Antisocial behavior

Definition

Antisocial behaviors are disruptive acts characterized by covert and overt hostility and intentional aggression toward others. Antisocial behaviors exist along a severity continuum and include repeated violations of social rules, defiance of authority and of the rights of others, deceitfulness, theft, and reckless disregard for self and others. Antisocial behavior can be identified in children as young as three or four years of age. If left unchecked these coercive behavior patterns will persist and escalate in severity over time, becoming a chronic behavioral disorder.

Description

Antisocial behavior may be overt, involving aggressive actions against siblings, peers, parents, teachers, or other adults, such as verbal abuse, bullying and hitting; or covert, involving aggressive actions against property, such as theft, vandalism, and fire-setting. Covert antisocial behaviors in early childhood may include noncompliance, sneaking, lying , or secretly destroying another's property. Antisocial behaviors also include drug and alcohol abuse and high-risk activities involving self and others.

Demographics

Between 4 and 6 million American children have been identified with antisocial behavior problems. These disruptive behaviors are one of the most common forms of psychopathology, accounting for half of all childhood mental health referrals.

Gender differences in antisocial behavior patterns are evident as early as age three or four. There has been far less research into the nature and development pattern of antisocial behavior in girls. Pre-adolescent boys are far more likely to engage in overtly aggressive antisocial behaviors than girls. Boys exhibit more physical and verbal aggression, whereas antisocial behavior in girls is more indirect and relational, involving harmful social manipulation of others. The gender differences in the way antisocial behavior is expressed may be related to the differing rate of maturity between girls and boys. Physical aggression is expressed at the earliest stages of development, then direct verbal threats, and, last, indirect strategies for manipulating the existing social structure.

Antisocial behaviors may have an early onset, identifiable as soon as age four, or late onset, manifesting in middle or late adolescence . Some research indicates that girls are more likely than boys to exhibit late onset antisocial behavior. Late onset antisocial behaviors are less persistent and more likely to be discarded as a behavioral strategy than those that first appear in early childhood.

As many as half of all elementary school children who demonstrate antisocial behavior patterns continue these behaviors into adolescence, and as many as 75 percent of adolescents who demonstrate antisocial behaviors continue to do so into early adulthood.

Causes and symptoms

Antisocial behavior develops and is shaped in the context of coercive social interactions within the family , community, and educational environment. It is also influenced by the child's temperament and irritability, cognitive ability, the level of involvement with deviant peers, exposure to violence, and deficit of cooperative problem-solving skills. Antisocial behavior is frequently accompanied by other behavioral and developmental problems such as hyperactivity, depression, learning disabilities, and impulsivity.

Multiple risk factors for development and persistence of antisocial behaviors include genetic, neurobiological, and environmental stressors beginning at the prenatal stage and often continuing throughout the childhood years.

Genetic factors are thought to contribute substantially to the development of antisocial behaviors. Genetic factors, including abnormalities in the structure of the prefrontal cortex of the brain, may play a role in an inherited predisposition to antisocial behaviors.

Neurobiological risks include maternal drug use during pregnancy, birth complications, low birth weight, prenatal brain damage, traumatic head injury , and chronic illness.

High-risk factors in the family setting include the following:

• parental history of antisocial behaviors
• parental alcohol and drug abuse
• chaotic and unstable home life
• absence of good parenting skills
• use of coercive and corporal punishment
• parental disruption due to divorce , death, or other separation
• parental psychiatric disorders, especially maternal depression
• economic distress due to poverty and unemployment

Heavy exposure to media violence through television, movies, Internet sites, video games , and even cartoons has long been associated with an increase in the likelihood that a child will become desensitized to violence and behave in aggressive and antisocial ways. However, research relating the use of violent video games with antisocial behavior is inconsistent and varies in design and quality, with findings of both increased and decreased aggression after exposure to violent video games.

Companions and peers are influential in the development of antisocial behaviors. Some studies of boys with antisocial behaviors have found that companions are mutually reinforcing with their talk of rule breaking in ways that predict later delinquency and substance abuse.

When to call the doctor

Parents and teachers who notice a pattern of repeated lying, cheating, stealing , bullying, hitting, noncompliance, and other disruptive behaviors should not ignore these symptoms. Early screening of at-risk children is critical to deterring development of a persistent pattern of antisocial behavior. Early detection and appropriate intervention, particularly during the preschool years and middleschool years, is the best means of interrupting the developmental trajectory of antisocial behavior patterns. Serious childhood antisocial behaviors can lead to diagnoses of conduct disorder (CD) or oppositional defiant disorder (ODD). Children who exhibit antisocial behaviors are at an increased risk for alcohol use disorders (AUDs).

