A conduct disorder involves a repetitive pattern of behavior that violates the basic rights of others.
Children with a conduct disorder are selfish and insensitive to the feelings of others and may bully, damage property, lie, or steal without guilt.
Doctors base the diagnosis on the history of the child’s behavior.
Psychotherapy may help, but separating children from an at-risk environment and providing a strictly structured setting, as in a mental health facility, may be the most effective treatment.
Normal behavior in children varies. Some children are better behaved than others. Conduct disorder is diagnosed only when children repeatedly and persistently violate rules and the rights of others in ways inappropriate for their age.
Conduct disorder usually begins during late childhood or early adolescence and is much more common among boys than girls.
Heredity and the environment probably influence the development of a conduct disorder. Children often have parents who have a mental health disorder, such as a substance use disorder, attention-deficit/hyperactivity disorder, a mood disorder, schizophrenia, or antisocial personality disorder. However, children from healthy families that function well may also develop conduct disorder.
Symptoms of Conduct Disorder
In general, children with a conduct disorder have the following characteristics:
They are selfish.
They do not relate well to others.
They lack an appropriate sense of guilt.
They are insensitive to the feelings and well-being of others.
They tend to misperceive the behavior of others as threatening and react aggressively.
They may engage in bullying, threatening, and frequent fights.
They may be cruel to animals.
They may damage property, especially by setting fires.
They may lie or steal.
Conduct disorder tends to affect boys and girls differently. Girls may be less likely to be physically aggressive. Instead, girls typically run away, lie, and sometimes engage in sex work. Boys tend to fight, steal, and vandalize. All people with conduct disorder are likely to use illicitsubstances. (See also Behavioral Problems in Adolescents and Substance Use Disorders.)
Seriously violating rules is common and includes running away from home and frequently being truant from school. Children are likely to use illicit drugs and have difficulties in school. Suicidal thoughts may occur and must be taken seriously to protect a child's safety.
Children with conduct disorders may have other disorders, such as depression, attention-deficit/hyperactivity disorder, or a learning disorder.
About two thirds of the children stop the inappropriate behaviors by adulthood. The younger a child is when conduct disorder begins, the more likely the behavior is to continue. If the behavior continues into adulthood, people often encounter legal trouble, chronically violate the rights of others, and are often diagnosed with antisocial personality disorder. Some of these adults develop mood, anxiety, or other mental health disorders.
Diagnosis of Conduct Disorder
A visit with a doctor or behavioral health specialist
Description of child's behavior (often by a parent or teacher)
Doctors base the diagnosis of conduct disorder on the child’s behavior. The symptoms or behavior must be troubling enough to impair functioning in relationships, at school, or at work.
The social environment is also considered. If misconduct develops as an adaptation to a very stressful environment (such as a war-torn area or area of civil unrest), it is not considered a conduct disorder.
Doctors also try to identify any other mental health or learning disorder children may have.
Treatment of Conduct Disorder
Often, moving children from an at-risk environment to a strictly structured setting
Psychotherapy
Treatment of conduct disorder is very difficult because children and adolescents with conduct disorder rarely perceive anything wrong with their behavior. Thus, scolding them and urging them to behave better do not help and should be avoided. Often, the most successful treatment for seriously disturbed children or adolescents is to separate them from the at-risk environment and to provide a strictly structured setting, such as a mental health or a juvenile justice facility.
Psychotherapy may improve the child's self-esteem and self-control, thus enabling them to control their behavior better.
Other disorders, if present, are treated. Certain medications may be somewhat effective, especially if children also have certain other disorders, such as attention-deficit/hyperactivity disorder or depression. Treatment of such disorders can help lessen the symptoms of conduct disorder. For learning disorders, the most useful treatment is education that is carefully tailored to the individual child.
