Conduct Disorder

Conduct disorder is a behavior disorder, sometimes diagnosed in childhood, that is characterized by antisocial behaviors that violate the rights of others and age-appropriate social standards and rules.

Antisocial behaviors may include irresponsibility, delinquent behaviors, violating the rights of others (such as theft) and / or physical aggression toward others (such as physical assault or rape). These behaviors sometimes occur together; however, one or several may occur without the other.

There are many factors that can contribute to the development of a conduct disorder. Neuropsychological testing has shown that children and adolescents with conduct disorders seem to have impairment in the frontal lobe of the brain that interferes with their ability to plan, avoid harm and learn from negative experiences.

Children or adolescents from disadvantaged, dysfunctional and disorganized home environments are more likely to develop conduct disorders. Social problems and peer group rejection have been found to contribute to delinquency also. Children and adolescents exhibiting delinquent and aggressive behaviors have distinctive cognitive and psychological profiles when compared to children with other mental health problems and control groups.

Approximately 6 percent of children have conduct disorders. The disorder is more common in boys than in girls by a 4:1 ratio and is believed to be more prevalent in urban (city) rather than in rural (country) settings.

Children and adolescents with conduct disorders often have other psychiatric problems as well. These other psychiatric conditions may contribute to the development of the conduct disorder.

The prevalence of conduct disorders has been observed to increase over recent decades.

Aggressive behavior is the reason for one-third to one-half of the referrals made to child and adolescent mental health services.

Most symptoms seen in adolescents with conduct disorder also occur at times in adolescents without this disorder. However, in adolescents with conduct disorder, these symptoms occur more frequently and interfere with learning, school adjustment and, sometimes, with the adolescent's relationships with others.

The following are the most common symptoms of conduct disorder. However, each adolescent may experience symptoms differently. The four main groups of behaviors include:

Aggressive Conduct

Aggressive conduct causes or threatens physical harm to others and may include:  

  • Intimidating behavior
  • Bullying
  • Physical fights
  • Cruelty to others or animals
  • Use of a weapon(s)
  • Forcing someone into sexual activity, rape or molestation  

Destructive Conduct

Destructive conduct may include:  

  • Vandalism; intentional destruction to property
  • Arson 

Deceitfulness

Deceitful behavior may include:  

  • Lying
  • Theft
  • Shoplifting
  • Delinquency 

Violation of Rules

Violation of ordinary rules of conduct or age-appropriate norms may include:  

  • Truancy (failure to attend school)
  • Running away
  • Staying out at night past curfew 

The symptoms of conduct disorder may resemble other medical conditions or behavioral problems. Always consult your adolescent's physician for a diagnosis.

An adolescent medicine physician, child and adolescent psychiatrist or a qualified mental health professional usually diagnoses conduct disorders in adolescents. A detailed history of the adolescent's behavior from parents and teachers, observations of the adolescent's behavior and, sometimes, psychological testing contribute to the diagnosis. Parents who note symptoms of conduct disorder in their adolescent can help by seeking an evaluation and treatment early. Early treatment may prevent future problems.

Further, conduct disorder often coexists with other mental health disorders, including mood disorders, anxiety disorders, substance abuse, attention-deficit / hyperactivity disorder and learning disorders, increasing the need for early diagnosis and treatment. Consult your adolescent's physician for more information.

Specific treatment for adolescents with conduct disorders will be determined by your adolescent's physician based on:

  • Your adolescent's age, overall health and medical history
  • Extent of your adolescent's symptoms
  • Your adolescent's tolerance for specific medications, procedures or therapies
  • Expectations for the course of the condition

Treatment May Include

Cognitive-behavioral Approaches

The goal of cognitive-behavioral therapy is to improve problem solving skills, communication skills, impulse control and anger management skills.

Family Therapy

Family therapy is often focused on making changes within the family system, such as improving communication skills and family interactions.  The family may need help carrying out special education or behavior plans in the home and at school.

Peer Group Therapy

Peer group therapy is often focused on developing social skills and interpersonal skills.

Medication

Medication can help reduce aggression and may be used if other symptoms or disorders are present, such as impulsivity or trouble paying attention.

Some experts believe that a developmental sequence of experiences occurs in the development of conduct disorder. This sequence may start with ineffective parenting practices, followed by academic failure and poor peer interactions. These experiences then often lead to depressed mood and involvement in a deviant peer group.

Other experts, however, believe that many factors, including child abuse, genetic susceptibility, history of academic failure, brain damage and / or a traumatic experience influence the expression of conduct disorder.

Early detection and intervention into negative family and social experiences may be helpful in disrupting the development of conduct disorder.


Last Updated 01/2014