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The saddest and scariest behavior disorder a parent can face is also the one which carries the simplest name: conduct disorder.

Characterized primarily by the plain disregard for the rights and feelings of others, it is one of the few for which treatment options are, unfortunately, extremely limited and sometimes ineffective.

According to the Diagnostic and Statistical Manual, Fourth Edition (DSM-IV) of the American Psychiatric Association, symptoms of conduct disorder include bullying, lying, repeatedly breaking parental curfews beginning before age 13, truancy beginning before age 13, physical cruelty to people and animals, using a weapon, destruction of property, running away, stealing, breaking and entering, sexual assault, drug abuse, fire-setting and even homicide.

Conduct disorder is currently diagnosed in up to 6% of children and adolescents; more often in boys than girls before puberty. Researchers have come up with a variety of possible reasons for the development of this condition, but cannot point to any one of them as a sure cause.  Poor parenting has been identified as one of the most likely risk factors, however.

Often parents and teachers of children with attention-deficit hyperactivity disorder (ADHD / ADD) think the behavior may be leading to conduct disorder, but this is very rare. It is more common for children with oppositional defiant disorder (ODD) to later develop conduct disorder in adolescence, but again, this does not often happen.

Treating conduct disorder usually involves a multi-systemic treatment (MST) approach that includes a combination of parent training, family therapy, social skills training and/or group therapy in the various environments in which the child functions.

Sometimes medication is prescribed as well, to address co-existing issues such as impulsivity, hyperactivity, depression or anxiety, but it is important to realize that its usefulness is extremely limited. Medication does nothing for conduct disorder itself.

There are several types of psychotherapy that are not effective for treating conduct disorder, however. Included among these are psychodynamic and insight-oriented individual or group therapy.

Conduct disorder is difficult to treat and even more difficult to live with. These kids rarely graduate high school – in fact, many never make it past the 10th grade.

Repeated, persistent behavior problems in children should always raise red flags for teachers and parents. It is especially urgent, however, to obtain an evaluation for any child that displays the above-listed behaviors as soon as possible.

The earlier the condition is diagnosed, the better the chance that treatment will succeed in resolving the problem. It may take years, but long treatment is certainly better than long-term problems with family, friends, teachers, employers and the law

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