What it is
Conduct Disorder involves a repetitive pattern of violating rights of others or major societal rules (aggression, property destruction, deceit/theft, serious rule violations). It’s diagnosed when behaviors cause significant impairment. Early, comprehensive, and compassionate intervention is critical.
Subtypes include childhood-onset (before age 10) and adolescent-onset; with and without limited prosocial emotions (callous–unemotional traits). CD can co-occur with ADHD, learning disorders, trauma, mood/anxiety disorders, and substance use.
Common signs and symptoms
- Aggression to people/animals: bullying, fighting, using weapons, cruelty
- Property destruction: fire-setting, vandalism
- Deceit or theft: breaking in, lying for gain, stealing
- Serious rule violations: truancy before age 13, running away, staying out at night despite prohibitions
- Impact: school suspensions, legal problems, family conflict, safety risks
These behaviors are distinct from occasional rule-breaking; they are persistent and impairing.
Why it happens
- Multi-factor influences: temperament, neurodevelopmental issues (impulsivity), trauma/adversity, peer environment, family stress, and community factors
- Skills gaps in emotion regulation, empathy, problem-solving
- Reinforcement cycles: coercive family interactions; peer modeling of risky behavior
What helps
- Multisystemic approach (home, school, community)
- Parent Management Training and family therapy to reduce coercive cycles
- Multisystemic Therapy (MST) or Functional Family Therapy (FFT) for high-severity cases
- School interventions: alternative education supports, behavior plans, mentoring
- Individual therapies
- CBT and Aggression Replacement Training (ART), problem-solving skills training
- Trauma-focused therapy when trauma is present
- Substance use treatment when indicated; prosocial peer activities
- Address co-occurring conditions
- ADHD treatment can reduce impulsive/aggressive behaviors
- Treat depression/anxiety, learning and language disorders; sleep interventions
- Safety and structure
- Supervision plans, curfews, safe peers, structured activities; limit access to weapons
- Positive reinforcement of prosocial behaviors; restorative practices when possible
- Medications
- No medication “for CD,” but options to target severe aggression/irritability or co-occurring ADHD, depression, or mood instability (e.g., stimulants for ADHD; SSRIs for mood/anxiety; short-term atypical antipsychotics for severe aggression with careful monitoring)
Early intervention, stability, and prosocial mentorship are protective.
When to seek help now
- Immediate safety risks, serious aggression, weapon involvement, fire-setting
- Legal issues or school expulsion
- Substance use or gang involvement; suicidal ideation or severe depression
How to talk to a clinician or school
- “We need a coordinated plan across home, school, and community. Please help us access MST/FFT, PMT, school behavior supports, and evaluation for ADHD/learning/trauma.”
Outlook
With coordinated, evidence-based interventions and support, many youths reduce risky behaviors and build prosocial skills. Positive adult relationships and structured opportunities are key to long-term outcomes.
Resources for readers in the USA
- Immediate help: 988 Suicide & Crisis Lifeline; 911 for imminent danger; Crisis Text Line text HOME to 741741
- Find care: Psychology Today (child/adolescent CBT, family therapy); FindTreatment.gov; NAMI HelpLine
- Programs: Multisystemic Therapy (mstservices.com/programs/what-is-mst); Functional Family Therapy (functionalfamilytherapy.com)
- School supports: 504/IEP, alternative education options, mentoring programs
- Low-cost/community: Community Health Centers (findahealthcenter.hrsa.gov); 211; youth mentoring (Big Brothers Big Sisters)
- Insurance tips: Verify in-network child/adolescent psychiatry/therapy, intensive in-home services; copay/coinsurance, deductible, out-of-pocket max
- Urgent options besides ER: Mobile Crisis for youth via 988 (where available), crisis stabilization units
Disclaimer: Educational information, not a diagnosis. If in crisis, use the resources above.