Conduct Disorder: Definition, Symptoms, & Treatments

What Is Conduct Disorder?

Conduct disorder is a mental health condition where a child or adolescent displays a consistent pattern of behavior that breaks with the standard rules of behavior and restricts the rights of others. Conduct disorder symptoms may develop over time, but they will clearly affect the individual and those around them.¹

How Common Is Conduct Disorder?

According to recent statistics, conduct disorder affects between 2% and 10% of children in the United States. Other research suggests that this rate may be as high as 16%. Additionally, conduct disorder is more common in males than females, as prevalence rates for males vary from 6% to 16% while only between 2% and 9% of females meet diagnosis.¹

Conduct Disorder Vs. Personality Disorders

Conduct disorder is a childhood condition that is strongly associated with personality disorders. Since there is no conduct disorder in adults, children who have conduct disorder typically transition into adults that have antisocial personality disorder.¹

Symptoms of Conduct Disorder

Conduct disorder symptoms vary depending on the severity of presentation and age of the child or teen, but common symptoms of conduct disorder include anger, rage, low self-esteem, irritability, and difficulty feeling remorse.

Symptoms of conduct disorder may include:^1,2

• Tantrums, losing composure easily
• Hostility and aggression
• Pathological lying
• Running away from home
• Delinquency
• Sexual abuse/assault
• Manipulation of others for personal gain
• Intentional violation of others’ rights
• Substance abuse

Outward Signs of Conduct Disorder

A child or teen with conduct disorder will exhibit troubling behaviors that draw negative attention from family members, school authorities, and law enforcement. They will frequently experience recurring troubles at home, school, and in most aspects of their life.

Children diagnosed with conduct disorder will display hostility and aggression towards others, commonly resulting in bullying or fighting their peers. Additionally, many will frequently manipulate people for personal gain, exhibiting cunning and deceitful behaviors to do so.

Signs of conduct disorder in children may include:

• Bullying peers or threatening violence
• Cruelty toward animals
• Stealing
• Destroying property
• Arson or purposefully setting fires
• Purposefully breaking rules and curfew
• Trespassing for no apparent reason
• Acts of vandalism
• Obtaining or wielding weapons

What Causes Childhood Conduct Disorder?

Conduct disorder is caused by a combination of biological and environmental factors that differ among individuals. The use of authoritarian parenting (high-discipline, low-affection parenting) or permissive parenting styles correlate with an increased risk of conduct disorder development. Traumatic experiences and generational trauma are also commonly linked with childhood conduct disorders.

Possible causes and risk factors for conduct disorder in children include:^1,3

• Male gender
• Parents who misuse drugs and alcohol
• Brain injury, impaired frontal lobe, or neurological abnormality
• Co-occurring substance misuse or mental illness
• Genetic factors
• Having a family member diagnosed with a mental illness
• Dysfunctional family life
• Childhood abuse and neglect
• Growing up or living in poverty
• Not being accepted by peer groups, social rejection
• Lack of or difficulty with moral awareness
• Low empathy or callousness
• Experiencing trauma
• Exposure to gang activity or violence
• Delinquency in peers
• Inconsistent discipline
• Authoritarian or permissive parenting styles

How Is Conduct Disorder Diagnosed?

Conduct disorder is diagnosed by a mental health care professional or medical provider. A child or teen will likely be referred for evaluation to seek remedy for any disturbance or conduct problems by authority figures in their life. A provider will use the DSM criteria for conduct disorder and clinical interviews to assess if a child’s behavior meets diagnosis.

A diagnosis may also include observing the child in their natural environment as well as the interviewing of parents, family members, and teachers. They will review the child’s behavior across different settings and contexts to look for variations in behavior.

Treatment of Conduct Disorder

The treatment for conduct disorder is an intense and ongoing course that involves the individual, the family, and a host of mental health professionals. The best treatment for conduct disorder requires patience and consistency as interventions and therapy for conduct disorder may not always yield immediately positive results.

Here are several treatment options for childhood conduct disorder:

• Family therapy: Family interventions can help the adults involved learn helpful ways of interacting and engaging with the child. With strong interventions, they may be able to manage some unwanted behaviors.
• Cognitive behavioral therapy (CBT): CBT for conduct disorder involves teaching the person how their thoughts, feelings, and behaviors are interconnected. By recognizing unwanted feelings, they could shift their thoughts and behaviors to produce better results.
• Group therapy: Group therapy for people with conduct disorder may be beneficial, but must be used cautiously. At times, people with similar personality issues could see symptoms worsen in a group therapy format.
• Parent management training: Like with family therapy, parent management training can focus on giving parents the skills needed to minimize the underwanted actions of conduct disorder.
• Multisystemic therapy: Multisystemic therapy is a specific form of family therapy that investigates how interactions in the family result in symptoms of conduct disorder.
• Community-based approaches: Community-based treatment for conduct disorder can involve mental health professionals engaging with the child in the community to practice appropriate, prosocial behaviors in public.
• Medications: Although there are no medications specifically for the condition, medication for conduct disorder could help manage behavioral symptoms, like impulsivity and hyperactivity, while addressing any mood-related symptoms.

Helping Your Child Cope With Conduct Disorder

Supporting your child or teen with conduct disorder can be challenging and exhausting. However, there are strategies that can help improve daily life for the child and family members and improve long-term positive outcomes.

Below are tips for helping your child if they have been diagnosed with conduct disorder:

• Learn more about their diagnosis: Learning about someone’s condition can be a great way to add insight and understanding. Doing so can help align your expectations and goals.
• Support them through treatment: Someone with conduct disorder may reject treatment and have a hard time changing their behavior, so they will need someone by their side to assist along the way.
• Join a parental support group: Having a child with conduct disorder is a stressful situation, but assistance is available through support groups, available online or in person.
• Build your social network: Speaking of online support, building a support network online of parents of people with conduct disorder can offer connections and helpful tools to make the situation as successful as possible.
• Praise positive behavior: Telling your child something as simple as, “Thank you for making your bed today,” reinforces positive behavior and lets them know you are paying attention to their efforts in improving.
• Set and maintain boundaries: Once boundaries are set, stick to them. Be clear and consistent with rules in your home and avoid power struggles.
• Assign chores to teach responsibility: Assign chores and age-appropriate tasks to your child. This will help them feel responsible and develop a sense of agency.
• Set a positive example for your child: Model the behaviors you want to see in your child. Interacting and behaving in a prosocial way is one way to start. Modeling is a powerful form of learning, especially in your child’s formative years.
• Establish a routine: Creating a consistent schedule for your child or teen will help foster stability and structure in the household and in their daily life.
• Spend time with your child: Spend meaningful time together. Engage your child in conversations. Listen to your child and engage in activities with them. Show them that they matter!
• Focus on communication: Get everyone in the family on the same page. As the restructuring of your household occurs, make sure everyone participates to avoid reverting back to prior ineffective family dynamics.
• Remember to stay patient: The process of change won’t happen overnight. Think of this process as a marathon and not a sprint.

Final Thoughts

Although conduct disorder is a condition with a challenging future, there are many tools and treatments a person can explore to help themselves or their loved ones. This condition may require lifelong treatment from professionals to limit the negative influence on life, but treatment can make a positive impact.