral disorders among children are a frequent pattern of conduct that is disruptive, inappropriate, and deviant from societal standards and norms. They disorders may include inattention, hyperactivity, impulsivity, defiant behavior, elicit drug use, and criminal activity. The three most common types of behavioral disorders include Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), and Conduct Disorder. (Behavioral Disorders, 2017)
One in six children alone in the United States have a documented mental, behavioral, or developmental disorder. (Cree et al, 2018) It was determined that approximately 7.4% (4.5 million) children between the ages of 3-17 years have been diagnosed with a behavior problem. (Ghandour et al, 2017)
Johns Hopkins University (n.d.) provides an overview of conduct disorder and what a patient or parent may expect to see or to look for when considering if their child has conduct disorder. Acts that may present in children who have conduct disorder may include but are not limited to a lack of responsibility, truancy, tardiness, theft, and committing violent acts against animals or people.
The main two types of conduct disorder that are commonly identified by therapists are early-onset or adolescence onset. The two are similar in that the behaviors and actions of the child or adolescent may present the exact same. But it is how the disorder is manifested and at what age that makes the difference. It has been argued that early onset is caused by an issue with neuro development in children where the adolescent onset emerges from the social surroundings and influences of other people. Despite this theory, Passamonti et al (2010) conducted testing of seventy-five male adolescents and young men from ages 16-21. There was an almost even split among early onset and adolescent onset. This test resulted in both types were associated with antisocial behavior and both were concluded to have neurophysiological abnormalities. Lastly, there was hypofunction in the amygdala found with early onset which could explain why the early onset is more severe and persistent.
Before looking into the treatment options for Conduct Disorder, it is important to share the diagnostic criteria in order to understand why these treatment options are utilized for their patients. Conduct disorder is ”A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of three (or more) of the following criteria in the past 12 months, with at least one criterion present in the past six months”
Some of the criterion listed includes aggression towards people and animals, bullying others, initiating physical altercations at school, using weapons, has deliberately destroyed property, has broken into private places to steal property, and is extremely defiant to include running away and staying away for days at a time. (Searight, Rottnek, and Abby, 2001)
Most behavior disorders are treated in the same manner. A combination of family therapy and behavior modification over a long period of time can yield exceptional results. In some cases, prescription medicine may aid the family and child.
In my professional experience in dealing with children who seem to exhibit some of the symptoms listed of conduct disorder, it is extremely hard on the parents and family, especially working-class single parents whom I have met. In one case, a single mother of four children live in an apartment complex where I work. We have responded because the second youngest child has caused issues to the point where the family is scared of being evicted from the complex. This young woman has broken into the leasing office, other apartments, and unlocked vehicles in order to steal. She causes fights with her mother to where the ambulance had been requested due to significant injuries to both mom and daughter. Mom does not have the resources, or the finances to send her daughter away for special programs. The young girl has been transported to mental health facilities but has no plan for long term treatment and care. What makes treatment most difficult is that mom can not convince nor force her daughter to make treatment visits as she has other children who do not cause issues and need care of their own. Her daughter will simply run away. My best recommendation for mom was to try and get the school involved and to make as much time as she has available to make and attend the treatment visits. Also to see if there is better ways for mom to communicate with her daughter that may keep the anger and physical violence to a minimum.
Thanks for reading.
References
Behavioral Disorders. (2017). Found in MentalHealth.gov. Retrieved from
Cree, R. A., Bitsko, R. H., Robinson, L. R., Holbrook, J. R., Danielson, M. L., Smith, C., … & Peacock,
G. (2018). Health care, family, and community factors associated with mental, behavioral, and developmental disorders and poverty among children aged 2–8 years—United States, 2016. Morbidity and Mortality Weekly Report, 67(50), 1377.
Ghandour, R. M., Sherman, L. J., Vladutiu, C. J., Ali, M. M., Lynch, S. E., Bitsko, R. H., & Blumberg, S.
J. (2019). Prevalence and treatment of depression, anxiety, and conduct problems in US children. The Journal of pediatrics, 206, 256-267.
Johns Hopkins University (n.d). Conduct Disorder. Retrieved from
Passamonti, L., Fairchild, G., Goodyer, I. M., Hurford, G., Hagan, C. C., Rowe, J. B., & Calder, A. J.
(2010). Neural abnormalities in early-onset and adolescence-onset conduct disorder. Archives of general psychiatry, 67(7), 729-738.
Searight, H. R., Rottnek, F., & Abby, S. (2001). Conduct disorder: Diagnosis and treatment in primary
care. American Family Physician, 63(8), 1579.
Answer preview for Discussion #3: Identify and discuss the two types of conduct disorder that are commonly identified by therapists. Assess the similarities
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