What is conduct disorder?

Children with conduct disorder repeatedly break the rules of society for a year or longer. They ignore the personal and property rights of others. They may lie, steal, set fires, run away from home, be cruel to animals and people, and defy authority.

What is the cause?

The cause of conduct disorder is unknown. It seems to occur more in some families. Many times, environment is a factor. A child may imitate physical or verbal abuse seen within the family. Watching violent TV shows and movies may teach children that violence is okay.

Factors that appear to increase the risk of developing this disorder include:

• Brain injury
• Inconsistent or poor parenting
• Neglect
• Abuse
• Hanging out with friends who misbehave

What are the symptoms?

Symptoms may include:

Aggression to people and animals

• Often bullies, threatens, or intimidates others
• Often starts physical fights
• Has used a weapon that can cause serious physical harm to others (a bat, brick, broken bottle, knife, gun)
• Is physically cruel to animals or people
• Has stolen while face-to-face with a victim (mugging, purse snatching, extortion, armed robbery)

Destruction of property

• Has deliberately destroyed other’s property
• Has deliberately set fires with the intention to cause serious damage

Deceitfulness or theft

• Has broken into someone else’s house, building or car
• Often lies to obtain goods or favors or to avoid work
• Has stolen items (shoplifting, forgery)

Serious violations of rules

• Often stays out at night without parents’ permission, beginning before 13 years of age
• Has run away from home overnight at least twice without returning home for a lengthy period
• Often skips school before age 13

Children with conduct disorder often have other problems as well. These may include:

• Hyperactivity
• Depression
• Learning disabilities
• Problems in peer relationships

Some children with conduct disorder have other mental disorders such as depression, anxiety, ADHD, or bipolar disorder.

How is it diagnosed?

The healthcare provider will do a physical exam and ask about the child’s symptoms and behavior. Medical tests and a psychological evaluation may be done. Diagnosis of conduct disorder is made only after other conditions are ruled out.

How is it treated?

It is usually best to use several different approaches to treat conduct disorder.

• Medicines may be prescribed if the child is depressed, hyperactive, anxious, or violent.
• Parents should be counseled on how to set limits with their child and be consistent and realistic when disciplining.
• Behavioral therapy can help a child learn to control his anger and develop new coping skills.
• Group therapy can help teach social skills, such as controlling anger impulses. It may help teach the child how to cooperate with others.
• Some children with this disorder need to spend time in special schools and residential facilities.

About half of the children with this disorder “grow out of it” by adulthood. The others often have problems as adults. These problems may include criminal behavior, aggression, and trouble holding a job.

How can I help my child?

Learn as much as you can about the conduct disorder. It is very important to be involved with your child in the treatment. Parents or other caregivers still remain the strongest influence on the child. They need to develop skills to control the child’s behavior and shape his or her future behavior.