What is CD? Conduct disorder (CD) refers to a set of problem behaviors exhibited by children and adolescents, which may involve the violation of a person, their rights or their property. It is characterized by aggression and, sometimes, law-breaking activities. Early intervention and treatment is important, since children with untreated CD are at increased risk of developing a range of problems during their adult years including substance use, personality disorders and mental illnesses.
Some of the typical behaviors of a child with CD may include:
- law-breaking behavior such as stealing deliberately lighting fires breaking into houses
- shoplifting sexual abuse vandalism suicidal tendencies. A child who ultimately develops CD is usually irritable
- temperamental during babyhood – although most difficult babies do not develop conduct disorder
The milder oppositional defiant disorder (ODD) usually develops before CD.
Constant defiance, hostility and a hair-trigger temper are common characteristics of ODD. Around one-third of children with CD also have attention deficit hyperactivity disorder (ADHD). One in 5 children with CD are depressed.
CD is typically diagnosed when the child is between 10 and 16 years of age, with boys generally diagnosed at an earlier age than girls. The causes of disruptive behavior disorders are unknown but researchers have found that while not all children with CD have family difficulties a child’s family life is a strong risk factor for many.
Some of the factors that increase a child’s risk of developing CD include:
- parents who do not follow through with consequences for unacceptable behavior (for example
- a parent may threaten to withdraw television for a night but then not follow through when the child’s behavior doesn’t change) aggressive parenting
- particularly from the father
Other factors that may contribute to the development of CD or exacerbate the characteristics of the disorder include:
- brain damage. Untreated
- some of the possible consequences in adulthood for children with CD include: law-breaking lifestyle
CD shares similarities with ODD and ADHD, which makes diagnosis difficult. CD needs to be professionally diagnosed by a child or adolescent psychologist, child psychiatrist or pediatrician specializing in the area of behavior disorders. The professional will make their assessment based on observation and interviews with the parents, the adolescent and teachers.
The adolescent’s behavior is compared to a checklist in the from the American Psychiatric Association.
If sufficient criteria are met, a diagnosis of CD can be made#
One of the greatest challenges in treating a child with CD is to overcome their mistrust of others, particularly authority figures.
The child’s unwillingness to follow any rules must also be taken into account. It may take some time to unravel the various factors that contribute to the child’s behavior and take appropriate action. Treatment depends on the individual but may include: medication (in case of co-existing depression or ADHD).
CD is one of a group of behavioral disorders known collectively as disruptive behavior disorders, which include Oppositional defiant disorder (ODD) and Attention deficit hyperactivity disorder (ADHD) The characteristics of CD refusal to obey parents or other authority figures truancy tendency to use drugs, including tobacco and alcohol, at a very early age lack of empathy for others spiteful and vengeful behavior being aggressive to animals being aggressive to people, including bullying and physical or sexual abuse tendency to hang out in gangs keenness to start physical fights using weapons in physical fights lying a tendency to run away learning difficulties low self-esteem The link to other behavioral disorders The influence of the family parents who do not set limits on a child’s behavior lack of parental monitoring of a child’s or adolescent’s whereabouts unhappy family life with many arguments poverty large family marital conflict domestic violence parents with a mental health problem parents who are involved in law-breaking behavior child abuse Other factors gender – boys are twice as likely as girls to have CD peer group substance misuse mood disorders learning difficulties post-traumatic stress disorder (PTSD) depression oppositional defiant disorder (ODD) attention deficit hyperactivity disorder (ADHD) Possible consequences mental health problems, including personality disorders depression alcoholism drug dependency Diagnosis of CD Diagnostic and Statistical Manual of Mental Disorders Treatment of CD behavior therapy cognitive behavioral therapy (CBT) anger management stress management social skills training special education program parent management training family therapy multisystemic therapy integrated approach by family, teachers and other carers management of any co-existing problems
Where to get help#
Sources & further reading
For evidence-based global guidance on this topic, consult authoritative public-health bodies such as the World Health Organization (WHO), CDC, NHS, and ECDC.