Washington (ISJ) - It's normal for a young child to have tantrums and be otherwise disruptive, but researchers have found, such prolonged or intense behaviour could result in conduct disorder ? a childhood psychiatric problem, forerunner of anti-social behaviour.
Researchers at Washington University School of Medicine in St. Louis found certain symptoms of conduct disorder indicate problems are likely to continue as kids reach school age. They recommend, children who exhibit these symptoms ? among them, high-intensity defiant behaviour, aggression and destruction of property ? be referred to mental health professionals for evaluation and possible intervention.
Their findings were published Jan. 15 in The Journal of Paediatrics.
"Previously, we did not understand the empirical differences between normal disruptive behaviours in pre-schoolers ? like temper tantrums, for example ? and behaviours that signal problems," said senior investigator Joan L. Luby, professor of child psychiatry. "If you went to your paediatrician and said, 'My 3-year-old is having tantrums,' the paediatrician wouldn't tell you to see a psychiatrist."
Although there was overlap between healthy young children and their peers who had conduct disorder, the researchers found those who exhibited high-intensity defiant behaviour, aggression toward people or animals, high-intensity destruction of property, peer problems and deceitfulness, including stealing, were likely to have conduct disorder. Having those symptoms also made it more likely they would carry the disorder into elementary school.
"Other factors that would qualify a symptom as high-intensity would hinge on how frequently the behaviour occurs and the context in which it occurs. A high-intensity symptom is one that is very acute or severe, occurs over a long duration of time and happens in a number of different contexts," added Luby.
"Children who had high-intensity symptoms as pre-schoolers were likely to have conduct disorder," said first author Ji Su Hong, who now works as a mental health provider for children treated at Grace Hill Health Centers in St. Louis. ?And those symptoms also tended to predict conduct disorder when they reached school age."
Although healthy pre-schoolers also engage in disruptive behaviours ? including losing their tempers, throwing toys and being untruthful ? about one in 20 pre-schoolers has conduct disorder.
"That's about one child per preschool class," Hong said. "And conduct disorder is a serious problem when it affects a child under 10 because early-onset problems are more likely to persist as the child grows up."
Kids with conduct disorder often have other disadvantages, too. Many children with school-age conduct disorder in the study were from homes with low incomes. Further, about half had a history of abuse or neglect; 43 percent came from intact families, meaning more than half were either from single-parent homes or didn?t live with either parent; and more than half had been diagnosed with preschool depression.
Hong and Luby believe that the best chance young children have to avoid recurring problems is early diagnosis and treatment.
Source: Washington University School of Medicine in St. Louis
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