Disorders of conduct in young children: Developmental considerations, diagnoses, and other characteristics

doi:10.1016/j.dr.2007.01.001

Developmental Review

Volume 28, Issue 3, September 2008, Pages 316-341

https://doi.org/10.1016/j.dr.2007.01.001 Get rights and content

Abstract

Disorders of conduct are the most common reason for preschoolers to be referred for psychological services. If these problems are severe enough, these young children will be diagnosed with a DSM-IV-TR diagnosis or a diagnosis from another diagnostic systems, such as the DSM-PC or DC: 0-3. Whether or not these young children receive a diagnosis for the constellation of conduct problems that they exhibit, it is well documented that young children who exhibit such problems at such an early age are likely to continue exhibiting similar behaviors and to have several related difficulties throughout their lifetime. In an effort to alleviate such problems for young children, several treatment options have been developed and validated. Treatment outcomes suggest that young children with disorders of conduct can be treated and experience more positive outcomes. In an effort to inform mental health and other professionals working with young children with conduct problems, this manuscript outlines the potential diagnoses that these young children may receive and discusses related issues that may be of importance for such diagnoses.

Section snippets

Developmental considerations

As it often is assumed that temper tantrums, noncompliance, and aggression are expected during the toddler years (Keenan et al., 1998), conduct and disruptive behaviors in early childhood have not been viewed as clinically concerning problems in the research literature (Campbell, 1995). When one considers how rapidly cognitive development occurs during the toddler years, distinguishing clinically concerning from normative conduct and disruptive behaviors is even more difficult. Among all the

Diagnostic and statistical manual of mental disorders

When using the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition-Text Revision; DSM-IV-TR; APA, 2000), mental health professionals have three disorders of conduct that are usually first diagnosed in infancy, childhood, or adolescence from which to choose. These disorders are Oppositional Defiant Disorder, Conduct Disorder, and Disruptive Behavior Disorder Not Otherwise Specified. These disorders, along with the diagnosis of Attention-Deficit/Hyperactivity Disorder (AD/HD),

Stability of conduct problems

Regardless of the diagnostic label that may be applied, research suggests that behavior problems are relatively stable, particularly when such problems are in the extreme range. Further, such problems increase the risk that children will develop a diagnosable problem by the time they begin school. Having behavior problems as a young child is not a guarantee that such problems will continue, however. Some young children just experience age-appropriate, short-lived manifestations of stress (

Other diagnostic considerations

When diagnosing conduct problems and disruptive behaviors in young children, it is recommended that mental health professionals use a developmental approach. As part of such an approach, normative development should be used as the context for the assessment of young children’s behaviors and symptoms (Keenan & Wakschlag, 2002). This approach also considers the physical constraints in how symptoms may be manifested by young children (e.g., having access to certain weapons). Thus, although the

Correlates of conduct problems

When considering conduct problems, mental health professionals also should consider reports of young children’s early temperament and the manner in which parents and their young children interact as well as the level of impairment experienced by young children. In general, preschool children who exhibit symptoms of Disruptive Behavior Disorders exhibit more impairment in parent–child, preschool, and clinical contexts (Wakschlag & Keenan, 2001). Each of these factors may contribute to the later

Treatments

Given the stability of conduct problems and disruptive behaviors in children, it is likely that young children will experience difficulties into adolescence and adulthood. As a result, mental health professionals must gain an understanding of when and how to intervene with these children. Such an understanding is particularly important when one considers that conduct problems and disruptive behaviors can be relatively resistant to treatment when diagnosed in school age or adolescence (Kazdin,

Summary

Conduct problems and disruptive behaviors are cited as the most common reason for clinic referrals for preschoolers (Luby & Morgan, 1997). During their presentation to a clinic, mental health professionals may diagnose these young children with a DSM-IV-TR diagnosis of ODD or CD. For some young children who are not meeting the criteria of these disorders exactly, mental health professionals may view the difficult behaviors exhibited by these young children as normative for the developmental

