Conduct disorders became established as a medical diagnosis in 1968. Today they are one of the most frequent reasons why children and adolescence are referred to a mental health clinic. Conduct disorders impact upon the emotional wellbeing of the individual, their social and family relationships, and their academic success at school and their future wellbeing as adults in society.
The school makes up a significant part of a child’s life and for children with conduct disorders the school environment can be particularly challenging. The nature of the school that enforces rules, boundaries and expectations on students’ behaviour is problematic for a child suffering from conduct disorders whom opposes the authority of the teacher and the school. This causes difficulties for the child and the teacher’s ability to ensure positive learning outcomes for all members of the classroom. Thus conduct disorders is a significant challenge for teachers, educational psychologists and the education system itself, placing high demands on the skills and knowledge of teachers, educational psychologist and other professional involved.
Central to understanding conduct disorders is that the diagnosis and treatment of conduct disorders is dependent upon the social and political context of the time. The historical perspective demonstrates that conduct disorders is a category that is ambiguous in its development and understanding. This challenges the educational psychologist to approach diagnosis and treatment with caution, treating each case thoughtfully and critically engaging the theoretical literature of the time with the needs of the individual child. To fully understand the contemporary perspective it is important to know how it originated and how it has developed. The origin of conduct disorders can be traced to the research around delinquency at the end of the 19th century. Thus, three significant questions are identified and answered in this thesis:
- What is the historical context that the diagnosis of conduct disorders rose from?
- In the last forty years how has changing diagnostic criteria reflected the theoretical developments?
- In what degree and kind have the theoretical understanding of conduct disorders developed, and how is this development reflected in the causal explanations, assessment and treatment of conduct disorder?
MethodTo answer the questions this thesis has employed the qualitative methods of historical and text analysis. This is done under post positivistic research paradigm guided by the ontology of critical realism.
SourcesThe literature is based around the main contributors to the historical development of conduct disorder. The early history draws on the writings of Lombroso, Aichhorn, Healy and Burt, the middle period on Bandura, Patterson, Robbins and the contemporary research of Burke, Frick, Maughan, Mofitt, Ogden, Nordahl, and Rutter among many others.
Findings/ conclusionThis thesis has identified three distinct periods in the history of conduct disorders. The first period begins in 1880 where the origins of conduct disorder lie within the social and legal problem of delinquency. This period is characterized by the initial recognition of delinquency and antisocial behaviour as a medical and educational problem. In the second period from 1910 until 1968 there was increased research interest in conduct problems of children as researchers attempted to identify the causes of inappropriate behaviours. This culminated with the first categorisation of Conduct Disorder as an official category in 1968. Thus the final period begins in 1968 and is marked by a rapid accumulation in the knowledge around conduct disorders and an increasingly holistic perception of the cause and treatment of conduct disorder, taking into account the individuals interaction with the environment.
The first period marked by the categorisation of delinquency arose from the development of three critical factors: the recognition of childhood and adolescence as distinct developmental periods, secondly the increasing presence of children in the public space that represented a problem for the general public; and the emerging discipline of criminology that developed theories around the cause of criminal behaviour. The initial research around delinquency was through the lens of biological determinism. Biological explanations were challenged by psychological explanations at the start of the 20th century as a result of the increasing popularity of Freudian psychoanalysis. Psychoanalysis became the main theoretical approach and remained so until the 1960s when it gradually was replaced by the social learning perspective of Albert Bandura and Gerald Patterson.
In the last 30 years, two key frameworks in the contemporary understanding of conduct disorders have emerged. Uri Brofenbrenners Ecological Systems Theory has contributed to insight into the role of different environmental systems in development and maintenance of conduct disorders. Developmental psychopathology has helped to integrating previous theories and perspectives, and has contributed to the understanding of how biological, cognitive and environmental factors can accumulate to increases the risk of a pathological outcome.
The historical perspective demonstrates that theoretical explanations are critical to not only explaining the cause of conduct disorders, but also the treatment and interventions in the medical, educational and justice system. Historically, treatments of conduct disorder have drawn upon psychoanalysis, individual psychotherapy, and behaviour and cognitive orientated interventions. Today the most successful treatment draws upon a variety of theoretical backgrounds and the historical developments and understanding of conduct disorder.