- Mental Health
The Difference Between Conduct Disorder and ADHD
Conduct Disorder and ADHD
There are some similarities, but many differences between Attention Deficit Hyperactivity Disorder (ADHD) and Conduct Disorder. Both are located on Axis I of the DSM-IV, as both are usually first diagnosed in infancy, childhood, or adolescence, and both are disorders involving deviations from normal development. Both disorders are about thee to five times more likely in boys than girls. Despite their similarities, the two disorders differ vastly in their presenting behaviors and diagnostic criteria.
ADHD is characterized by inattention, impulsiveness, and hyperactivity. The child is often easily distracted, forgetful, and disorganized. They may fidget in their seats, or have difficulty staying seated or waiting their turn. Many cases stem from central nervous system dysfunction, but the more risk factors a child experiences, the more likely he is to develop ADHD. Children with ADHD are at a greater risk for other psychiatric and social problems in adolescence and adulthood. The prevalence in school-aged boys is about 8 -10%, and about 2% in school-aged girls.
Conduct Disorders are characterized by persistent pattern of behavior that violates societal norms and the basic rights of others. Children with this disorder often exhibit physical aggression toward people or animals, fighting, vandalism, lying, stealing, and defiance of authority. These children often lack empathy and compassion, and seldom express remorse for their destructive behaviors. Both genetic and environmental factors contribute to conduct disorder and delinquent behavior. Genetic and environmental factors both contribute to the likelihood of a child having a conduct disorder. An unstable home environment is particularly dangerous to children who are genetically vulnerable. About 6 -16 % of boys and 2 - 9 % of girls have a conduct disorder.
Despite their differences, the way teachers and school districts often respond to these disorders is similar. They see the child as a disruption in class, and have difficult time "warming up" to the child. They tend to label their students without the benefit of diagnostic data. Often one disorder is mistaken for the other. Not surprisingly, children with these disorders often end up with Oppositional-Defiance Disorder added to their diagnosis. This is characterized by defiant, argumentative, and purposefully annoying behaviors. They are often angry, resentful, spiteful, or vindictive. This can develop into Anti-social personality order in adults.
Many parents call their kids hyperactive simply because they are so much more active than most adults. They are kids...they are supposed to be very active. Parents tend to think that just because their child exhibits some of the behaviors some of the time, that makes them ADHD. For a kid to be properly diagnosed, he needs to be displaying the behaviors consistently in a variety of settings, not just at home or just at school. Any kid that can sit glued to a movie or a video game for two hours is probably not ADHD. Lots of different factors could be causing the behaviors, like boredom, no place to run and play outside at home, (or not getting enough physical activity at school) learning disabilities, diets full of sugar and artificial ingredients, family crisis, or another mental disorder, to name a few.
About 10-12 years ago, I was working as a Title I instructor (working w/ low income kids to bring them up to grade level) in a poor, inner-city neighborhood. We take our 6th graders to science camp at Sly Park every year, (6th grade science camp is standard in most California schools.) Sly Park can accommodate about 3-4 schools at a time. One of the other schools attending when we went was from an extremely high income community. We each had about 75 students. I took 5 of our kids down for meds every morning. The "rich kids school", as my students called it, had 25 kids waiting in line for their morning meds. So that raises the question, are affluent parents over-diagnosing and over-medicating their kids, or are the poor kids undiagnosed and under-treated?