Conduct disorder

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Conduct Disorder: A simple guide

Conduct disorder (CD) is a mental health condition diagnosed in children or teens. It means a lasting pattern of behavior that shows a serious disregard for the rights of others or for age-appropriate rules. People with CD may act aggressively, lie, steal, bully, or destroy property. They may have trouble at school and with family.

What are the symptoms?
- Aggression to people or animals
- Destruction of property
- Deceit or theft
- Serious violations of rules (like truancy or running away)
- The behavior often comes with a lack of empathy or remorse and ongoing trouble keeping to rules

Two common patterns
- Childhood-onset CD: signs appear before age 10 and tend to be more persistent and severe, with more ADHD symptoms and family stress.
- Adolescent-onset CD: signs appear after age 10 and are usually less severe; some cases improve over time and may reflect typical teenage rebellion.

Causes and risk factors
- CD results from a mix of biology and environment: genetics, brain development, family life.
- Risk factors include ADHD, learning problems, a history of abuse or neglect, poverty, family conflict, and associating with deviant peers.
- CD often co-occurs with other problems like substance use. Some youths with CD may be at higher risk for antisocial personality disorder in adulthood if not treated.

Diagnosis and treatment
- CD is diagnosed based on a pattern of behaviors that lasts over time and starts before age 18 (adult antisocial personality disorder criteria differ).
- Treatment usually starts with psychotherapy and behavior management, including training for parents and coordination with school and family to help the child learn new skills.
- Medications are not specifically approved for CD, but may be used to help with aggression or irritability in some cases (for example, risperidone or certain antidepressants).
- Evidence shows that programs linking parent and child work best, especially for younger children. Benefits for older teens are smaller.

Outlook and prevention
- About a quarter to two-fifths of youths with CD may develop antisocial personality disorder as adults, but many others continue to have challenges.
- Early, comprehensive treatment and supportive family and school environments can improve outcomes.
- Prevention programs that support families, schools, and communities can help reduce risk.

Who is affected
- CD affects about 1–10% of children; higher rates are seen in youth in detention facilities.
- More boys are diagnosed than girls, though girls may show different patterns of behavior.
- Race differences in diagnosis exist in some studies, influenced by how behavior is observed and judged.

If you or someone you know shows signs of Conduct Disorder, a healthcare professional can help with a plan that fits the child’s needs.