Conduct Disorders in Children and Adolescents
What Is Conduct Disorder?
Children with conduct disorder (CD) repeatedly violate the personal or property rights of others and the basic expectations of society. A diagnosis of conduct disorder is likely when symptoms continue for 6 months or longer. Conduct disorder is known as a "disruptive behavior disorder" because of its impact on children and their families, neighbors, and schools.
Another disruptive behavior disorder, called oppositional defiant disorder (ODD), may be a precursor of conduct disorder. A child is diagnosed with oppositional defiant disorder when he or she shows signs of being hostile and defiant for at least 6 months. Oppositional defiant disorder may start as early as the preschool years, while conduct disorder generally appears when children are older.
The differential diagnosis of conduct disorder includes oppositional defiant disorder, attention-deficit/hyperactivity disorder (ADHD), mood disorder and intermittent explosive disorder. There is a high degree of overlap among CD, ODD, and ADHD.
What Are the Signs of Conduct Disorder?
Some symptoms of conduct disorder include:
Children with conduct disorder or oppositional defiant disorder also may experience:
- Aggressive behavior that harms or threatens to harm other people or animals;
- Destructive behavior that damages or destroys property;
- Lying or theft; and
- Truancy or other serious violations of rules;
- Early tobacco, alcohol, and substance use and abuse; and
- Precocious sexual activity.
How Common is Conduct Disorder?
- Higher rates of depression, suicidal thoughts, suicide attempts, and suicide;
- Academic difficulties;
- Poor relationships with peers or adults;
- Sexually transmitted diseases;
- Difficulty staying in adoptive, foster, or group homes; and
- Higher rates of injuries, school expulsions, and problems with the law.
Conduct disorder affects 1 to 4 percent of 9- to 17-year-olds, depending on exactly how the disorder is defined. The disorder appears to be more common in boys than in girls and more common in cities than in rural areas.
Who Is at Risk?
Research shows that some cases of conduct disorder begin in early childhood, often by the preschool years. In fact, some infants who are especially "fussy" appear to be at risk for developing conduct disorder. Other factors that may make a child more likely to develop conduct disorder include:
What Help Is Available for Families?
- Early maternal rejection;
- Separation from parents, without an adequate alternative caregiver;
- Early institutionalization;
- Family neglect;
- Abuse or violence;
- Parental mental illness;
- Parental marital discord;
- Large family size;
- Crowding; and
Although conduct disorder is one of the most difficult behavior disorders to treat, young people often benefit from a range of services that include:
What Can Parents Do?
- Training for parents on how to handle child or adolescent behavior.
- Family therapy.
- Training in problem solving skills for children or adolescents.
- Community-based services that focus on the young person within the context of family and community influences.
Some child and adolescent behaviors are hard to change after they have become ingrained. Therefore, the earlier the conduct disorder is identified and treated, the better the chance for success. Most children or adolescents with conduct disorder are probably reacting to events and situations in their lives. Some recent studies have focused on promising ways to prevent conduct disorder among at-risk children and adolescents. In addition, more research is needed to determine if biology is a factor in conduct disorder.
Parents or other caregivers who notice signs of conduct disorder or oppositional defiant disorder in a child or adolescent should:
People who are not satisfied with the mental health services they receive should discuss their concerns with their provider, ask for more information, and/or seek help from other sources.
- Pay careful attention to the signs, try to understand the underlying reasons, and then try to improve the situation.
- If necessary, talk with a mental health or social services professional, such as a teacher, counselor, psychiatrist, or psychologist specializing in childhood and adolescent disorders.
- Get accurate information from libraries, hotlines, or other sources.
- Talk to other families in their communities.
- Find family network organizations.
Important Messages About Children's and Adolescents' Mental Health:
Source: Center for Mental Health Services
- Every child's mental health is important.
- Many children have mental health problems.
- These problems are real and painful and can be severe.
- Mental health problems can be recognized and treated.
- Caring families and communities working together can help.
Page last modified or reviewed on January 11, 2012