First, it is important to state that diagnosing childhood psychological disturbance is fraught with difficulties as, once the child enters adolescence, behavioural problems are very far from uncommon, especially irritability, mood fluctuations, boundary testing/defiance and breaking social rules.
However, the DSM (Diagnostic Statistical Manual) does list six conditions related to childhood conduct problems. It should be noted, however, that about two thirds of children displaying antisocial behaviours such as those I am about to list, do NOT go on to develop anti-social personality disorder (APD) – sometimes referred to as psychopathy – as adults.
The conditions listed in the DSM relating to child conduct problems, together with their symptoms, are as follows :
1) CONDUCT DISORDER (CD) :
– persistent violation and disregard for other people’s rights
– a developing pattern of aggressive behaviour (towards people and/or animals)
– persistent lying and deceitfulness
– serious violations of rules at home and/or at school
– destruction of property
2) OPPOSITIONAL DEFIANT DISORDER (ODD) :
– frequent resistance against authority figures
– frequent arguments/confrontations with adults
– recurring temper tantrums
– a general pattern of defiance and disobedience
– enduring and significant anger and resentment
(if, of course, there are blatantly good reasons for defiance of authority/anger/resentment etc these should not be viewed as abnormal reactions)
3) DISRUPTIVE BEHAVIOUR DISORDER NOT OTHERWISE SPECIFIED (DBD-NOS) :
– ongoing signs of above two conditions but not so severe that they meet the criteria for these diagnoses
4) ADJUSTMENT DISORDER WITH MIXED DISTURBANCE OF EMOTIONS AND CONDUCT :
– shows a variety of anti-social and emotional symptoms that become apparent within three months of a stressor but these do not meet the diagnostic criteria to be categorized above.
5) ADJUSTMENT DISORDER WITH DISTURBANCE OF CONDUCT :
– similar to above but with anti-social behaviour symptoms only
6) CHILD OR ADOLESCENT ANTI-SOCIAL BEHAVIOUR :
– this category is for those who have displayed a significant, but isolated, anti-social behaviour but this is not indicative of a psychiatric condition.
It has already been stated that just because a young person falls into one of the above categories, this in no way implies that they will go on to develop APD in adulthood. However, there are certain symptoms which have been highlighted as risk factors that a young person might go on to develop APD later in life :
RISK FACTORS FOR DEVELOPING APD IN ADULTHOOD :
– hyperactivity and impulsivity
– particularly early onset of conduct disorder
– committing a large variety of different types of anti-social behaviour
– displaying anti-social behaviour in a variety of different contexts/environments (eg not just at home)
– high degree of irresponsibility
– prone to become very easily bored
– frequent deceitfulness
The more of the above behaviours the young person displays, and the more severe they are, the higher the probability that the child or adolescent is at risk of going on to develop APD in adulthood.
NEUROLOGICAL DEFICIT THEORY :
It has been theorized that both conduct disorder in young people and APD in adults is underpinned by the same neurological deficit – it is thought this deficit is linked to problems constraining behaviour in those that have it.
EARLY RELATIONSHIP DISRUPTION THEORY :
The view has also been put forward that those who do not bond securely to their mothers in the first year of life are at greater risk of developing APD as adults. Indeed, those at risk of APD frequently have significant problems relating to others in general when growing up. At the extreme end of the APD scale, it has been observed that child killers have frequently experienced problems relating to others.
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David Hosier BSc Hons; MSc; PGDE(FAHE).