The Mental Emotional Health Blog

Conduct Disorder is an interesting diagnosis for those of us that work with children and adolescents. Within the field of mental health, I have heard Conduct Disorder referred to as “the toughest diagnosis to work with for kids”, and “it’s just a catch-all diagnosis for misbehaving teens”. That’s quite a range. I am glad to be able to say the majority of colleagues I work with and worked with in the past emphasize the person over the diagnosis.

Destruction, aggressive speech and actions, frequent dishonesty, indifference to discipline, and breaking rules or laws are typical characteristics. As a clinician, I think the defining characteristic is lack of empathy and remorse. Most kids and teens get into a little trouble, or are defiant at some point. Those with Conduct Disorder go beyond isolated incidents and do these things often, and often ignore or minimize the emotional (or physical) pain caused to others.

When I work with kids and teens who have been diagnosed with Conduct Disorder, I try to speak in a matter-of-fact manner. I do that in order to remove my emotions from the conversation, since those that meet criteria of Conduct Disorder often tend to feed off of others’ feelings despite seeming to not care about them.

WebMD has a good summary of this difficult condition. Here is a link to info on Conduct Disorder at WebMD .

Today, I want to draw attention to a recent weekly column by family psychologist John Rosemond. He has a great website about traditional parenting, is a sought-after speaker, and is a syndicated columnist appearing in about 250 newspapers in the United States.

His parenting positions are based on common sense and tradition, and he isn’t afraid to be provocative. Actually, I could correct that to say that he can be very direct and many in the U.S. find that provocative when it comes to parenting concerns and beliefs. I personally like being challenged to consider different intellectual topics so I have spent some time considering his parenting column from last week.

The link is here, and is worth reading if you are a parent or guardian:  Living With Children. I initially bristled at his challenging of the idea that high self-esteem in children is good. As I read the rest of the article, I came around to agreeing with his point. Teaching a child to respect others is more important than teaching them to have high self-esteem. That doesn’t mean children should have no or low self-esteem, it’s just that minimizing respect for others in favor of self-esteem is a poor parenting choice and could be socially dangerous. Remember that children are forming beliefs that will stay with them for a long time, possibly for the rest of their life. Respecting other people should be emphasized. This makes sense to me as a therapist and as a parent, and I endorse Mr. Rosemond’s perspective on it.

Have a great week everyone!

As a therapist, I have lost count of the number of resources out there for parents about raising children. It is great that there are so many websites where you can find information, helpful articles, and support. On the other hand, it can be tough to know which sites have the best info and advice. Today, I want to introduce you to one that I think is one of the best.

Connect With Kids is a powerful network of parenting resources.  The topics are relevant and timely, and CWK addresses sensitive child and teen subjects with professionalism and wisdom. There are videos, articles, and also discussion boards so you can connect with other parents.

The website is here (Connect With Kids), and I highly suggest you check it out if you are raising a child or adolescent, or work with those ages as a health provider.

Research studies are useful, even necessary in studying psychological trends. Then I see results of studies (or the reporting of them) like the one listed below that make me groan. The title of a short article in the Chicago Tribune from March 2, 2009, stated: Video game violence warnings make kids more likely to want to play, study says. The link is here for the full article: http://www.chicagotribune.com/business/technology/chi-talk-gamesmar02,0,4702900.story .

The title itself had me annoyed as a therapist and as a parent, and the first actual sentence in the article didn’t help: If you want to make blood-and-gore video games less appealing to minors, toss those restrictive age and violent-content warnings. The lure of something off-limits only increases demand, a new study says. This is a perfect example of putting emphasis in the wrong place. Warnings are just that: warnings to people who are responsible enough to use them effectively, especially in parenting. The article goes on to suggest that kids should not buy their own video games (I think that is obvious), and the parents should monitor risk factors such as grades dropping (I think that is also obvious). But the last suggestion is that policy-makers rethink (implying ”drop”) the Mature Rating Classification: which will only make the games “unspeakably desirable.” 

The bottom line is it doesn’t matter how much a child/teen wants a video game. If a parent is informed about the content of a video game, the parent is in a better position to make decisions about its appropriateness. It is up to parents to stay informed, and warnings are a simple and effective way to keep them informed. Also, there are responsible teens out there that do take it upon themselves to check the ratings and warnings on their own.

The restrictions suggested by the ESRB (Entertainment Software Rating Board) provide both age appropriateness and content description. The ESRB link is below, and is a good resource for parents since a video game search is on the main page: http://www.esrb.org/ratings/ratings_guide.jsp . Another good link is from PBS: http://www.pbs.org/kcts/videogamerevolution/impact/esrb.html .

I have added some links to articles that reported how parents can benefit from the ratings system:

•  http://www.xboxsolution.com/2003/12/06/study-shows-parents-approve-of-video-game-ratings/
• http://www.dmwmedia.com/news/2004/11/22/study-parents-find-video-game-ratings-highly-accurate
• http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=104&STORY=/www/story/11-22-2004/0002496229&EDATE=

Removing warnings of the content in video games would allow teens and children to keep parents in the dark about what they are playing. But more important is the fact that parents and guardians have the right and responsibility to determine what is appropriate for their kids, regardless of how much the kids want to play certain games.

I really do think people mean well most of the time. The idea for this post came to me after I spoke with one of my friends the other day. She and her husband are expecting their first child in a few months. That got me thinking about all the “wisdom” expecting parents and new parents receive. I myself am a father of a 5 year old and 2 year old. Despite being a guy, I have learned some things.

My first thought was that a lot of this “wisdom” is unsolicited. Here’s a fictional example (which many can relate to):

Expectant Parent: We’re expecting in a few months and we’re so excited!

Self-Appointed Authority on Parenting: That’s great! You know your life is going to be completely different. Are you ready?

EP: I think so. We’ve almost got the baby’s room all set up and people have been great with getting us all the things we’ll need.

SAAP: Uh-huh. Do you have a baby wipe warmer yet? You have to have that you know.

EP: Umm . . . no, not yet. But we can still put it on the baby register.

SAAP: Okay. You should probably do it soon so you don’t forget. You probably won’t be remembering everything for a while, or never again after you actually become a parent. What kind of car seat did you get?

EP: We decided on <insert model here>.

SAAP: Oh. Okay, well make sure you put in the car the right way. Sometimes you think you have it in there but it’s not according to requirements.

I dramatized that a little, I admit. But isn’t it amazing how people trying to be supportive end up trying to prepare expectant parents instead, and freak them out instead?

It doesn’t stop there either. After the child is born and the new parents are thankful for this wonderful child, the lectures keep coming. It doesn’t matter that fatigue, sleeplessness, and the daily need to adapt to a major life change are ever-present. The “support” typically comes in comments like these:

Cherish these moments because children grow up fast.

Just wait until 2 years from now.

Just wait until they are teenagers.

You won’t ever sleep well again. Even after they’re 18, you’ll still worry about what they’re up to late at night.

Have you learned the correct breast-feeding method?

Make sure you burp the baby the right way.

It’s a lot easier to be supportive to new parents by keeping support simple and direct. Try asking if they need anything, or reminding them you are there if they do need something over the next few months. That is simply more helpful. No one is completely prepared for the transition to parenting, and it’s not your job to remind them of that.