Diagnosis

In the American Psychiatric Association classification system for diagnosing mental disorder (DSM-IV), conduct disorder is defined as ''a repetitive and persistent pattern of conduct in which the basic rights of others or major age-appropriate societal norms or rules are violated'' (American Psychiatric Association, 1994). Conduct disorder has become one of the most valid and reliably diagnosed psychiatric disturbances. The problem behavior is transsituational—it is manifested in the home, at school, and in daily social functioning. Often, CD youth are suspicious of others and, consequently, they misinterpret the intentions and actions of others. By adolescence, aggression may become so severe that violent assault, rape, and homicide are committed. Precocious sexual behavior and sexual misbehavior, especially among females, are also common. Denial and minimization generally occur when the youngsters are confronted about their behavior. Typically, feelings of guilt are not experienced.

Other, less severe, types of behavior disorders are also known. The most common that resemble CD are

(1) adjustment disorder with disturbances of conduct;

(2) childhood (or adolescent) antisocial behavior; and

(3) oppositional defiant disorder.

Substantial differences in the behavioral manifestations of CD have prompted efforts to develop subtypes. The most well-known subtyping criteria are

(1) socialized versus unsocialized;

(2) aggressive versus nonaggressive; and

(3) overt versus covert.

Just one variant of CD, the solitary aggressive type, characterizes approximately 50 percent of incarcerated youth; they are usually socioeconomically disadvantaged and typically derive from dysfunctional families. Moral development is arrested, cognitive abilities are low, and behavior is often dangerous both to self and others. This CD variant should not be confused with adaptive delinquency, in which the behavior is an attempt to adjust to the manifold disadvantages of inner-city living.

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