Short Communication - Journal of Psychology and Cognition (2020) Volume 5, Issue 2
Significance association of conduct disorder in child & adolescent and parental discord.
Clinical Psychologist, Institute of Psychiatry, Psychology & Neuroscience (IOPPN), Kings College, London, United Kingdom
- *Corresponding Author:
- Amna Tariq
Institute of Psychiatry, Psychology & Neuroscience (IOPPN)
Kings College, London, United Kingdom
E-mail: [email protected]
Accepted date: June 20, 2020
This present study focuses on the association of conduct disorder in children and adolescents in Parental discord. It focuses whether a disruptive Parental environment - involving marital conflict, divorce and separation, for example – influences the prevalence of conduct disorder in this group. The sample size was 412 children, aged between 10 and 17, who had diagnoses of either conduct disorder or (control) Internalization. Of the 412 children in the sample, 29 did not have adequate ratings of parental discord to be included in the study, leaving 383 children with a rated value so there were 239 cases of conduct disorder and 173 cases of (control) internalization disorder. Internalization group include anxiety and depression. Hypothesis is that there is a significant association of conduct disorder in children and adolescents and parental discord. The result shows that there was presence of conduct disorder in parental discord is 24.8% as compare to internalization group is 13.8% in this shows that the higher prevalence of Parental discord in the conduct disorder group is significant.
Psychology, Child psychiatry, Mental health
This study focuses on the association of conduct disorder in children and adolescents and Parental discord. Childhood antisocial behavior is associated with Parental conflict and divorce [1,2] and parental separation . There is a consistent link between parental divorce and conduct disorder. This observation supports the hypothesis that there is an association between conduct disorder in children & adolescent and Parental discord. It emphasizes on the association of conduct disorder in children & adolescent and Parental discord. Children and adolescent with conduct disorder is compared with the internalization (control) group to know the significant association of conduct disorder in children & adolescent and Parental discord.
Definition of conduct disorder
Conduct Disorder (CD) is a behavioral and emotional disorder of childhood and adolescence. Children with conduct disorder act inappropriately, infringe on the rights of others, and violate the behavioral expectations of others (DSM4).
Prevalence of conduct disorder
9-17 years old children and adolescent affects from conduct disorder (U.S. Department of health and human resources, 1999) and under the age of 18, 6-16 percent of boys and 2-9 percent of girls have prevalence of conduct disorder.
Risk factors for conduct disorder
Genetics factors of conduct disorder: There is genetic risk of conduct disorder in children whose parents have antisocial personality disorder and there is high link between the externalizing behavior, i.e., conduct disorder and hereditary .
Anti-social personality associated with genetic factor: Antisocial behavior can be defined in terms of psychiatric diagnoses (Oppositional Defiant Disorder [ODD], Conduct Disorder [CD], Disruptive Behavior Disorder [DBD]; Diagnostic and Statistical Manual of Mental Disorders, 4th ed. [DSM-IV]; Antisocial personality is associated with genetic factor as in the influence of marital conflict, within each generation child anti-social behavior leads to adults anti-social behavior .
Family neglect: Family neglect is one of the risk factor which leads children and adolescent to conduct disorder; as previous studies suggested that; Familial factors related to the development of conduct disorder . Importance of family focuses by the review that family plays important role on children, as Parental conflict and physical violence within the family leads children to conduct disorder.
Parental discord/separation: Parental discord/separation or family disruption in which research suggests that child disturbance is associated with family discord/marital conflict and child healthy development is associated with stable familiar environment. Externalizing behaviors i.e., conduct disorder includes anger, aggression, hostility towards caregivers and siblings are associated with the single parenthood.
Parental conflict and conduct disorder: The association of parental conflict/disruption with conduct disorder as studies has shown that intense parental relationship leads children strongly towards conduct disorder and unresolved conflict are strongly influenced on children emotional responses.
Conduct disorder and internalization in children & adolescents
Internalization group (Anxiety and depression)
Definition of anxiety: Anxiety disorders are group of mental disturbances characterized by anxiety as central or core symptom (DSM 4).
