What is conduct disorder (CD)?

Conduct disorder is a behavior disorder, sometimes diagnosed in childhood, that is characterized by antisocial behaviors which violate the rights of others and age-appropriate social standards and rules. Antisocial behaviors may include irresponsibility, delinquent behaviors (such as truancy or running away), violating the rights of others (such as  theft), and/or physical aggression toward others (such as assault or rape). These behaviors sometimes occur together; however, one or several may occur without the other(s).

What causes conduct disorder?

The conditions that contribute to the development of conduct disorder are considered to be multifactorial, with many factors (multifactorial) contributing to the cause. Neuropsychological testing has shown that children and adolescents with conduct disorders seem to have an impairment in the frontal lobe of the brain that interferes with their ability to plan, avoid harm, and learn from negative experiences. Childhood temperament is considered to have a genetic basis. Children or adolescents who are considered to have a difficult temperament are more likely to develop behavior problems. Children or adolescents from disadvantaged, dysfunctional, and disorganized home environments are more likely to develop conduct disorders. Social problems and peer group rejection have been found to contribute to delinquency. Low socioeconomic status has been associated with conduct disorders. Children and adolescents exhibiting 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 adolescents interact with other people.

Who is affected by conduct disorder?

According to the American Academy of Family Physicians, approximately 6 to 16 percent of boys and 2 to 9 percent of girls may be classified as having 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 be a contributing factor to the development of the conduct disorder. The prevalence of conduct disorders has increased over recent decades. Aggressive behavior is the reason for one-third to one-half of the referrals made to child and adolescent mental health services.

What are the symptoms of conduct disorder?

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

The following are the most common symptoms of conduct disorder. However, each child may experience symptoms differently. The four main groups of behaviors include the following:

  • Aggressive conduct. Aggressive conduct 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(s)

    • Forcing someone into sexual activity, rape, molestation

  • Destructive conduct. Destructive conduct may include the following:

    • Vandalism; intentional destruction to property

    • Arson

  • Deceitfulness. Deceitful 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 (failure to attend school)

    • Running away

    • Pranks

    • Mischief

    • Very early sexual activity