b) Read the text. Which of the questions you wrote were answered in it?
Child and adolescent clinical psychology: Conduct Disorder
(1) The major problems child and adolescent clinical psychology deals with are as follows: 1. problems of infancy and early childhood (sleep disorders, toileting problems, learning and communication difficulties, autism and persuasive developmental disorders) 2. problems of middle childhood (conduct problems, attention and overactivity problems, fear and anxiety problems, repetition problems, somatic problems); 3. problems in adolescence (drug abuse, mood problems, anorexia and bulimia nervosa, schizophrenia). It also handles child abuse (physical abuse and neglect, sexual abuse), adjustment to major life transitions (foster care, separation and divorce, grief and bereavement).
(2) Conduct disorder is one of the most difficult and intractable mental health problems in children and adolescents. It involves a number of problematic behaviors, including oppositional and defiant behaviors and antisocial activities (eg, lying, stealing, running away, physical violence, sexually coercive behaviors).
(3) The etiology of conduct disorder involves an interaction of genetic/constitutional, familial and social factors. Children who have conduct disorder may inherit decreased baseline autonomic nervous system activity, requiring greater stimulation to achieve optimal arousal. This hereditary factor may account for the high level of sensation-seeking activity associated with conduct disorder.
Parental substance abuse, psychiatric illness, marital conflict, and child abuse and neglect all increase the risk of conduct disorder. Exposure to the antisocial behavior of a caregiver is a particularly important risk factor. Another common feature appears to be inconsistent parental availability and discipline. As a result, children with conduct disorder do not experience a consistent relationship between their behavior and its consequences.
(4) Four types of symptoms of conduct disorder are recognized:
(1) Aggression or serious threats of harm to people or animals;
(2) Deliberate property damage or destruction (e.g., fire setting, vandalism);
(3) Repeated violation of household or school rules, laws, or both; and
(4) Persistent lying to avoid consequences or to obtain tangible goods or privileges.1
(5) Conduct disorder usually appears in early or middle childhood as oppositional defiant behavior. Nearly one half of children with early oppositional defiant behavior have an affective disorder, conduct disorder, or both by adolescence. Thus, careful diagnosis to exclude irritability due to another unrecognized internalizing disorder is important in childhood cases. Evaluation of parent-child interactions and teacher-child interactions is also critical. Even in a stable home environment, a small number of preschool-aged children display significant irritability and aggression that results in disruption severe enough to be classified as conduct disorder.
(6) Conduct disorder has two subtypes: childhood onset and adolescent onset. Childhood conduct disorder, left untreated, has a poorer prognosis. Behaviors that are typical of childhood conduct disorder include aggression, property destruction (deliberately breaking things, setting fires) and poor peer relationships. In about 40 percent of cases, childhood onset conduct disorder develops into adult antisocial personality disorder. Adolescent conduct disorder should be considered in social context. Adolescents exhibiting conduct disorder behavior as a part of gang culture or to meet basic survival needs (e.g., stealing food) are often less psychologically disturbed than those with early childhood histories of behavior disorders. Additionally, new-onset conduct disorder behavior, such as skipping school, shoplifting or running away, in the context of a family stressor, often remits if appropriate structure and support are provided.
(7) Conduct disorder is highly resistant to treatment. It follows a clear developmental path with indicators that can be present as early as the preschool period. Treatment is more successful when initiated early and must include medical, mental health, and educational components as well as family support. Close communication between home and school is particularly important at younger ages.