Conduct
Disorder
Dr. Aubrey H. Fine
Overt
Aggression
How is Overt Conduct Disorder
Identified and Treated?
Conduct Disorder
• Characterized by persistent
antisocial behavior that violates:
– The rights of others
– Age-appropriate social norms
• Includes:
– Aggression to people and animals
– Destruction of property
– Deceitfulness and theft
– Violation of rules
Students with
Conduct Disorder
• Differ from peers in
– Rate of noxious behaviors
– Persistence of such conduct
beyond age at which most
children have adopted less
aggressive behaviors
How Do These Students Do
in School?
• Teachers see these students as:
– Uninterested
– Unenthusiastic
– Careless
• Students with Conduct Disorder have:
– Poor interpersonal relations
– Rejected by their peers
– Poor social skills
• Students with Conduct Disorder are most likely to
be:
– Left behind in grades
– Show lower achievement levels
– End school sooner than same-age peers
The Vile
Weed:
Stages
in the
Coercion
Model
Conduct Disorder Case Study
• Tony is 13 and has conduct disorder and depression. He is living
with his Uncle and Aunt who have basically raised him since birth.
Occasionally his mom comes by, but not on a regular basis. The
father is unknown. Tony’s Uncle and Aunt adopted him. They are
the head of a “team” which cares for Tony. This includes respite
foster parent’s two weekends a month, Tony’s other Uncle one
weekend a month, and his grandparents or his adopted parents
the other weekend. At the moment, Tony is doing well. After the
last sentencing, they were able to get better cooperation from their
probation officer and a more workable probation agreement. Tony
is supervised more than his adopted parent’s four year old. Last
year he was hospitalized after he cut his wrist when he was caught
drinking. Tony is now part of a group at school who are putting
together a house. For once he is doing really well, expect when he
tried to steal an electric saw. But Tony’s parents had warned the
school to watch for this, and they did, and they caught him. The
punishment? No electric guitar for four days. Every week or so
while Tony is at school, his parents go through all his stuff. They
have told Tony they will do this. Tony now thinks it is mean and
unfair. On the other hand, their have been no knives in the house
for a month now. His parents call it “room service”.
Conduct Disorder
• Is often comorbid with other
disorders
• Is one of the most prevalent
psychopathological disorders
• Affects:
– 6 – 16% of males
– 2 – 9% of females
– 1.3 to 3.8 million children have
conduct disorder
Conduct Disorder
• Males exhibit:
– Fighting
– Stealing
– Vandalism
• Overly aggressive
• Females exhibit:
– Lying
– Truancy
– Running away
– Substance abuse
– Prostitution
• Less aggressive
Conduct Disorder
• May be classified by age of
onset
• Earlier onset usually predicts
more serious impairment
The
Causal
Wheel
Classified As:
• Mild (resulting in only minor harm to
others)
• Moderate
• Severe (causing considerable harm to
others)
• Undersocialized (violent behavior)
• Socialized (more covert antisocial acts)
– Versatile (both overt and covert forms of
antisocial conduct)
Conduct Disorder
• Subtypes
–Overt Aggression
–Covert Antisocial
–Versatile
Causes of Aggression
• Learned through:
– Modeling
– Reinforcement
– Ineffective punishment
• Risk can be increased through these
factors:
– Personal
– Family
– School
– Peer
– Cultural
Preventing Aggression
• Consequences that deter
aggression
• Instruction in nonaggressive
responses
• Early intervention
• Restriction of tools of aggression
• Correction of living conditions
• More effective school options
Assessing Aggression
• Behavior rating scales, AND
• Direct observation
• Must include:
– Evaluation of a variety of domains
– Prosocial skills
– Social deficits
– Functional assessment of behavior
Interventions for
Aggression
• Interventions based on social learning
– Most reliable
– Include strategies such as:
•
•
•
•
•
•
•
Rules
Teacher praise
Positive reinforcement
Verbal feedback
Stimulus change
Contingency contracts
Modeling and reinforcement
Uses and Misuses of Punishment
• Punishment should:
– Be reserved for serious misbehavior
– Be instituted in ongoing behavioral
management and instructional programs
– Be used only by people who are warm and
loving toward the individual
– Be administered matter-of-factly, without
anger, threats, or moralizing
– Be fair, consistent, and immediate
– Be of reasonable intensity
– Involve response cost
– Be related to the misbehavior
– Be discontinued if it is not quickly apparent
that it is effective
– Have written guidelines for using specific
punishment procedures
Behavior Cycle and Precorrection
1) Calm: Behaving in ways that are expected and
appropriate
2) Trigger: First stage in moving towards a major
blowup
3) Agitation: Overall behavior in unfocused and off
task
4) Acceleration: Student engages the teacher in a
coercive struggle
5) Peak: Student’s behavior is out of control
6) De-escalation: Student is beginning to disengage
from the struggle and is in a confused state
7) Recovery: Eager for busy work and a semblance
of ordinary glasswork
The Acting Out
Cycle
School-Wide Discipline
• School-wide discipline plans must:
– Focus on earlier phases in the acting out
cycle
– Focus efforts on positive attention to
appropriate behavior
– Provide clear expectations and monitoring of
student behavior
– Provide staff communication and support
– Provide consistent consequences
Covert
Aggression
How is Covert Conduct Disorder
Identified and Treated?
