Conduct disorder (CD) is a mental health condition that involves a consistent pattern of aggressive and disobedient behaviors. It affects children and teens and is treatable with various forms of psychotherapy (talk therapy).
Conduct disorder (CD) is a mental health condition that affects children and teens that’s characterized by a consistent pattern of aggressive behaviors and actions that harm the well-being of others. Children with conduct disorder also often violate rules and societal norms.
Conduct disorder lies on a spectrum of disruptive behavioral disorders, which also includes oppositional defiant disorder (ODD). In some cases, ODD leads to CD.
Conduct disorder often occurs alongside other psychiatric conditions, including:
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A personality disorder is a mental health condition that involves long-lasting, disruptive patterns of thinking, behavior, mood and relating to others. Most personality disorders begin in the teen years when personality further develops and matures. As a result, almost all people diagnosed with personality disorders are above the age of 18.
One exception to this is antisocial personality disorder (ASPD) — approximately 80% of people with this disorder will have started to show symptoms by the age of 11.
There’s not much difference between conduct disorder (CD) and ASPD, but CD is typically diagnosed in children. If an adult meets the criteria for both conditions, then a mental health professional would give them a diagnosis of ASPD instead of CD.
Conduct disorder affects children and adolescents. It can have early onset before age 10, but commonly develops in adolescence (between ages 10 years to 19 years).
The condition is more common in children assigned male at birth (AMAB) than children assigned female at birth (AFAB). The average age of presentation is 10 years to 12 years in children AMAB and 14 years to 16 years in children AFAB.
Conduct disorder affects anywhere between 2% and 10% of children and adolescents in the United States.
Characteristic behaviors of conduct disorder develop gradually over time. Children with conduct disorder tend to be impulsive and difficult to manage. They don’t seem to be concerned about the feelings of other people.
The four core behaviors of conduct disorder include:
Signs of aggressive behavior toward others include:
Signs of the destruction of property include:
Signs of deceiving, lying and stealing include:
Signs of violations of rules include:
Other common signs of conduct disorder include:
It’s important to note that occasional rebellious behavior is common during childhood and adolescence. The signs and symptoms that lead to the diagnosis of conduct disorder demonstrate a disruptive and repetitive pattern.
Adults who have conduct disorder may have difficulty keeping a job or maintaining relationships. They may be prone to illegal or dangerous behavior.
Symptoms of conduct disorder in an adult may be diagnosed as antisocial personality disorder.
Researchers aren’t sure what exactly causes conduct disorder (CD), but they think it’s a complex combination of genetic/biological and environmental factors.
Parental, familial and environmental factors:
It’s important to note that conduct disorder can occur in children from high-functioning, healthy families.
A mental health professional diagnoses conduct disorder using criteria provided in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.
They diagnose conduct disorder in children or adolescents who’ve demonstrated three or more of the following behaviors in the previous 12 months, in addition to at least one in the previous six months:
These behaviors must be significant enough to impair functioning in relationships, at home, at school and/or at work.
Your child will likely need to see a child and adolescent psychologist or psychiatrist if they’re showing signs of conduct disorder. These mental health professionals use specially designed interview and assessment tools to evaluate a child for a mental health condition.
Psychologists and psychiatrists often rely on reports from the child’s parents, siblings, friends and teachers to get a full understanding of the child’s behavior.
The go-to treatment for conduct disorder (CD) is multiple forms of psychotherapy (talk therapy) for your child and family, as well as community-based treatment.
Healthcare providers typically don’t use medication to directly treat conduct disorder, but as other mental health conditions often occur alongside conduct disorder, your child may benefit from medication to manage these conditions.
At this time, there’s no known way to prevent conduct disorder, as it’s likely caused by a complex combination of factors, but many of the related problems might be lessened with treatment. Seeking help as soon as symptoms appear can help decrease the disruption to your child’s life, family and friendships.
The prognosis (outlook) for conduct disorder depends on how early the condition developed and if it was treated.
Usually, the disruptive behaviors of conduct stop during early adulthood, but in about one-third of cases, they continue. Many of these cases meet the criteria for antisocial personality disorder.
Early onset of the condition (before 10 years of age) is associated with a poorer prognosis and is strongly associated with a significant decline in school performance.
Some children and adolescents with conduct disorder develop other mental health conditions, including:
Depression and bipolar disorder may also develop in the teen years and early adulthood. Suicidal ideation can be a complication of these conditions. It’s important to get your child immediate medical care if they’re talking about or threatening suicide.
If your child has conduct disorder, aside from getting them professional care, you can help them and yourself in the following ways:
If your child has been diagnosed with conduct disorder, and their behavior becomes more severe or further disrupts family or school life, talk to their mental health provider.
If your child displays behavior that harms or endangers others, such as other people or animals, or themselves, it’s important to get them immediate medical care.
A note from Cleveland Clinic
Children and teens who are disobedient or aggressive can be very challenging for parents. While it’s normal for young children and teens to show defiant behavior from time to time, frequent and disruptive aggressive behavior may indicate conduct disorder (CD).
Starting treatment early for conduct disorder is important, and the first step to treatment is to talk with a healthcare provider or a mental health provider. Don’t be afraid to ask your provider questions. They’re available to help.
Last reviewed by a Cleveland Clinic medical professional on 08/04/2022.
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