Introduction to Genetic Disorders:
Genetic disorders can have a major impact on a person’s development and health because they are frequently hereditary problems. Conduct disorder is a mental health condition where kids or teens have serious aggressive and antisocial behaviors. They break the rules, don’t feel guilty, and show no concern for others. They act out at home, school, and in other situations. It involves behaviors that violate the rights of others and go against societal norms.
These behaviors include aggression, cruelty, property damage, lying, and stealing. It’s important to recognize the severity of these behaviors beyond typical mischief. Callous and unemotional traits may also be present, leading to additional challenges for individuals and their families.
They can be physically aggressive, use drugs or alcohol, threaten or bully others, steal, run away, and do other things that are not normal for their age. Children can inherit genetic disorders from their parents, which can have an early negative impact on their health. While some genetic disorders are uncommon, others are more prevalent in particular groups of people. Conduct disorder can be caused by various factors like psychology, neurodevelopment, environment, and how parents interact with the child. These factors together create circumstances that lead to conduct disorder.
Comorbidity:
Oppositional defiant disorder (ODD) is another externalizing disorder in the DSM-IV-TR. There is some debate about its relationship to conduct disorder. ODD is diagnosed when a child doesn’t meet the criteria for conduct disorder but displays behaviors like losing temper, arguing with adults, refusing to comply, and being spiteful or vindictive. ODD often co-occurs with ADHD, learning disorders, and communication disorders. Unlike ADHD, ODD is not believed to stem from attentional deficits or impulsiveness. Boys are slightly more likely to have ODD, but prevalence rates are similar for boys and girls.
Clinical Description, Prevalence, and Prognosis of Conduct Disorder and Genetic Disorders
Conduct disorder is often defined by a child’s behavior’s impact on people and their surroundings. Schools, parents, peers, and the justice system determine unacceptable behaviors. Many children with conduct disorder also have substance abuse and internalizing disorders. Research shows a strong association between substance use and delinquent acts, with conduct disorder and substance use often occurring together and worsening each other, particularly for boys.
Children with conduct disorder often experience anxiety and depression, with estimates ranging from 15 to 45 percent. Conduct disorder typically precedes depression and most anxiety disorders, except for specific and social phobias. Girls with conduct disorder may be at a higher risk for developing comorbid disorders. The prevalence of conduct disorder is around 9.5 percent, with rates varying for boys and girls. Serious lawbreaking peaks around age 17 and decreases in young adulthood.
A researcher, Moffitt Proposal:
A researcher, Moffitt proposed that there are two distinct patterns of conduct problems. Some individuals exhibit a life-course-persistent pattern, starting early and continuing into adulthood. Others show an adolescence-limited pattern, where antisocial behavior is mainly during adolescence. The maturity gap between physical maturation and adult responsibilities may contribute to the adolescence-limited pattern.
The life-course-persistent pattern is more common among boys than girls. This distinction is supported by cumulative evidence from a study in Dunedin, New Zealand, involving over 1,000 participants assessed from age 3 to 32.
Moffitt and Caspi about Conduct Disorder
Moffitt and Caspi found that kids with the life-course-persistent type of conduct problems often have other issues like struggling in school, having neuropsychological deficits, and even ADHD. It seems like these kids also tend to have more severe neuropsychological deficits and family psychopathology. These findings have been seen in different cultures.
Kids with ongoing conduct problems have more serious issues throughout their lives, like mental health problems, physical health issues, lower socioeconomic status, and violent behavior. Even those with temporary behavior problems still struggle with substance use, impulsivity, and overall mental health. It’s worth noting that conduct problems can continue beyond adolescence.
By age 32, women with adolescent-onset conduct problems no longer had violent behavior, but both men and women still faced challenges with substance use, money, and physical health. The outlook for children with conduct disorder varies, but those with persistent problems are more likely to have ongoing difficulties.
Causes and symptoms of Conduct Disorders:
Doctors believe that conduct disorder can have various causes, including genetic, environmental, and biological factors. These factors may include exposure to substances during pregnancy, a hostile or unstructured home environment, ineffective discipline, exposure to negative parental habits, experiencing poverty, and atypical brain development.
Symptoms: To be diagnosed with conduct disorder, individuals must meet certain criteria. It must include exhibiting at least three out of 15 possible symptoms. These symptoms may include lying, stealing, fighting, vandalizing, skipping school, using drugs, and engaging in promiscuous sexual behavior, among others. Academic difficulties may also be present.
Etiology of conduct disorder:
Multiple factors contribute to the development of conduct disorder, including genetics, neurobiology, psychology, and social factors. These factors interact in a complex way, with heritable temperamental characteristics. It is interacting with neurobiological difficulties and various environmental factors such as parenting, school performance, and peer influences.
Genetic Disorders factor:
The evidence regarding genetic disorder’s influences on conduct disorder is mixed. Some studies suggest a modest genetic influence, while others indicate a substantial genetic influence. Family-environment influences also play a significant role. Adoption studies show that both genetic and environmental factors contribute to criminal and antisocial behavior.
Interestingly, the genetic disorders and environmental contributions to conduct disorder do not differ between boys and girls. A meta-analysis suggests that around 40 to 50 percent of antisocial behavior is heritable.
Differentiating between types of conduct disorder problems can provide insight into the heritability of conduct disorder. Twin studies suggest that aggressive behavior is heritable, while other delinquent behavior may not be. The age at which antisocial and aggressive behaviors start also relates to heritability, with childhood-onset behaviors being more heritable than those that begin in adolescence.
