Conduct Disorder and ODD

Legal cases involving oppositional defiant disorderThe term “conduct disorder” in the psychology has both a descriptive and diagnostic value. At the descriptive level, this term is often used to denote the set of social destructive patterns of behavior, observed in children or adolescents. This behavior is regarded as unacceptable in most social contexts and includes disobedience, defiance, verbal and physical aggression, hyperactivity, impulsivity, deceitfulness, theft, vandalism and drugs abuse. At the diagnostic level, the term “conduct disorder” is used to refer to a specific psychiatric disorder, involving the presence of well-defined set of behavioral symptoms, diagnosis of which is possible when matching certain criteria (e.g., age and duration of symptoms). In DSM-IV conduct disorder is defined as «persistent pattern of behavior, in which the basic rights of others and major age-appropriate rules and regulations are broken». This pattern of behavior is usually observed in a variety of social situations.

Conduct Disorder as a Diagnostic Unit

There is strong empirical evidence about validity of conduct disorder as a diagnostic unit. Taxonomic study of the psychopathology of childhood and adolescence age help us distinguish two stable central syndromes, which are usually called as aggression and delinquency. Described in children aged 6 to 16 years, these syndromes are detected mostly in boys. Taxonomic findings have their parallels in the classification systems of childhood disorders. DSM-III-R describes the violent antisocial behavior in children and adolescents in a wide diagnostic class of disruptive behavior disorders, which includes hyperactivity attention deficit disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder (CD). Oppositional defiant disorder is characterized by stable disobedience, negativism, resentment, provoking and rejection the authorities. Conduct disorder is characterized by the repeated violations of general rights of other people and major social rules. Conduct disorder often includes important features of ODD, and ADHD, but it is a more serious disease than the ODD, since many of its symptoms may have serious law consequences.
Despite the existence of empirical evidence of its validity, it is still unclear whether CD is a single multifaceted disorder, manifestations of which may vary depending on the process of personal development, or there are two or more different disorders, presumably with different etiologies and different progress. Although the taxonomic and diagnostic studies are trying to identify specific syndromes in the conduct disorder (for example., DSM-IV makes a distinction between individual and group aggression and undifferentiated CD), the empirical evidence for such differentiation is not convincing enough. Results of recent research show that behavior problems of the majority of aggressive, antisocial children begin at a relatively early age. These problems manifest themselves differently in children and adolescents and often persist into adulthood, although the weakening of the symptoms may begin at any stage of individual development.

Measurements of behavioral disorder

Prevalence. Large-scale epidemiological studies conducted in several western countries, show that the prevalence of behavior problems in the general population reaches 8-12%. In 50% of cases, this is due to the presence of conduct disorder, the prevalence of which is about 5%. Although these figures are very high, they are based on researches, which take information from only one single source. These figures do not suggest that all children, having appropriate to diagnostic criteria for conduct disorder, show marked violations in the various social situations.

Gender differences. Conduct disorder is more pronounced in boys, the ratio is 3-4/1 for children and 2.5/1 for the adolescents. Reducing differences in adolescence is caused by a later age of onset of this disorder in girls. The disorder is found averagely in 12-13-year-old girls, and in 10-year-old boys. However, gender differences can be erased because recent data show sharp increase in the prevalence of behavioral disorders in the past decade in both genders.

Ethnic differences. There are no reliable communications in the prevalence of conduct disorders in childhood with ethnic or racial affiliation. However, American and British works show the prevalence of severe behavioral disorders in black male adolescents compared with whites, even after controlling for differences in these populations by socioeconomic status. But Dr. Bloomstine and other scientists have shown that ethnic differences in prevalence reflect differences in participation in delinquent and criminal behavior, rather than the frequency of illegal acts (in other words, the black teenage male become offenders in more percentage of cases than those in the white population). However, entering into conflict with the law, black men do not commit a greater number of offenses per year, compared with their white people. The same situation is with the level of recidivism. A larger number of black teenagers with conduct disorder were arrested at least once, but data on the frequency of repeated arrests for black and white offenders are comparable.

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