Conduct disorder is a pattern of aggressive, deceitful, or rule-breaking behaviors beginning in childhood or adolescence. DSM-5 retains core diagnostic domains and adds specifiers (childhood-onset, callous-unemotional traits). Causes are multifactorial - individual, family, and social factors interact. Best outcomes come from early, evidence-based psychosocial interventions (parent management training, CBT, multisystemic therapy), coordinated care for comorbidities, and limited, targeted medication use for severe symptoms.

What is conduct disorder?

Conduct disorder (CD) is a childhood and adolescent mental health condition marked by a persistent pattern of behaviors that violate the rights of others or major age-appropriate social rules. Typical themes include aggression to people or animals, destruction of property, deceit or theft, and serious rule violations.

DSM-5 (2013) defines CD by a pattern of behaviors across these domains. A clinician looks for multiple symptoms present over months, and uses specifiers such as childhood-onset (first symptoms before age 10), adolescent-onset, and the presence of callous-unemotional traits.

How it shows up

Observable behaviors can include:

  • Bullying, threatening, physical fights, cruelty to people or animals.
  • Deliberate property destruction or arson.
  • Lying, shoplifting, theft, or conning others.
  • Truancy, running away, or serious rule violations.
Some young people show early irritability and oppositional behavior that meets criteria for oppositional defiant disorder (ODD). ODD can coexist with or precede CD, but not all children with ODD develop CD.

Causes and risk factors

CD arises from multiple interacting factors:

  • Child factors: impulsivity, difficult temperament, neurodevelopmental differences, and callous-unemotional traits.
  • Family factors: inconsistent discipline, harsh or neglectful parenting, family instability, or parental substance use.
  • Social/environmental factors: poverty, neighborhood violence, peer delinquency, and exposure to abuse or trauma.
Genetic vulnerability and early brain development can also contribute to risk, often in combination with adverse environments.

Diagnosis and prognosis

Assessment should be comprehensive and include screening for common comorbidities: ADHD, mood and anxiety disorders, substance use, and learning problems. Childhood-onset CD (symptoms before age 10) and presence of callous-unemotional traits are associated with a higher risk of persistent problems and adult antisocial personality disorder.

Treatment approaches

Early intervention improves outcomes. Effective, evidence-based strategies focus on family and systems as well as the child:

  • Parent management training (PMT) and caregiver education to improve discipline, supervision, and positive reinforcement.
  • Cognitive-behavioral therapies that teach problem solving, emotion regulation, and social skills.
  • Multisystemic Therapy (MST) or other intensive community-based programs for severe, entrenched problems.
  • Address comorbid conditions (e.g., ADHD, depression) which may reduce risk and improve response to psychosocial treatment.
Medications do not treat conduct disorder itself but can be used short-term for severe aggression or to treat comorbid conditions (e.g., stimulants for ADHD, selective use of antipsychotics for aggression). Medication decisions should be individualized and closely monitored.

Practical points for families

Early help, consistent parenting strategies, safe and structured environments, and coordinated care across school, mental health, and social services give the best chance of improvement. Juvenile justice contact complicates treatment but should be paired with rehabilitative interventions rather than only punitive responses.

FAQs about Conduct Disorder

How is conduct disorder different from oppositional defiant disorder (ODD)?
ODD involves a pattern of angry/irritable mood, argumentative or defiant behavior, and vindictiveness. Some children with ODD develop CD, but ODD is generally less severe and does not include the property destruction, theft, or serious rule violations that define CD.
Can conduct disorder be cured?
There is no single cure, but many children improve with early, evidence-based interventions. Family-based therapies, skills training, and community programs can substantially reduce harmful behaviors and improve functioning.
Are there medicines for conduct disorder?
No medications are approved specifically for CD. Clinicians may prescribe medications to manage severe aggression or comorbid conditions (e.g., ADHD) on a case-by-case basis, with careful monitoring.
What predicts a worse outcome?
Earlier onset (before age 10), callous-unemotional traits, coexisting ADHD or substance use, and unstable or neglectful family environments are associated with higher risk of persistent antisocial behavior into adulthood.
When should parents seek professional help?
Seek evaluation if a child repeatedly harms people or animals, destroys property, steals, or regularly breaks important rules in a way that interferes with school, safety, or family life. Early assessment improves treatment options.

News about Conduct Disorder

A new treatment approach to conduct disorder and callous-unemotional traits: an assessment of the acceptability, appropriateness, and feasibility of Impact VR - Frontiers [Visit Site | Read More]

Brain differences seen in children with conduct disorder depend on abuse history - University of Bath [Visit Site | Read More]

Scientists make ‘striking’ discovery about what mental health conditions do to your brain - The Independent [Visit Site | Read More]

Journal of Child Psychology and Psychiatry | ACAMH Pediatric Journal | Wiley Online Library - Wiley [Visit Site | Read More]

VCU researchers use virtual reality to help children with conduct disorders - WWBT [Visit Site | Read More]

Mental health of adolescents - World Health Organization (WHO) [Visit Site | Read More]

Virtual reality program reduces aggression and conduct problems in youth, VCU study finds - VCU Health [Visit Site | Read More]

Youth with mental health conditions share strikingly similar brain changes, regardless of diagnosis - Medical Xpress [Visit Site | Read More]