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One study found that 41% of KA children experience emotional and behavioral problems (Kim, Guo, Koh, & Cain, 2010), but only 35% of American children experience emotional and behavioral problems (Webster-Stratton & Hammond, 1998). Without intervention, children with emotional and behavioral problems show increased risk for depression, family conflicts, conduct disorders, substance abuse, failure in school, suicide attempt in adolescence (Campbell, 2002; Hale, Van Der Valk, Engels, & Meeus, 2005; Renk, 2007; Saluja et al., 2004; SAMHSA, 2000; Webster-Stratton & Taylor, 2001), and convictions and crimes in adulthood (Albor, Benjet, Mendez, & Medina-Mora, 2017; Hein et al., 2017; Jaffee, 2017). These increased risks raise a concern because studies have found that KA adolescents experience depression at higher rates than American adolescents (39% and 24% respectively) (Choi et al., 2002; Kim & Cain, 2008), and more intergenerational conflict than Chinese or Japanese American adolescents (Yeh & Inose, 2002).
Faith and community based inquiry approaches are rarely used to develop research interventions. The purpose of this article is to present how a research team worked with six Korean American Christian churches to revise the prototype Korean Parent Training Program (KPTP), based upon the Bright Futures Parenting Program. The collaboration was sought to better integrate and align the KPTP with Korean culture and faith. The KPTP was developed to promote positive parenting practices and decrease mental health disparities of Korean American children.
Sixteen church participants completed a Delphi survey, a workshop series, Community Theaters, and focus groups.
The participants suggested adding Korean traditional parenting virtues, Christian parenting principles, and revising the standardized parent training and program philosophy.
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Cognitive and executive functions in colombian school children with conduct disorder: Sex differences
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CD is ostensibly more frequent among men than among women6–8 and tends to have a high comorbidity with learning disorders, substance use disorders and attention-deficit/ hyperactivity disorder [ADHD]1,9,7, being a comorbid condition with the latter that affects 50% of cases3. CD is associated, too, with poor relationships with peers and adults, academic failure, low emotional reactivity, medical complications during pregnancy and childbirth, difficult temperament in early childhood, low empathy, low tolerance for frustration, impulsivity, irritability, recklessness, sensation seeking, disinhibition, extraversion and low moral development1,6,9–12. Other features that have been associated with CD include parental psychopathology, parent's criminal history, child abuse, inadequate parenting practices, constant marital conflict and belonging to a large family7,9,13.
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: We used a case-control design. The cases were participants who met the diagnostic criteria for CD (n=39) and controls who did not meet these criteria (n=39), according to reports of a professional of the participants’ institution, and a structured interview for childhood psychiatric syndromes. The two groups were selected from educational institutions, and there were no differences in age, school grade, or socioeconomic level. The IQ was reviewed, as well as the presence of other mental disorders, serious physical illnesses, and more serious neurological signs. The cognitive and executive functions were evaluated using a child neuropsychological test battery.
We found that participants with CD had significantly lower scores in construction abilities, perceptual abilities (tactile, visual and auditory), differed in verbal memory, differed in visual memory, language (repetition, expression and understanding), meta-linguistic abilities, spatial abilities, visual and auditory attention, conceptual abilities, verbal and graphic fluency, and cognitive flexibility. The same differences were found between males, except in repetition, whereas girls showed fewer differences, thus the cognitive and executive performance was poorer in males with CD than in females, especially in verbal and linguistic-related functions.
Children with CD could show generalized cognitive and executive deficits. These deficits seem to be more frequent in boys than in girls with CD.
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Se utilizó un diseño de casos y controles, en el que los casos eran los participantes que cumplían los criterios diagnósticos de TD (n = 39) y los controles, aquellos que no cumplían estos criterios (n = 39), de acuerdo con el reporte de un profesional de la institución de los participantes y una entrevista estructurada de síndromes psiquiátricos infantiles. Los dos grupos fueron seleccionados de instituciones educativas y no diferían en edad, grado escolar y nivel socioeconómico. El CI fue controlado, así como la presencia de otros trastornos mentales, enfermedades físicas graves y signos neurológicos mayores. Las funciones cognitivas y ejecutivas fueron evaluadas a través de una batería neuropsicológica infantil.
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Disorders of conduct in young children: Developmental considerations, diagnoses, and other characteristics