Diagnosis

Systematic diagnostic interviews with parents and children provide opportunity for a thorough assessment of individual risk factors and family and societal dynamics. Such assessment should include parent-adolescent relationships; peer characteristics; school, home, and community environment; and overall health of the individual.

Various diagnostic instruments have been developed for evidence-based identification of antisocial behavior in children. The onset, frequency, and severity of antisocial behaviors such as stealing, lying, cheating, sneaking, peer rejection, low academic achievement, negative attitude, and aggressive behaviors are accessed to determine appropriate intervention and treatment.

Treatment

Enhanced parent-teacher communications and the availability of school psychologists and counselors trained in family intervention within the school setting are basic requirements for successful intervention and treatment of childhood antisocial behaviors.

School-based programs from early childhood onward that teach conflict resolution, emotional literacy, and anger management skills have been shown to interrupt the development of antisocial behavior in low-risk students. Students who may be at higher risk because of difficult family and environmental circumstances will benefit from more individualized prevention efforts, including counseling, academic support, social-skills training, and behavior contracting.

Academic settings with the capacity to deliver professional parental support and provide feedback in a motivating way can help parents to develop and hone effective parenting skills that may interrupt further progression of antisocial behavior patterns in their children. Access to written and video information on parenting skills and information about community family resources, as well as promotion of parent-support groups, are effective intervention strategies for changing family dynamics that shape antisocial behavior in the children.

Older students who already exhibit a persistent pattern of antisocial behavior can be helped with intensive individualized services that may involve community mental health agencies and other outside intervention.

Community-based programs, including youth centers and recreational programs with trained therapists, can provide additional support for at-risk children.

Prognosis

The longer antisocial behavior patterns persist, the more intractable they become. Early-onset conduct problems left untreated are more likely to result in the development of chronic antisocial behavior than if the disruptive behavior begins in adolescence. Though it is never too late to intervene, researchers warn that if by age eight a child has not learned ways other than coercion to meet his social goals, he has a high chance of continuing with antisocial behavior throughout his lifetime.

Longitudinal studies have found that as many as 71 percent of chronic juvenile offenders had progressed from childhood antisocial behaviors through a history of early arrests to a pattern of chronic law breaking.

Prevention

Healthy nutrition and prenatal care, a safe and secure family and social environment, early bonding with an emotionally mature and healthy parent, role models for prosocial behaviors, non-coercive methods of parenting, peer relationships with prosocial individuals, and early intervention when problems first appear are all excellent means of assuring development of prosocial behaviors and reducing and extinguishing antisocial behaviors in children.

Parental concerns

Parents may hesitate to seek help for children with antisocial behavior patterns out of fear of the child being negatively labeled or misdiagnosed. Almost all children will engage in some form of antisocial behavior at various stages of development. Skilled parents will be able to lovingly confront the child and help the child recognize that certain behaviors are unacceptable. However if these conduct disturbances persist and worsen, they should be taken seriously as precursors to more serious problems. Early intervention is important for the sake of the child and the entire family system.

Resources

BOOKS

Coloroso, Barbara. The Bully, the Bullied, and the Bystander. New York: Harper Collins, 2003.

Connor, Daniel F. Aggression and Antisocial Behavior in Children and Adolescents. New York: Guilford Press, 2002.

Reid, John B., et al. Antisocial Behavior in Children and Adolescents. Washington, DC: American Psychological Association, 2002.

Walker, Hill M., et. al. Antisocial Behavior in School , 2nd ed. Belmont, CA: Wadsworth/Thomson Learning, 2004.

WEB SITES

Clark, Duncan B., et al., "Childhood Antisocial Behavior and Adolescent Alcohol Use Disorders." National Institute on Alcohol Abuse and Alcoholism , November 2002. Available online at http://www.niaaa.nih.gov/publications/arh26-2/109-115htm (accessed October 11, 2004).

Wood, Derek. "What is Antisocial Personality Disorder?" Mental Health Matters. Available online at http://www.mental-health-matters.com/articles/print.php?artID=51 (accessed October 11, 2004).

Clare Hanrahan