Conduct Disorder

What Is Conduct Disorder?

Conduct disorder is a serious impulse control disorder that affects the emotions and behavior of children and teens. Adolescents with conduct disorder typically display disruptive, aggressive, and sometimes violent behavior that can continue into adulthood.

While it’s normal for children and teens to have episodes of rebellious behavior or rule-breaking, the behavior caused by conduct disorder is far more serious. Children with conduct disorder will often engage in actions that violate others’ rights, destroy property, and disrupt school and home life.

While conduct disorder can have an early onset before age 10, the condition typically develops between ages 10 to 19.

Conduct Disorder VS Autism Spectrum Disorder

Although conduct disorder and autism spectrum disorder may share some traits, the two conditions are very different from one another.

Autism spectrum disorder is a neurological and developmental disorder that affects how people interact with others, communicate, learn, and behave.

Conduct disorder, on the other hand, is an impulse control disorder that features behavioral and emotional problems characterized by a disregard for others. In some cases, children with autism may have co-occurring conduct disorder and vice versa.

What Does Conduct Disorder Turn Into in Adults?

If symptoms of conduct disorder persist into adulthood, the individual is almost always diagnosed with a personality disorder.

In many cases, adults with adolescent-onset conduct disorder symptoms will be diagnosed with antisocial personality disorder (ASPD), as the two conditions have virtually the same symptoms.

80% of people with this antisocial personality disorder will start to show symptoms by 11 years of age. However, not all children with conduct disorder will receive an ASPD diagnosis, depending on the child’s upbringing and treatment plan.

Other Impulse Control Disorders

Conduct disorder is one of five impulse control disorders described in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, fifth edition). Impulse control disorders are a group of disorders defined by urges and behaviors that are excessive and/or harmful to oneself or others.

Impulse control disorders can cause significant impairment in social and occupational functioning and lead to many legal and financial difficulties.

Conduct disorder is included in the spectrum of disruptive behavioral disorders. Disruptive behavioral disorders also include oppositional defiant disorder. In some cases, oppositional defiant disorder can lead to conduct disorder.

The five impulse control disorders currently recognized in the DSM-5 include:

• Kleptomania: compulsive urge to steal items
• Pyromania: compulsive urge to set fires
• Conduct disorder: aggressive, violent, and rule-breaking behavior
• Oppositional defiant disorder (ODD): defiant and sometimes hostile behavior toward people in authority
• Intermittent explosive disorder (IED): frequent impulsive outbursts of anger or aggression that cause extreme distress

Symptoms of Conduct Disorder

Conduct disorder causes antisocial behavior, meaning behaviors that violate social norms. These conduct problems arise in adolescence and are often aggressive and violent.

Common symptoms of conduct disorder include:

• Aggressive behavior problems towards people or animals, often violating the rights of others
• Getting into verbal and physical fights
• Consistently skipping school (truancy), running away, playing harmful pranks, or being sexually active at a very young age
• Repeated lying, shoplifting, or breaking into homes or cars to steal
• Vandalism or destruction of property
• Arson or fire-setting
• Consistent deceitfulness and/or stealing
• Engaging in substance use at a young age
• Forcing another person into unwanted sexual activity
• Serious violations of rules
• Blaming others for their behavior

Conduct Disorder and Addiction

Substance use disorder and conduct disorder often co-occur. Young people with conduct disorder frequently engage in substance abuse, especially with alcohol.

Children and teens with conduct disorder are more likely to abuse substances to defy rules and cope with symptoms of co-occurring mental illnesses.

Conduct Disorder Causes and Risk Factors

Conduct disorder can lead to potentially dangerous outcomes if not addressed and treated. Therefore, understanding the causes and risk factors of developing conduct disorder can lead to faster diagnosis and treatment.

What Causes Conduct Disorder?

Mental health professionals have not identified the exact cause of conduct disorder. However, it is believed that a complex combination of genetic, biological, and environmental factors may cause conduct disorder.

Common genetic and biological factors associated with conduct disorder include:

• High levels of testosterone, which contributes to aggression
• Seizures, traumatic brain injury, and neurological damage
• Family history of impulse control disorders, addiction, attention deficit hyperactivity disorder (ADHD), mood disorders, schizophrenia, or antisocial personality disorder

Common environmental factors associated with conduct disorder include:

• Parents who engage in substance abuse and antisocial behaviors such as child abuse, stealing, lying, and hurting others
• Chaotic, neglectful, and abusive upbringing
• Living in low social and economic communities affected by economic and social stress

Risk Factors for Conduct Disorder

According to the Centers for Disease Control (CDC), an estimated 3% of children and teens in the United States have conduct disorder. Conduct disorder is twice as common among males than females and tends to be more common among children with ADHD.

Common risk factors for developing conduct disorder include:

• Being male
• Family history of antisocial behavior, anger management issues, addiction, and mental health conditions
• Being abused as a child
• Having common comorbid disorders such as ADHD, bipolar disorder, anxiety disorders, and learning disabilities

Diagnosis of Conduct Disorder

To receive a conduct disorder diagnosis, a mental health professional must evaluate the child and their parents or caregivers. A therapist or psychologist will interview the child and members of their family to get a clear picture of their symptoms and risk factors.

Using the DSM-5 diagnostic criteria, the provider will rule out other mental health conditions and determine if the patient meets the requirements for a conduct disorder diagnosis. Once a diagnosis is obtained, your provider will recommend a treatment plan.

Treatment for Conduct Disorder

Treatment options for conduct disorder often include psychotherapy and, in some cases, medications to address symptoms of co-occurring disorders.

Psychotherapy for conduct disorder often includes one-on-one sessions with the child and family therapy to address the child’s behavior.

Early intervention and therapies that involve the whole family are the best way to prevent adolescents from getting into serious trouble that follows them into adulthood.

Common types of therapy used to treat conduct disorder include:

• Cognitive behavioral therapy helps patients identify and address problematic behaviors
• Parent management training helps by training parents to alter their child’s behavior in the home
• Multisystemic therapy helps parents and caregivers institute positive coping activities that increase accountability and problem-solving for all family members

Long-Term Effects of Untreated Conduct Disorder

If conduct disorder is left untreated, aggressive and rule-breaking behavior will likely escalate. Should their symptoms persist into adulthood, patients with conduct disorder will likely obtain a personality disorder diagnosis like antisocial personality disorder.

The risk of harming other people and property increases as their behavior worsens. Many untreated children with conduct disorder will face serious legal consequences, including arrests, convictions, and jail or prison time.

Find Support and Treatment for Conduct Disorder

Raising a child with conduct disorder can be incredibly challenging, causing you to feel powerless and alone as you try to manage their disruptive behavior. However, some adolescent psychiatry experts are ready to help you find solutions.

You can start by speaking with your doctor about your child’s symptoms and learning what treatment options are available to you and your family.

If you’re unsure what providers are in your area, use SAMHSA’s online treatment locator or call 1-800-662-4357 (HELP) to get a list of local mental health providers.