Assessment and Treatment of Childhood-Onset Conduct Disorder: A Literature Review

Abstract

Introduction: Conduct disorder (CD) is among the most highly represented diagnostic issues in child psychiatry. Current research suggests that early-onset CD is predictive of a worse prognosis and trajectory than other CD subtypes if not subsequently met with appropriate psychological assessment and symptom management. This paper aims to provide an overview of the literature from 2014 to 2021 in assessment and intervention protocols that target childhood-onset type specific CD, and appraise associated barriers implicated by the findings.

Methods: This review involved a thorough literature search in electronic databases to extract empirical studies directly related to childhood-onset CD. The review was performed on PsycINFO and PubMed using the following search words: “conduct disorder(s)” OR “CD” OR “conduct disordered”, AND “child(hood)-onset” OR “elementary-onset” OR “early-onset”, AND “assessment” OR “evaluation” OR “examination”, AND “intervention” OR “treatment” OR “symptom management”.

Results: Based on trends, articles were sorted into three common topics: assessment, treatment, and barriers to psychological services. The studies demonstrated the importance of sensitive and specific assessment tools, neural measures, behavioural markers, and the limited prosocial emotions (LPE) specifier. The results indicated that comorbidities, tailored school- and family-based intervention, parent-child conflict, and the LPE specifier in addition to the age-of-onset subtype is an area of research for clinicians.

Discussion: Research has shown that childhood-onset CD, compared to other age-of-onset subtypes, is associated with individual risk factors such as neurological and cognitive deficits, poor emotion regulation, familial maladaptive parenting styles, and evocative family instability. While research has focused on dispositional risk factors for this heterogenous disorder, it is important to shift the focus to evidence-based clinical assessment and treatment strategies tailored to the poor prognosis of this subtype. Future research should examine current assessment sensitivity and appraise key stakeholders in early identification and treatment.

Conclusion: Early detection and intervention will increase the chances of a positive outcome for all parties, which includes reducing emotional strain and internalizing thoughts of caregivers and teachers and preventing antisocial personality disorder in adulthood. Normative treatment options for childhood-onset CD coincides with individual risk factors, further research will have implications in identifying and providing early care to at-risk children.