Definition
• Covert Antisocial Behavior includes:
– Untrustworthiness and manipulation of others;
– Running away; and
– Concealment of one’s acts.
• “Masculine” Antisocial Behaviors
– Vandalism, fighting, and stealing.
• “Feminine” Antisocial Behaviors
– Lying, running away, and substance abuse.
• Behaviors Clustered Together for Males
and Females
– Truancy, expulsion, underachievement, and
discipline
Casual Factors
and Prevention
Assessment
• Covert behaviors are difficult to
observe
• Involves:
– Long periods of observation
– Self reports
Definitions of Animal
Abuse
• Social Science: Socially unacceptable
behavior intentionally causes
unnecessary pain, suffering, distress,
or death.
Law: Unnecessarily overloads,
overdrives, torments, deprives of
necessary sustenance or shelter, or
unnecessarily mutilates, or kills any
animal (misdemeanor); intentionally
Types of Animal Abuse
•Neglect - no satisfaction derived; due to
carelessness, callousness and
ignorance
• Abuse - satisfaction derived from dominance
or from behavioral response
•Sadistic- takes satisfaction from suffering
•Hoarding
•Sexual abuse: crush videos
•Subcultural abuse: socially acceptable
Animal Abuse and Adult Criminality
•MSPCA Study: 1975-1996
—80,000 complaints
—268 efforts to prosecute
—119 convictions
—91 fined
—28 served time (average of 4.5 months)
•Compared to “next door neighbors,” men prosecuted
for animal abuse were
• 5 X more likely to commit violent crimes
• 4 X more likely to commit property crime
• 3 X more likely to have record for drug or
disorderly conduct offense
Adult Criminality and Childhood
Animal Abuse
•Alan Felthous and Stephen Kellert Studies—Compared criminals to non-criminals and psychiatric
to “normal”
—Significant association between acts of cruelty to
animals in childhood and serious, recurrent aggression
against people as an adult; most aggressive criminals
committed more severe acts of animal cruelty
•Frank Ascione
—48% of individuals incarcerated for sexual homicide
abused animals as children
—46% of convicted rapists abused animals as children
Child Abuse and Animal
Abuse
•New Jersey Study - 53 families met criteria for
child abuse or neglect. 60% had confirmed
instances of cruelty to animals; in families referred
for physical abuse, 88% had instances of animal
abuse: 2/3 by fathers; 1/3 by children.
•1980 study in England: Of 23 families with
history of animal abuse, 83% had children at risk
for abuse or neglect.
•Pennsylvania study corroborated that behavior
patterns toward children and pets are similar.
Abused Children Abuse Animals
• In one study, 4.7% of “normal” children
acknowledged animal abuse, compared to
13% who were sexually abused
24.5% who were physically abused
34% who were both physically and sexually
abused
• Children who witness violence are at greater risk of
becoming abusers or victims
• 26% to 32% of children in abusive families cruel to
animals
Responses
• Primary Prevention
– Humane education
• Secondary Prevention
– Programs for at-risk children
• Tertiary Prevention
– The AniCare Model of Treatment for
Animal Abuse
– AniCare Child
Programs—Pairing At-Risk Children
and Families with Animals in Need
•“Forget Me Not Farm,” collaboration of Humane
Society of Sonoma County, the San Francisco Child
Abuse Council, and the YWCA of Sonoma County,
which includes the Women’s Emergency Shelter
and a therapeutic child care services program.
Teaching gentleness with gardens and animals
to children from violent homes and communities.