Definition of depression: Depression is defined as a depressed mood is often reported as feeling depressed, sad, helpless, and hopeless (DSM4).
The literature highlightens on that conduct disorder is more as compare to internalization i.e., anxiety and depression of children & adolescent in Parental discord.
Conduct disorder is more in Parental discord as compare to internalizing group as children as; familial discord/marital conflict did not mediate internalization problem in children & adolescent.
This study examined how the impact of Parental discord is mediated in children and adolescent which leads towards conduct disorder. It draws upon data from the Maudsley Item sheet data base at Michael Rutter Centre, Institute of Psychiatry, King’s College London. The sample size was 412 children, aged between 10 and 17, who had diagnoses of either conduct disorder or (control) Internalization. There were 239 cases of conduct disorder and 173 cases of (control) internalization disorder-this last group including children with anxiety and depression. Of this sample, 29 cases did not have adequate ratings of Parental discord, leaving a total of 383 children who had both a diagnosis and Parental discord rating.
The inferences are to be drawn from the statistical associations between conduct disorder and Parental discord.
Data is computerized and provide record of referral data and on base of multi-axial diagnostic formulation, i.e., coding F91 and F32, the data base was searched for subjects of F91 conduct disorder and F32 depression + F40 anxiety=internalization, anxiety and depression group was re coded to make one group as internalization. Systematic comparison was taken between two groups conduct disorder and internalization (control) group.
Maudsley item sheet data base, information is recorded on the bases of score recoded as 0 not present and score 1 Definite. Previous researchers reported about item sheet data base that it is reliable, internally consistent and validity of item scores can be checked .
Item sheet in the Maudsley community is the principle of multi-axial classification, using ICD 10 multiaxial system.
Definition of Maudsley item sheet data base
After the initial psychiatric assessment of every patient attending the Maudsley Hospital child psychiatry department, a summary sheet containing data on the patient's psychiatric symptoms (0, not present; 1, minimal or dubious; 2, definitely present), psychological, medical and socio-demographic characteristics and family circumstances was systematically completed by medical staff, and these data have been computerized since 1968. Data are available for 52 psychiatric symptoms (12 emotional and 6 somatic; 12 speech, language and motor functioning; 12 conduct symptoms; 7 disturbed relationships; and 3 other). The reliability, internal consistency and validity of item scale scores have been reported elsewhere.
A great importance is given to Maudsley item sheet for collecting and analyzing data in a scientific way. Clinical data is based on the Maudsley Hospitals.
Data from Psychiatrist assessments on the register and which provides demographic characteristics, symptomatology, treatment, diagnoses and outcome. There is acceptable reliability on the clinical ratings within the register . In Research item sheet is helpful, useful and proven to be great value in research for both direct source of analyzing data and collecting data . Maudsley item sheet has gain importance as data source more than clinical data collection System.
Data is registered on the item sheet on the principle and bases of Multi-axial classifications. The requirement is filled by trained staff in the form of coded psychiatric diagnoses for axis 1. List of psychiatrist syndrome have been coded in the ICD 10 classification in which senior member of Maudsley Hospital participate for simplifying, retaining the categories according to the research. On trained staff is trained in the way to recognize the psychiatric disorder such as conduct disorder. ICD 10 manual has great value in assisting to non-medical staff to recognize and assess diagnostic codes according to ICD 10.
Data collection procedures
To estimate the likelihood i.e., association of conduct disorder and adolescent in parental discord in which Participants or data that is collected is 412 sample, in which children and adolescent divided into group, conduct disorder and internalization(control group) was collected from the Maudsley item sheet. One group was conduct disorder which includes 239 cases and other group is internalization includes 173 cases. Data was anonymous and data size is 412 which were distributed into gender and age. 238 males and 145 females, aged 10-17 from the Michael Rutter centre Institute of Psychiatry, Kings College London. Data of conduct disorder and internalization in children & adolescent was registered in 1992 to onwards.