Genetic Disorders and Environment:
In a fascinating study, researchers looked at the interaction between genetics and environment in predicting adult antisocial behavior. They focused on the MAOA gene, which affects the activity of an enzyme that metabolizes neurotransmitters. The study found that being maltreated as a child, combined with low MAOA activity, increased the likelihood of developing conduct disorder. The findings highlight the importance of both genes and environment in shaping behavior. Other studies support these findings, showing that genetics play a role in the link between maltreatment and antisocial behavior.
Neurological factors of Genetic Disorders and the Auto-nervous system:
Children with conduct disorder often exhibit neuropsychological deficits, such as poor verbal skills, difficulties with executive functioning, and memory problems. Those who develop conduct disorder at an earlier age tend to have lower IQ scores compared to their peers, even when socioeconomic status and school performance are taken into account.
On the other hand, adolescents with conduct disorder have lower levels of resting skin conductance and heart rate, indicating lower arousal levels. This suggests that they may not fear punishment as much as other adolescents, making them more likely to engage in antisocial behavior without the fear of getting caught.
Psychological factors of genetic disorders:
Children with conduct disorder often lack moral awareness and remorse for their actions. Behavioral theories suggest that modeling and operant conditioning play a role in developing and maintaining conduct problems. Factors such as exposure to aggression, inconsistent discipline, and lack of parental monitoring contribute to these issues.
Parents who use harsh and inconsistent discipline, as well as those who fail to monitor their children, are often associated with conduct problems. According to Kenneth Dodge’s social information processing theory, aggressive children have a cognitive bias that leads them to interpret ambiguous acts as hostile, resulting in aggressive behavior.
When aggressive children are consistently met with aggression from their peers, it can create a cycle of hostility. Deficits in social information processing also predict antisocial behavior in adolescents. Recent research shows that a low heart rate predicts antisocial behavior in males, while a high heart rate is linked to social information processing deficits in both males and females.
Peer Influence of Genetic Disorder:
Research on peer influences in aggressive and antisocial behavior in children has focused on two main areas: peer acceptance/rejection and affiliation with deviant peers. Being rejected by peers is causally linked to aggressive behavior, especially when combined with ADHD. Associating with deviant peers also increases the likelihood of delinquent behavior. Recent studies suggest that both social selection (choosing like-minded peers) and social influence (being around deviant peers) contribute to antisocial behavior in children with conduct disorder, influenced by genetic factors. The environment, like the neighborhood and family, can affect whether kids hang out with bad influences, which can make conduct disorder worse.
Sociocultural factors of Genetic Disorder:
Living in poverty and urban areas is linked to higher delinquency rates due to factors like unemployment, inadequate education, disrupted family life, and acceptance of delinquency in the subculture. When a child exhibits early antisocial behavior and comes from a socioeconomically disadvantaged family, it predicts early criminal arrests.
This study looked at African American and white youths in Pittsburgh and found that the higher levels of delinquency among African Americans were linked to living in poorer neighborhoods, not their race. Factors like hyperactivity and lack of parental supervision were also important, but once those were controlled, the neighborhood had a significant impact on delinquent behavior, while ethnicity did not.
Treatment of Genetic Disorders and Conduct Disorders
Family intervention: Treating conduct disorder is most effective when it addresses multiple systems in a child’s life, such as family, peers, school, and neighborhood. Family interventions, like the Family Checkup (FCU) and Parent Management Training (PMT), have shown promising results.
The FCU involves three meetings to assess and provide feedback to parents, while PMT teaches parents to modify their responses and reward prosocial behavior. These interventions have been associated with reduced disruptive behavior even years later.
Parent Management Training (PMT) is a super effective treatment for kids with conduct disorder and oppositional defiant disorder. It changes how parents and kids interact, which helps reduce bad behavior. It even has positive effects on siblings and moms. It’s been adapted for Latino families too. PMT works well in the long run, and it’s even used in community programs like Head Start to promote good parenting.
Multisystemic Treatment (MST) is a promising therapy for serious juvenile offenders. It provides intensive and comprehensive services in the community, targeting the adolescent, family, school, and peer group. MST therapists use a variety of strategies, focusing on strengths, addressing social factors, and using present-focused interventions. Treatment takes place in real-life settings to ensure lasting improvement. MST has been proven effective in multiple studies.
Conclusion
Compared to traditional individual therapy, adolescents who received Multisystemic Treatment (MST) had fewer behavior problems, and fewer arrests, and their families showed more support and less conflict. Even those who dropped out of MST had fewer arrests than those who completed traditional therapy.
Conduct disorder is a behavioral issue that often occurs in teenagers. It involves persistent patterns of aggressive, defiant, and rule-breaking behaviors. The exact causes of conduct disorder are not fully understood, but several factors contribute to its development. These factors include genetic predisposition, family dysfunction, harsh parenting, exposure to violence or abuse, peer influence, and socio-economic factors.
When it comes to treatment, a few approaches have shown promise. One of them is Parent Management Training (PMT). This therapy focuses on improving parent-child interactions, teaching parents effective discipline techniques, and promoting positive behavior. PMT is effective in reducing conduct disorder symptoms and improving family functioning.
Another treatment approach is Multisystemic Treatment (MST). MST takes a comprehensive approach by addressing various systems that influence a teenager’s behavior, such as family, school, and community. It aims to provide therapy services in real-life settings and involves the active participation of the adolescent, family, and other key individuals. MST has shown positive outcomes in reducing delinquent behaviors and improving family functioning.
