Mental illness, neuropsychologic deficits, child abuse, and violence

The commonest diagnosis given to the violent child or adolescent is conduct disorder, a label associated with unsuccessful treatment and adult maladaptation. Such a superficial diagnosis is often made because the behaviors that constitute the diagnosis of conduct disorder are diverse and are common to a multitude of other diagnoses. Clinicians often fail to look further and identify the kinds of potentially treatable psychiatric, neurologic, and neuropsychologic impairments and environmental stressors that underlie aggressive, antisocial behavior. The purpose of this article is to describe the kind of meticulous and systematic diagnostic evaluation that is required to identify the underlying causes of a youngster's aggression. Such comprehensive assessments invariably reveal previously overlooked and untreated neuropsychiatric and intrafamily disturbances, all of which have implications fur therapeutic interventions and the prevention of violence.