Conduct Disorder

Most children will test their parents’ rules at some point during their development. However, when a child “goes to the extreme” in breaking these rules and even breaks the law, then they may have conduct disorder.

Signs and Symptoms

Typical signs and symptoms of conduct disorder include aggression, rule violation, and property destruction. Some
examples of potential behaviors include:

• Bullying, threatening, or intimidating others
• Initiating physical fights with others
• Using a weapon that could cause serious physical harm to others (for example, a bat, brick, broken bottle, knife, or gun)
• Being physically cruel to others
• Stealing from someone while confronting him or her (for example, assault)
• Forcing someone into sexual activity
• Staying out at night often despite parental objections
• Running away from home
• Skipping school often
• Breaking into someone else's building, house, or car
• Lying to obtain goods or favors or to avoid obligations
• Stealing from someone without confronting him or her (for example, shoplifting without breaking and entering)
• Setting fire to property or objects

Evaluation and Diagnoses

It is crucial for conduct disorder to be diagnosed early to reduce the risk of the child getting hurt or hurting others, as well as reduce the risk of the child getting involved with the judicial system. Conduct disorder can be diagnosed at any time in childhood or adolescence. It is especially important to address conduct disorder in young children, as this disorder tends to be more problematic when it starts at a young age.

Treatment

Early treatment of conduct disorder is important and can help a child develop into a healthy adult. However, treatment is complex and depends on the severity of a child’s case. In many cases acomprehensive and team-based approach to treatment is used. The team should include family, school professionals, and other professionals who can hold the child responsible for their behavior and help the child avoid problems with the law. In addition to the child’s pediatrician, the team could include a child and adolescent psychiatrist, a psychotherapist, and an advanced practice registered nurse.

Comprehensive treatment for conduct disorder needs to occur over a long period of time. Treatment needs to individually address each of the causes for the child’s behaviors. Depending of the particular situation, different treatments, including medication, may be needed. Parent management training is an essential part of treatment for conduct disorder. In addition, psychotherapy (particularly, cognitive behavioral therapy) may also be very helpful.

Learn more about mental health treatment

It is important to note that some types of treatment do not work. For example, group psychotherapy is not a recommended form of treatment for children with conduct disorder. In addition, inoculation approaches are not effective. Inoculation approaches are “scared straight” methods that try to prevent the behavior by scaring the child with the consequences of the behavior. Examples of these approaches include putting a child in jail for a few days or sending them to boot camp.

If conduct disorder is affecting the child’s ability to learn, adjustments may need to be made in their education program.

Learn more about the school system

A child with conduct disorder may also benefit from a diversionary program that would address the child’s risk for entering the legal system.