Conduct Disorder | American Academy of Child & Adolescent Psychiatry

Conduct Disorder

No. 33; Updated May 2012
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"Conduct disorder" refers to a group of behavioral and emotional problems in youngsters. Children and adolescents with this disorder have great difficulty following rules and behaving in a socially acceptable way. They are often viewed by other children, adults and social agencies as "bad" or delinquent, rather than mentally ill. Many factors may contribute to a child developing conduct disorder, including brain damage, child abuse or neglect, genetic vulnerability, school failure, and traumatic life experiences.

Children or adolescents with conduct disorder may exhibit some of the following behaviors:

Aggression to people and animals

bullies, threatens or intimidates others
often initiates physical fights
has used a weapon that could cause serious physical harm to others (e.g. a bat, brick, broken bottle, knife or gun)
is physically cruel to people or animals
steals from a victim while confronting them (e.g. assault)
forces someone into sexual activity

Destruction of Property

deliberately engaged in fire setting with the intention to cause damage
deliberately destroys other's property

Deceitfulness, lying, or stealing

has broken into someone else's building, house, or car
lies to obtain goods, or favors or to avoid obligations
steals items without confronting a victim (e.g. shoplifting, but without breaking and entering)

Serious violations of rules

often stays out at night despite parental objections
runs away from home
often truant from school

Children who exhibit these behaviors should receive a comprehensive evaluation by an experience mental health professional. Many children with a conduct disorder may have coexisting conditions such as mood disorders, anxiety, PTSD, substance abuse, ADHD, learning problems, or thought disorders which can also be treated. Research shows that youngsters with conduct disorder are likely to have ongoing problems if they and their families do not receive early and comprehensive treatment. Without treatment, many youngsters with conduct disorder are unable to adapt to the demands of adulthood and continue to have problems with relationships and holding a job. They often break laws or behave in an antisocial manner.

Treatment of children with conduct disorder can be complex and challenging. Treatment can be provided in a variety of different settings depending on the severity of the behaviors. Adding to the challenge of treatment are the child's uncooperative attitude, fear and distrust of adults. In developing a comprehensive treatment plan, a child and adolescent psychiatrist may use information from the child, family, teachers, community (including the legal system) and other medical specialties to understand the causes of the disorder.

Behavior therapy and psychotherapy are usually necessary to help the child appropriately express and control anger. Special education may be needed for youngsters with learning disabilities. Parents often need expert assistance in devising and carrying out special management and educational programs in the home and at school. Home-based treatment programs such as Multisystemic Therapy are effective for helping both the child and family.Treatment may also include medication in some youngsters, such as those with difficulty paying attention, impulse problems, or those with depression.

Treatment is rarely brief since establishing new attitudes and behavior patterns takes time. However, early treatment offers a child a better chance for considerable improvement and hope for a more successful future.

For additional information see Facts for Families:
#3 Teens: Alcohol and Other Drugs
#55 Understanding Violent Behavior in Children and Adolescents
#72 Children with Oppositional Defiant Disorder
#6 Children Who Can't Pay Attention
#12 Children Who Steal
#38 Bipolar Disorder in Children and Teens
#80 Bullying
# 81 Fighting and Biting
#00 Definition of a Child and Adolescent Psychiatrist

See also: Your Child (1998 Harper Collins) / Your Adolescent (1999 Harper Collins)

Click here to order Your Child from Harper Collins
Click here to order Your Adolescent from Harper Collins

Excerpts from Your Child on Conduct Disorders

Children misbehave for a variety of different reasons. Perhaps they don’t understand the rules, they feel they need to assert their own autonomy, or maybe they wish to test the limits imposed on them. However, some children misbehave because they are experiencing internal distress: anger, frustration, disappointment, anxiety, or sorrow. The younger a child is, the more likely he is to call attention to his distress through his behavior. As a child matures, however, there is an expectation that he will be increasingly able to resolve much of his distress on his own and will express his feelings through words rather than outwardly directed misbehavior.

There are also children, however, whose behavior is consistently troubling to others. In these cases, the children’s behaviors are outside of the range of what is considered normal or acceptable for their level of development. Perhaps most alarming is that many of these children show little remorse, guilt, or understanding of the damage and the pain inflicted by their behavior.

Click here for more on Conduct Disorder from Your Child

Click here to order Your Child

Excerpts from Your Adolescent on Conduct Disorders

By the time a person reaches adolescence, she likely knows what type of behavior is expected of her and which behaviors are unacceptable. Yet all teenagers misbehave from time to time, for a variety of reasons. Perhaps they feel that they need to assert their own autonomy. Maybe they wish to test the limits imposed on them. Teenagers sometimes misbehave because they are experiencing internal distress: anger, frustration, disappointment, anxiety, or hopelessness.

There are also teenagers whose behavior is consistently troubling to others. In these cases, the teen’s behavior is clearly outside the range of what is considered normal or acceptable. Perhaps most alarming is that many of these teenagers show little remorse, guilt, or understanding of the damage and the pain inflicted by their behavior.

Additional information can be found on Identifying the Signs, Causes and Consequences, and How to Respond.

Click here for more on Conduct Disorder from Your Adolescent

Click here to order Your Adolescent

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The American Academy of Child and Adolescent Psychiatry (AACAP) represents over 8,500 child and adolescent psychiatrists who are physicians with at least five years of additional training beyond medical school in general (adult) and child and adolescent psychiatry.

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