Last reviewed:
14th Nov 2022
PharmD, BCPS
Conduct disorder is a disruptive behavior disorder associated with aggression toward others and frequent violation of rules. It is treated with individual and family therapy, and patients may also take medication to treat co-occurring disorders, such as attention deficit hyperactivity disorder (ADHD), depression, or bipolar disorder [1].
Conduct disorder is a behavioral disorder in which a person repeatedly violates the rights of others and fails to follow age-appropriate social norms or rules. This disorder is diagnosed in children and adolescents [2].
Youth with conduct disorder engage in antisocial behaviors like destroying property, harming people or animals, and violating laws, which could include shoplifting or becoming truant from school. In addition, a child with conduct disorder may also display a lack of empathy and remorse when engaging in destructive behaviors or harming others [2].
There is not one single contributing factor that leads a child to develop conduct disorder. Instead, a combination of risk factors increases the likelihood of someone developing this condition.
The following factors increase the risk of conduct disorder in children [1]:
Children and adolescents with conduct disorder demonstrate symptoms related to disregard for the rights of others, as well as a lack of regard for rules and social norms. Some signs of the condition are as follows [2]:
Conduct disorder is diagnosed using criteria in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM 5). A clinician, such as a clinical social worker, psychologist, or psychiatrist, will review symptoms with the child and caregiver and examine the child’s medical and social history to make a diagnosis of conduct disorder. In addition, the clinician will ask a parent or caregiver about the onset and history of symptoms, and gather information about any stressors in the child or family’s life [1].
A clinician will perform a full psychiatric evaluation to determine if a child has coexisting conditions, such as ADHD. Ideally, they will gather information from the child’s school and determine if the child has a learning disability or cognitive delay that may contribute to symptoms. The clinician will also rule out alternative explanations for disruptive behavior, such as a mood disorder or psychotic episode [1].
Ultimately, a diagnosis is made if other explanations are ruled out and the child meets the following DSM 5 criteria [2]:
Beyond these general diagnostic criteria, there are specifiers associated with a conduct disorder diagnosis [2]:
There is no definitive cause of conduct disorder. Instead, medical research points to factors correlated with conduct disorder and therefore increases the risk that a child will develop this condition. Often, it is a combination of genetic and environmental factors that leads to the development of conduct disorder [3].
A study on genetic factors linked to conduct disorder found that genetics contribute moderately to the development of the condition. Some specific genes may be linked to conduct disorder, but the condition seems to develop due to environmental influences and genetic risk factors. There is evidence that children with a genetic risk of conduct disorder may be more likely to place themselves in risky environments, which affects the development of the condition [3].
A second study that evaluated environmental risk factors for conduct disorder found that the following factors are strongly linked to the development of conduct disorder [4]:
Study authors noted that while the above factors increase the conduct disorder risk, there is not enough evidence to say that these factors directly cause a child to develop conduct disorder [4].
There is no surefire way to prevent conduct disorder. However, some evidence suggests that affectionate parenting, positive role models, and developing healthy emotional regulation skills can be protective against conduct disorder [1].
Early intervention and treatment can also be helpful. Children must receive treatment for trauma and other neurological disorders, like ADHD, associated with conduct disorder [1]. One recent study found that a school-based training program effectively reduced children’s emotional callousness, impulsivity, and conduct disorder symptoms [5].
Given that there is no exact cause of conduct disorder, it is impossible to prevent every case of it; however, there are steps that parents and caregivers can take to reduce risk factors.
Conduct disorder is often treated with psychosocial interventions, including various counseling or therapy techniques. Some common therapies used to treat conduct disorder are described below:
Living with a child with conduct disorder can create stress for parents, so it’s important to practice self-care and take steps to manage the condition effectively. The following tips can help you learn to live with a child who has conduct disorder:
The answers to the following questions provide additional information about conduct disorder:
The length that conduct disorder symptoms last can vary widely from person to person. The length of symptoms will depend upon the disorder’s severity and whether or not a child receives treatment. Early identification and treatment can reduce the duration of conduct disorder symptoms.
Conduct disorder is generally diagnosed in children, whereas antisocial personality disorder is diagnosed in adults. Research suggests that as high as 50% of children with conduct disorder will develop antisocial personality disorder as adults [8]. While the diagnostic criteria for conduct disorder include a specification of either childhood or adolescent onset [2], the criteria for antisocial personality disorder state that a person cannot be diagnosed before age 18 [9].
Symptoms of antisocial personality disorder include impulsivity, failing to comply with laws or social norms, showing a lack of remorse for hurting others, irresponsibility, lying or conning others, disregarding the safety of other people, and aggressive behavior that leads to physical fights. In addition, a person with antisocial personality disorder must have a history of conduct disorder with onset before age 15 [9]. In summary, conduct disorder and antisocial personality disorder appear similar, but conduct disorder is diagnosed in children, whereas antisocial personality disorder is diagnosed in adults.
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