Abstract

Section snippets

Developmental considerations

Diagnostic and statistical manual of mental disorders

Stability of conduct problems

Other diagnostic considerations

Correlates of conduct problems

Treatments

Summary

Journal of the American Academy of Child and Adolescent Psychiatry

Cognitive and Behavioral Practice

Journal of the American Academy of Child and Adolescent Psychiatry

Journal of the American Academy of Child and Adolescent Psychiatry

Journal of the American Academy of Child and Adolescent Psychiatry

Clinical Psychology Review

Journal of the American Academy of Child and Adolescent Psychiatry

Journal of the American Academy of Child and Adolescent Psychiatry

Cognitive and Behavioral Practice

Empirically based assessment of the behavioral/emotional problems of 2- and 3-year-old children

Journal of Abnormal Child Psychology

Psychometric evaluation of 5- and 7-year-old children’s self-reports of conduct problems

Journal of Abnormal Child Psychology

Child care practices anteceding three patterns of preschool behavior

Genetic Psychology Monographs

Trouble in the second year: three questions about family interaction

Child Development

Do measures of externalizing behaviour in normal populations predict later outcomes? Implications for targeted preventions to prevent conduct disorder

Journal of Child Psychology and Psychiatry

Outcomes of parent–child interaction therapy: a comparison of treatment completers and study dropouts one to three years later

Child and Family Behavior Therapy

Parent–child interaction therapy with a family at high risk for physical abuse

Child Maltreatment

Effective psychosocial treatments of conduct-disordered children and adolescents: 29 years, 82 studies, and 5,272 kids

Journal of Clinical Child Psychology

Parent–child interaction therapy: parents’ perceptions of untreated siblings

Child and Family Behavior Therapy

Parenting disruptive preschoolers: experiences of mothers and fathers

Journal of Abnormal Child Psychology

Parent-referred problem three-year-olds: developmental changes in symptoms

Journal of Child Psychology and Psychiatry

Behavior problems in preschool children: Clinical and developmental issues

Behavior problems in preschool children: a review of recent research

Journal of Child Psychology and Psychiatry

Behavior problems in preschool children: developmental and family issues

Developmental perspectives

Follow-up of hard-to-manage preschoolers: adjustment at age 9 and predictors of continuing symptoms

Journal of Child Psychology and Psychiatry

Noncompliant behavior, overactivity, and family stress as predictors of negative maternal control with preschool children

Development and Psychopathology

Hard-to-manage preschool boys: symptomatic behavior across contexts and time

Child Development

Boys’ externalizing problems at elementary school age: pathways from early behavior problems, maternal control, and family stress

Development and Psychopathology

Early externalizing behavior problems: toddlers and preschoolers at risk for later maladjustment

Development and Psychopathology

A comparison between African American and Caucasian children referred for treatment of disruptive behavior disorders

Child and Family Behavior Therapy

Parent–child interaction therapy: an effective treatment for young children with conduct problems

The Behavior Therapist

Aggression and antisocial behavior

Symptoms of behaviour disturbance and adjustment to school

Journal of Child Psychology and Psychiatry

The development of physical aggression from toddlerhood to pre-adolescence: a nation wide longitudinal study of Canadian children

Journal of Abnormal Child Psychology

Autonomy as competence in 2-year-olds: maternal correlates of child defiance, compliance and self-assertion

Developmental Psychology

The incidence, prevalence, and severity of behavior disorders among preschool-age children in day care

Journal of Abnormal Child Psychology

Aggression between peers in early childhood: individual continuity and developmental change

Child Development

Predictors of treatment outcome in parent training: mother insularity and socioeconomic disadvantage

Behavior Assessment

Parent–child interaction therapy with behavior problem children: relative effectiveness of two stages and overall treatment outcome

Journal of Clinical Child Psychology

Parent–child interaction therapy

New developments in psychosocial, pharmacological, and combined treatments of conduct disorders in aggressive children

Psychopharmacology Bulletin

Parent–child interaction therapy with behavior problem children: one and two year maintenance of treatment effects in the family

Child and Family Behavior Therapy