Teens out of control

In August 2006, in the small town of Mabopane north of Pretoria, a scene of unspeakable horror unfolded behind locked doors when an 18-month-old toddler was severely burnt with boiling oil and water, and had chillies smeared over his body and pills forced into his mouth to stop him from screaming.

Perhaps as shocking as the crime itself was the ages of the perpetrators: two boys, aged 12 and 13. The boys claimed they’d been under the influence of dagga and thinners at the time the crime took place.

Two years later the boys, who’d been kept in a place of safety while awaiting trial, were referred to Weskoppies Hospital for psychiatric evaluation. An initial psychologist’s report suggested that they might both be suffering from conduct disorder.

An estimated 5% of children show some sort of serious conduct problems, from impulsiveness to aggression, which can manifest when a child is as young as 4 years old. Various reasons have been posited for this, from the straightforward genetic inheritance of a ‘difficult’ temperament to ineffective parenting and living in an environment in which violence is common. But most children outgrow antisocial behaviour.

Conduct disorder, which usually has its onset in late childhood or early adolescence, may be diagnosed when a child seriously and repeatedly misbehaves in a belligerent, destructive, threatening, physically cruel, deceitful or dishonest way. This may include stealing, intentional injury (especially to animals) and forced sexual activity.

Children with conduct disorder seem to have an inability to ‘read’ other people, and will often misunderstand the intentions of others, often believing that people are threatening them or putting them down, and they tend to react aggressively to these supposed threats.

They generally show a disregard for societal rules and the rights of others, and many appear to show little concern for the feelings of others and no guilt or remorse for their own actions. Their self-esteem is usually low, although they may project an image of toughness. They also tend to behave in a reckless manner, without regard for the safety of themselves or others.

Conduct disorder is more common in boys than girls. Boys with conduct disorder are more inclined to fight, steal and participate in acts of vandalism, such as fire setting. Girls with conduct disorder are more likely to lie, run away and be involved in severe sexual promiscuity. Both boys and girls with conduct disorder often struggle at school.

Kids with this disorder are at an extremely high risk of substance abuse. They also frequently will threaten suicide, and these threats should be taken seriously.

What causes conduct disorder?

Clinical psychologist Jenny Perkel explains, ‘An environment that’s unstable because of parental substance abuse, the absence of one or both parents, physical, emotional or sexual abuse, poverty and/or unemployed parents can make a teen more likely to become conduct disordered. A child who’s feeling neglected, lonely and unloved might start to steal, make fires and become aggressive with other kids.’

If you suspect your child may have conduct disorder, it’s vital that you get professional help for both him/her and yourself. It isn’t an easy disorder to diagnose as there is often an overlap in symptoms with other disorders (including oppositional defiance disorder and childhood bipolar disorder), and treatment may take a long time, but with the right care, it is possible to improve your child’s self-esteem and self-control.

While in some kids conduct disorder may develop into antisocial personality disorder or other mood/anxiety disorders, the good news is that many teens with conduct disorder stop exhibiting these behaviours in early adulthood.

Has your child been diagnosed with conduct disorder?

Read more about conduct disorder:
Conduct disorder resources
Kids at risk

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