–
Safe Haven for Pets Programs
• Various arrangements, depending on local
community
• Local vets provide shelter and medical
care
• Fostering
•
AniCare
Child
Practical, concrete tools for assessment,
prevention, and intervention
• Designed for all professionals working with
children--counselors, teachers, social service
workers, probation department officials, clergy
• Focuses on empathy development and self
management skills
• Includes case studies, projective materials, and
individual and group exercises
The AniCare Model of Treatment
for Animal Abuse
• Stresses accountability and empathy
development
• Cognitive-behavioral
• Active therapist, directly addresses problem
• Pre- and Post-Treatment Questionnaires
• Ten AniCare Exercises, with homework
–
–
–
–
Becoming the Victim
Fostering Flexibility
Learning to Nurture
Establishing Intergenerational Accountability
Responding to Stealing
•
•
•
•
•
•
Define stealing
Parents decide when theft has occurred
Parents apply consequences
Every instance of stealing receives consequences
Parents “keep eyes open” and ask questions
Consequences involve specified interval of work or
period of restriction
• No positive reinforcement for periods of nonstealing
• Program remains in effect for at least 6 months
Responding to Lying
• Careful monitoring of verbal and written
products
• Providing reinforcement for honest
behavior
• Punishing occurrences of lying
• Determining if child can differentiate truth
from non-truth
• Avoiding getting caught up in arguments
about the veracity of statements
Firesetting
• Children may be more likely to set
fires if:
– They do not understand the danger of fire
– They do not have the necessary social skills
to obtain gratification in other ways
– They engage in other antisocial behaviors
– They are motivated by anger and revenge
Vandalism
• Appears to be a reaction to aversive
environments:
– Vague rules
– Punitive discipline
– Rigid punishment
– School curriculum not matched with student
needs
– Little recognition for appropriate behavior or
achievement
Responding to Truancy
• Social Learning Principles
– Attendance is praised
– Systems where attendance earns
rewards
– School work that is interesting
– Connecting school and home
– Stopping harassment by peers
– Decreasing fun outside of school during
school hours
Problem
Behaviors of
Adolescence
How are problem behaviors
identified and treated in
adolescence?
Juvenile
Delinquency
• Delinquent acts
• Index crimes
• Status offenses
Types of Delinquents
• Those who commit a few delinquent
acts vs. repeat offenders
• Age at first offense
– Prognosis is worse for juveniles who
offend before the age of 12
Causes of
Delinquency
•
•
•
•
•
•
•
History of child abuse
Hyperactivity and impulsivity
Low intelligence and achievement
Lax parental supervision
Family history of criminality
Poverty and large family size
Antisocial behavior or conduct disorder
Causes of Delinquency
Responding to
Delinquency
• Families
– Intervention is extremely difficult
• Juvenile Courts and Correction
– Harsher punishments seem
counterproductive
• Schooling
– Typical punishment is usually ineffective
Street Gangs
• The typical gang member has:
– A notable set of personal
deficiencies
– A notable tendency toward defiance
– A greater-than-normal desire for
status, identity, and companionship
– A boring, uninvolved lifestyle
Substance Abuse
• Usually episodic for most adolescents
• Alcohol and tobacco are the largest problems
• Important Terms
– Intoxication
• Symptoms of a toxic amount of substance in the blood stream
– Tolerance
• Physiological adoption to a substance so that an increasing amount
is required to produce the same effects
– Addiction
• Compulsive use of a substance and that obtaining and using the
substance has become a central concern and pattern of behavior
– Dependence
• The need to continue using a substance to avoid physical or
emotional discomfort or both
– Withdrawal
• Physical or emotional discomfort associated with a period of
abstinence
Preventing
Substance Abuse
• Must be designed for the individual
case
• School based interventions must:
– Require clear school policies
– Require systematic efforts to provide
information
– Provide referral to other agencies
– Involve families and peers
Preventing Substance Abuse
– con’t
• Skills for students to learn:
– Resist peer pressure
– Change attitudes, values, and behavioral
norms related to substance use
– Recognize and resist adult influences toward
substance use
– Use problem-solving strategies such as selfcontrol, stress management, and appropriate
assertiveness
– Set goals and improve self-esteem
– Communicate more effectively
Seven Possible Symptoms of
Drug Involvement
1) Change in school or work attendance or
performance
2) Alteration of personal appearance
3) Mood swings or attitude changes
4) Withdrawal from responsibilities / family
contacts
5) Association with drug-using peers
6) Unusual patterns of behavior
7) Defensive attitude concerning drugs
Early Sexual Activity
• Increases:
– Risk of pregnancy
– Sexually transmitted diseases
– Psychological and health problems
• Current school based
interventions may be ineffective