Conduct Disorders

Children with conduct disorder can be found across all races, cultures and socioeconomic groups. 

What are Conduct Disorders? 

Conduct disorder refers to a group of behavioral and emotional problems characterized by a disregard for others. Children with conduct disorder have a difficult time following rules and behaving in a socially acceptable way. Their behavior can be hostile and sometimes physically violent.

In their earlier years, they may show early signs of aggression, including pushing, hitting and biting others. Adolescents and teens with conduct disorder may move into more serious behaviors, including bullying, hurting animals, picking fights, theft, vandalism and arson.

Children with conduct disorder can be found across all races, cultures and socioeconomic groups. They often have other mental health issues as well that may contribute to the development of the conduct disorder. The disorder is more prevalent in boys than girls.

What Symptoms Should Parents Look for?

There are four basic types of behavior that characterize conduct disorder:

  • Physical aggression (such as cruelty toward animals, assault or rape).
  • Violating others’ rights (such as theft or vandalism).
  • Lying or manipulation.
  • Delinquent behaviors (such as truancy or running away from home).

Conduct disorder is characterized by aggression toward others and a callous disregard for their rights and needs. Adolescents and teens with conduct disorder can find acts of aggression, deceit and coercion to be gratifying. Your child may meet the criteria for conduct disorder if you find them engaging in several of the below behaviors:

  • Bullying or threatening behavior
  • Physical aggression
  • Cruelty toward people or animals
  • Fire-setting
  • Breaking curfew
  • Truancy from home or school
  • Trespassing
  • Lying
  • Cheating
  • Stealing
  • Vandalism
  • Emotionally or physically abusive behaviors (such as wielding a deadly weapon or forcing sex)

Many young people with conduct disorder will have trouble:

  • Feeling and expressing empathy or remorse.
  • Showing emotion toward others.
  • Performing well in the school or community and blaming others for poor performance.

They often misinterpret the actions of others as being hostile or aggressive. They respond by escalating the situation into verbal or physical conflict.

In adolescents and teens, conduct disorder may be associated with other difficulties, including:

  • Substance use.
  • Risk-taking behavior.
  • School problems.
  • Physical injury from accidents or fights.

In younger children, it can be more of a challenge to distinguish signs of conduct disorder from more typical “acting out".

At times, these same symptoms can be seen in children without the disorder. The difference is frequency, intensity, and duration, as well as to what extent it impacts their functioning. In children with conduct disorder, these behaviors happen much more frequently. 

What Causes Conduct Disorder in Children?

Many factors seem to contribute to this disorder. Research has found that children and teens with conduct disorder seem to have an impairment in the frontal lobe of the brain. This interferes with their ability to plan, avoid harm, and learn from negative experiences.

In addition, these factors seem to put children and teens at a higher risk to develop conduct disorder:

  • Having experienced abuse, parental rejection or neglect.
  • Being diagnosed with other psychiatric disorders.
  • Biological parents diagnosed with ADHD, alcohol use disorder, depression, bipolar disorder, or schizophrenia.
  • Poor nutrition.
  • Living in poverty.
  • Maternal psychopathology.
  • Poor parenting / lack of parental involvement.
  • Inconsistent, overly harsh, or otherwise ineffective discipline.
  • Exposure to violence.
  • Peer delinquency.
  • Having been subjected to physical, sexual, and/or emotional abuse.
  • Lack of adequate parental or other adult supervision.

How is Conduct Disorder Diagnosed and Treated?

A child psychiatrist, psychologist, or other qualified mental health professional usually diagnoses conduct disorders in children and teens by completing:

  • A detailed history of the child's behavior, as well as relevant biological, psychological, social, and cultural factors, which are identified during a clinical interview with the child and caregiver(s).
  • A review of historical data such as school records, court/child welfare records, past treatment records, and interviews with collaterals.
  • Additional information can also be obtained via the following:
    • Observations of the child's behavior.
    • Psychological testing.

Treatment can be complex and challenging. And it can last for several months. Children with conduct disorder tend to be uncooperative with others. They often fear and distrust adults. And adding to the complication is the fact that conduct disorder is often (but not always) diagnosed along with a number of other psychological conditions.

Treatment for conduct disorder may include:

  • Multisystemic therapy: Intensive, often home- or community-based interventions to promote positive behavior change in the youth’s environment. Treatment relies heavily on family and school involvement.
  • Family therapy.
  • Medication.

Conduct disorder can be difficult to overcome. But it is manageable. The earlier the treatment is started after symptoms appear, the more successful it is likely to be.

As with many psychiatric disorders, early intervention is key.