If your child is defying authority, acting out, skipping school, bullying other kids, breaking the law, acting violent, using weapons or any number of symptoms such as this, s/he may be diagnosed with “Conduct disorder” CD. Here is a link to the American Academy of Child and Adolescent Psychiatry web site http://www.aacap.org/cs/root/facts_for_families/conduct_disorder giving easily understood information about this diagnosis.
You will notice however, if you read the article here and followed the link to Oppositional Defiance Disorder that the symptoms of the two diagnoses overlap almost completely. In my mind at least, there’s not enough difference in the two to be meaningful as far as treatment goes.
There is a percentage of these children who will, when they are over age 18, be accurately diagnosed as psychopaths or Anti-social personality disordered. Unfortunately there is no way to tell at 12, 13, or 15 for sure which of the adolescents with ODD or CD who will respond to treatment and which will not.
Not all medical insurance pays a significant portion, if any, of mental health treatments for adolescents with these problems, and it is sometimes difficult to impossible to find an appropriate treatment modality for these individuals. In addition to ODD or CD many of these adolescents also have ADHD or bi-polar disorder which may start rearing its head at this age. Finding a good clinician to evaluate the individual is sometimes also difficult. As the AACAP web site states, treatment will be lengthy and difficult as there may be little or no cooperation from the child.
There was a story in the news a while back about an American nurse who adopted a child from Russia and after some period of time, she put the child, alone, on a flight back to Russia with a note that said she couldn’t handle him and was sending him back. This event caused an international incident resulting in Russia stopping adoptions of children from that country by Americans.
Her hometown newspaper, said http://www.t-g.com/story/1625110.html
“a Shelbyville woman put a young Russian boy she had adopted on a one-way flight back to his homeland unaccompanied.Artyom Savelyev, who carried the adoptive name Justin Hansen, got off a flight from Washington on Thursday at a Moscow airport, the Kremlin children’s rights office said Friday. The boy was listed as 7 years old by some media outlets and 8 by others.
The office said he was carrying a letter from his adoptive parent, Torry Hansen of Shelbyville, saying she was returning him due to severe psychological problems.
“This child is mentally unstable. He is violent and has severe psychopathic issues,” the letter said, according to Russian officials, who sent what they said was a copy to The Associated Press. “
While the news reports and every article I read about this event criticized this woman for what she did, have some empathy for her. I don’t agree with how she handled this situations, but I do realize she was probably at her wit’s end in dealing with a child with probable CD or ODD at an early age.
Apparently many of the children available for adoption from Russia are ones from families with unstable emotional backgrounds and many of the children have been severely neglected or abused already, so it is not unusual for a child to have fetal alcohol syndrome to one degree or another or to come from a family with multiple mental problems. Add the neglect, abuse and poor DNA prospects, and the child may have little chance at that point to even bond with the very best of nurturing parents.
Even in the US the “adoption syndrome” has been noticed that a higher percentage of adopted children are problematic than in the general population. Back in the day when children were presumed to be born blank slates on which environment wrote all, the parents were blamed, or the child was assumed to blame the birth parents for abandoning them and this was accepted as why adopted children were more apt to be problems.
Now that medical science has finally accepted what every breeder of dogs or livestock has known for centuries, “attitude is genetic.” The average Beagle has one disposition and the average wolf has another disposition. True, you can take a wolf pup off its mother the day it is born and suckle it on the Beagle, but when it grows up, it will be a wolf, not a domestic dog. In most cases a “tame” wild animal is more dangerous than a wild one that at least fears man and tries to run away.
People have DNA that influences our behavior and attitudes just like animals do. Genes though are not destiny. Genes can be turned on or turned off by environment. My family has the gene for type II diabetes and I gained enough weight in middle age that I turned that gene on and my blood sugar went too high and my blood pressure started to rise. If I had not gained that weight I probably would never have had sugar problems or elevated blood pressure.
People who are born to parents who have the gene for alcoholism may or may not inherit that genetic tendency to become addicted to alcohol. I came from a family that had addictions to alcohol and nicotine and I apparently inherited the gene for addiction to nicotine and not alcohol as I can take alcohol or leave it, but I crave nicotine even though I long ago stopped smoking. Many psychological illnesses and problems are now known to be influenced by genes and by environment. Bi-polar, formerly called manic-depressive disorder, depression, schizophrenia, Conduct Disorder, Oppositional Defiance disorder, Anti-Social Personality Disorder, ADHD, and many many more.
If a child is abused or neglected, s/he I think is more inclined to develop any number of problems, but they can also develop these problems in what appears to be an ideal nurturing home with good parents who do their best to provide a good environment for their children in which their siblings grow up to be typical members of society.
Unfortunately, though, even many mental health professionals, schools and police, seem to tend to “blame” the parents 100% for the child’s conduct.
One lady I counseled had a 16 year old son who was frankly bi-polar and manic most of the time, and who was ODD, and threatening to burn the house down while she slept if she didn’t let him do what he wanted to, the psychiatrist told her, “Just make him take his medication.” How, pray tell, is she going to make this son who is bigger than she is swallow pills three times a day? She called the police, but they wouldn’t do anything until AFTER he committed a crime.
This poor woman was at her wit’s end, literally, in trying to find help for her son. Trying to save her son from himself. She wasn’t able to succeed in saving her son from himself, but with support, she came to accept that he is what he is and that she will never have a “typical” mother-son relationship with him. She still loves him, but sees him seldom and no longer spends her life worrying about him any more, but is moving on with her business and with her life.
Sometimes accepting what the situation is and realizing that you did the best you could to fix it will be the best outcome we can find, but other times we succeed in making the situation better. We just have to find the place when we know to keep working, or know that we must “let go, and let God.”
Joyce Alexander, RNP, retired