Conduct Disorder

What is conduct disorder?

Conduct disorder is a behavior disorder sometimes diagnosed in childhood. A child with this disorder may show antisocial behaviors. These behaviors violate the rights of others, as well as basic social standards and rules. These behaviors may include:

  • Irresponsibility

  • Delinquent behaviors (such as truancy or running away)

  • Violating the rights of others (such as theft)

  • Physical aggression toward animals or others (such as assault or rape)

These behaviors sometimes occur together. But 1 or more may occur without the others.

What causes conduct disorder?

Many factors contribute to this disorder. Neuropsychological testing has shown that children and teens with conduct disorders 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. Childhood temperament is considered to have a genetic basis. Children or teens who are considered to have a difficult temperament are more likely to develop behavior problems. Children or teens from disadvantaged, dysfunctional, and disorganized home environments are more likely to develop conduct disorders, although it can be found in all socioeconomic groups. Social problems and peer group rejection have been found to contribute to delinquency. Low socioeconomic status has been linked to conduct disorders. Children and teens who show delinquent and aggressive behaviors have distinctive cognitive and psychological profiles when compared to children with other mental health problems and control groups. All of the possible contributing factors influence how children and teens interact with other people.

Who is affected by conduct disorder?

The disorder is more common in boys than in girls. Children and adolescents with conduct disorders often have other psychiatric problems as well that may contribute to the development of the conduct disorder. The prevalence of conduct disorders has increased over recent decades across races, cultures, and socioeconomic groups. 

What are the symptoms of conduct disorder?

Most symptoms seen in children with conduct disorder also occur at times in children without this disorder. But in children with conduct disorder, these symptoms occur more often. These symptoms also interfere with learning, school adjustment, and sometimes with the child's relationships.

Each child’s symptoms may vary. But the 4 main groups of behaviors include the following:

Aggressive conduct. This behavior causes or threatens physical harm to others and may include the following:

  • Intimidating behavior

  • Bullying

  • Physical fights

  • Cruelty to others or animals

  • Use of a weapon

  • Forcing someone into sexual activity, rape, or molestation

Destructive conduct. This may include the following:

  • Intentional destruction to property (vandalism)

  • Arson

Deceitfulness. This behavior may include the following:

  • Lying

  • Theft

  • Shoplifting

  • Delinquency

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

  • Truancy (not going to school)

  • Running away

  • Pranks

  • Mischief

  • Very early sexual activity

The symptoms of conduct disorder may look like other medical conditions or behavioral problems. Always see your child's healthcare provider for a diagnosis.

How is conduct disorder diagnosed?

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

Conduct disorder often occurs along with other mental health disorders including:

  • Mood disorders

  • Anxiety disorders

  • Posttraumatic stress disorder

  • Substance abuse

  • ADHD (Attention-deficit/hyperactivity disorder)

  • Learning disorders

Early diagnosis and treatment is important. See your child's healthcare provider for more information.

Treatment for conduct disorder

Your child's healthcare provider will figure out the best treatment plan for your child based on:

  • How old your child is

  • Your child’s overall health and medical history

  • Extent of your child’s symptoms

  • How well your child handles certain medicines, treatments, or therapies

  • If your child’s condition is expected to get worse

  • The opinion of the healthcare providers involved in your child's care

  • Your opinion and preference

Treatment for conduct disorder 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. This is often focused on making changes within the family system, such as improving communication skills and family interactions.

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

  • Medicine. Medicine is not considered effective in treating conduct disorder. But it may be used if other symptoms or disorders are present and responsive to medicine.

Prevention of conduct disorder in childhood

Some experts believe that a developmental series of experiences occurs in the development of conduct disorder. This 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 believe that many factors influence conduct disorder including:

  • Child abuse

  • Genetic susceptibility

  • History of academic failure

  • Brain damage

  • A traumatic experience

Early detection and intervention into negative family and social experiences may be helpful. This may disrupt the series of experiences that leads to more disruptive and aggressive behaviors.

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