NCJ Number
198434
Date Published
2002
Length
19 pages
Annotation
This chapter discusses trauma as a key to understanding the development and persistence of conduct disorder.
Abstract
Trauma effects can help to account for many features of conduct disorder, including lack of empathy, impulsivity, anger, acting-out, and resistance to treatment. The current standard of care does not fully address trauma, which may explain the low success rate of existing treatment approaches. The reinforcement for coercive behavior model shows a pattern of ineffectual, explosive discipline reinforcing non-compliant and coercive rather than pro-social behaviors. The child’s antisocial behaviors lead to positive outcomes, such as termination of aversive parental behavior and/or obtaining desired goods or privileges. The cumulative risk model shows that the greater number of risk factors present, the greater the risk that conduct disorder will develop. Trauma may play a role in several of the risk factors that have been identified as contributing to conduct disorder. Trauma treatment involves two general phases: establishing a sense of safety and working though the traumatic material. Current treatment approaches for conduct disorder do not address the working-through phase very well. Trauma-related assessment should be included in prospective studies of child/adolescent development. Trauma history and symptoms should be assessed at intake or at other points when youth with conduct disorder are identified and accessible. The interaction between traumatic exposure, post-traumatic symptoms, behavioral contingencies, and other identified contributors to conduct disorders should be studied further. Existing effective prevention approaches for conduct disorder should be analyzed for impact on trauma-related issues, such as increased environmental stability and reduced risk of trauma exposure. It may be useful to consider trauma as an organizing principle informing prevention and treatment approaches. 1 figure, 92 references