Conduct Disorder
A serious behavioral and emotional disorder characterized by a persistent pattern of behavior that violates the basic rights of others or major age-appropriate societal norms and rules. Includes aggression to people and animals, destruction of property, deceitfulness or theft, and serious rule violations.
Prevalence: 2-10% of population (varies by country, setting, assessment). More common in males (4:1 ratio). Higher in urban areas and low-income populations. One of most common reasons for mental health referral in children.
Common Symptoms
- Aggression toward people or animals
- Bullies, threatens, or intimidates others
- Initiates physical fights
- Used a weapon that can cause serious harm
- Physically cruel to people
- Physically cruel to animals
- Stolen while confronting victim (mugging, purse snatching, robbery)
- Forced someone into sexual activity
- Destruction of property deliberately
- Fire-setting with intent to cause damage
- Destroyed others' property
- Deceitfulness or theft
- Broken into someone's house, building, or car
- Lies to obtain goods or avoid obligations
- Stolen items of nontrivial value without confronting victim
- Serious violations of rules
- Stays out at night despite parental prohibitions (before age 13)
- Run away from home overnight at least twice
- Often truant from school (before age 13)
- Lacks empathy or remorse for behavior
- Callous/unemotional traits in some cases
Risk Factors
- History of oppositional defiant disorder or ADHD
- Family history of conduct problems or antisocial behavior
- Child abuse, neglect, or trauma
- Harsh, inconsistent, or lack of parenting
- Parental substance abuse or criminality
- Family conflict and domestic violence
- Early-onset aggressive behavior
- Peer rejection and association with deviant peers
- Male gender
- Low socioeconomic status
- Neighborhood violence and crime
- Academic failure
- Callous-unemotional traits
Treatment Approaches
- Multisystemic Therapy (MST) - Gold standard for serious CD
- Cognitive Behavioral Therapy (CBT) with anger management
- Parent Management Training (PMT)
- Functional Family Therapy
- Group therapy (with caution - can worsen if all deviant peers)
- Individual therapy
- Social skills training
- Problem-solving skills training
- School-based interventions and behavioral plans
- Medications: Treat comorbid conditions (ADHD, mood disorders)
- Atypical antipsychotics for severe aggression (short-term)
- Substance abuse treatment
- Residential treatment for severe cases
- Wraparound services
- Mentoring programs
- Intensive case management
- Early intervention critical for best outcomes
Self-Help & Natural Approaches
- Multisystemic Therapy (MST) - Evidence-based for serious cases
- Parent Management Training adapted for CD
- Consistent structure, rules, and consequences
- Close supervision to prevent antisocial behavior
- Positive reinforcement for prosocial behavior
- Mentoring programs (Big Brothers/Big Sisters)
- Teach empathy and perspective-taking
- Anger management and emotional regulation training
- Social skills training
- Problem-solving skills training
- School-based interventions
- Vocational training for older adolescents
- Recreational programs (sports, arts)
- Functional family therapy
- Avoid deviant peer groups
- Substance abuse treatment if present
- Address academic difficulties
- Community-based programs
- Restorative justice approaches
- Residential treatment for severe cases
When to Seek Professional Help
- Any aggressive or violent behavior toward people or animals
- Fire-setting or property destruction
- Stealing or breaking the law
- Running away from home
- Truancy from school
- Gang involvement or delinquent peer association
- Substance use
- Sexual aggression or inappropriate behavior
- Weapons possession or use
- Lack of remorse for harmful actions
- Family cannot manage behavior safely
- Risk to self or others
- Legal involvement or arrest
Crisis Resources
- Emergency: 911 if immediate danger to self or others
- 988 Suicide & Crisis Lifeline
- Crisis Text Line: Text HELLO to 741741
- NAMI HelpLine: 1-800-950-6264
- SAMHSA National Helpline: 1-800-662-4357
- Juvenile Justice system for legal issues
- Local mental health crisis services
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.