The Maudsley Item Sheet includes one variable rating discord between the parents. In the rating of parental discord in the Maudsley Item Sheet, the ratings measured whether there was no discord, the presence of some discord, or the definite presence of discord in the last 6 months. For the purposes of analysis, the last two categories were collapsed and added together to create an ‘any discord’ category. This variable was then used in analysis with the following methods. Comparisons between conduct disorder and internalization group and gender of both groups were performed using the χ2 test. Comparisons of age were done with the Student's t-test.
Results and Discussion
There were 412 children between the ages of 10-17 in the sample. Of these, 29 did not have adequate ratings of parental discord to be included in the study, leaving 383 children with a rated value. Overall, 38.6% of this sample showed some discord in the family, as shown in Table 1.
Table 1. Parental discord.
Table 2 gives the percentage of the group with two types of diagnosis, either conduct disorder or an internalization disorder.
Table 2. Incidence of disorder.
Figure 1 shows that of the 61% of cases where there was no parental discord present, 32% showed conduct disorder and 29% showed internalization. In the 39% of cases where there was parental discord, of these 25% showed conduct disorder and the 14% showed internalization. This difference was tested using chi-square.
We have compared results of Conduct disorder and Internalization in children & Adolescent of Parental discord.
This demonstrates that gender has no association with parental discord, so is unlikely to be a confounding factor in these results. Of the 238 boys in the study, 62% had no experience of parental discord, and 38% did. Of the girls, the respective figures were 61% and 39%. This demonstrates that gender has no association with parental discord, so is unlikely to be a confounding factor in these results.
Result shows that there is no indication there was a difference in age of the children experiencing parental discord.
There is higher prevalence of conduct disorder vs. internalization in parental discord group, thus difference was significant.
The purpose of this study is to know the significant association of conduct disorder in children & adolescent and Parental discord. It focuses on the presence of parental discord/ disrupted family and Conduct disorder which includes antisocial behavior, substance abuse and aggression in children. As Results showed that there is significant association between marital stress or presence of parental discord and conduct disorder in children and adolescent.
This research highlights in on the parental discord, i.e., conflicting relationship, arguments, divorce and separation which leads children and adolescents aged 10-17 towards conduct disorder.
There is now evidence that conduct disorder is significant in parental discord vs. no parental discord as this study has emphasized on 412 children, aged 10-17 years leads towards conduct disorder in parental discord. Results found that gender has no association with parental discord. There is no indication that there was a difference in age of the children experiencing parental discord when the difference in age between the parental discord group and the normal group was made in which results investigated differences in age of the parental discord group versus the normal group.
Hence, there is significant presence of conduct disorder in parental discord. The current findings are generally consistent. The result shows that there were 24.8% presence of Conduct disorder in parental discord and 13.8% presence of Internalization in Parental discord. This difference was significant at the 0.05 level (chi-square=4.8, df=1, p=0.028).
Results suggest aimed at identifying of conduct disorder is significantly and consistently associated with parental discord. Hence it supported the hypothesis that there is significant association of conduct disorder in children and adolescent who experienced parental discord.
- Amato PR, Keith B. Parental divorce and the well-being of children: A meta-analysis. Psychol Bull. 1991;110(1):26-46.
- Cummings EM, Ballard M, El-Sheikh M, Lake M. Resolution and children’s responses to interadult anger. Dev Psychol. 1991;27(3):462-470.
- Fergusson DM, Horwood J, Lynksey MT. Parental separation, adolescent psychopathalogy & problem behavior. J Am Acad Child Adolesc Psychiatry. 1994;33(8):1122-1131.
- Goodman R, Simonoff E. Reliability of clinical ratings by trainee child psychiatrists: A research note. J Child Psychol Psychiatry. 1991;32(3):551-555.
- Goodman SH, Kohlsdorf B. The developmental psychopathology of conduct problems: Gender issues. Prog Exp Pers Psychopathol Res. 1994;15:121-161.
- Harrington R, Fudge H, Rutter M. Adult outcomes of childhood and adolescent depression. I. Psychiatric status. Arch Gen Psychiatry. 1990;47(5):465-473.