Conduct Disorder: Causes, Symptoms & Treatment

Do you feel like your child is aggressive or purposely defiant? They might have a conduct disorder. Read on to learn more about how to identify and treat the condition.

Conduct disorder is a behavioral disorder that affects how children and adolescents think, feel, and act toward others. It involves a persistent pattern of aggression, rule-breaking, and antisocial behavior that goes beyond typical mischief or rebellion. This condition often shows up through repeated aggression, deceit, or deliberate violations of social norms. Conduct disorder can deeply impact families, schools, and communities, but with early diagnosis and effective treatment, it’s possible to overcome. Understanding the signs and causes of conduct disorder is the first step toward getting children the treatment and support they need to build healthier, more positive behaviors.

What is conduct disorder?

Conduct disorder is a type of disruptive behavior disorder characterized by a persistent pattern of antisocial behavior, aggression, and disregard for rules or the rights of others. The American Psychiatric Association (APA) defines it as a repetitive and persistent pattern of behavior that violates societal norms or the basic rights of others. Children and adolescents with conduct disorder often show a tendency toward violence, deceit, vandalism, or theft, and they may struggle with emotion regulation and empathy.

Conduct disorder is one of several disruptive behavior disorders, alongside oppositional defiant disorder (ODD) and attention deficit hyperactivity disorder (ADHD). While ODD typically involves defiance and hostility toward authority, conduct disorder involves more severe violations, such as aggression toward people or animals and deliberate destruction of property.

Conduct disorder in children

Conduct disorder in children often emerges before age 10 and is known as childhood-onset conduct disorder. Affected children may display frequent aggression, lying, or rule-breaking at home and school. They might bully others, start fights, or harm animals. Early signs often appear as behavioral problems such as hostility, impulsivity, and a lack of remorse after hurting someone. 

Children may also show academic difficulty and resistance to punishment, which can make school environments particularly challenging. When left untreated, conduct disorder in childhood can evolve into more serious personality disorders or antisocial behavior in adulthood. Some of these symptoms may look like neurodivergent conditions, like ADHD or autism, but the conditions are different.

Conduct disorder in adults

In adulthood, lingering traits may still appear. When conduct disorder continues past adolescence, it may transition into symptoms similar to antisocial personality disorder (ASPD). Adults with a history of conduct disorder often show ongoing patterns of antisocial behavior, disregard for laws, and a lack of empathy or remorse. However, not every person with conduct disorder develops ASPD. Furthermore, adults might engage in chronic substance use, alcohol abuse, violence, or criminal behavior, and may struggle to maintain employment or relationships.

Conduct disorder examples

1. Aggression toward people or animals (bullying, fighting, using weapons).

2. Destruction of property (vandalism, arson).

3. Deceitfulness or theft (lying, shoplifting).

4. Serious violations of rules (staying out all night, running away, skipping school).

5. Experimenting with drugs or alcohol at a young age.

Causes of conduct disorder

The causes of conduct disorder are complex and involve both biological and environmental factors. These influences can interact over time, shaping a child’s ability to regulate emotion, control impulses, and form healthy relationships.

1. Biological factors

• Genetic predispositions to impulsivity, aggression, or mood instability. 
• Family history of mental health disorders (such as bipolar disorder).
• Neurological differences affecting areas of the brain responsible for emotion regulation and empathy.
• Coexisting mental health disorders such as ADHD, depression, or bipolar disorder.

2. Environmental factors

• Exposure to abuse, neglect, or household violence.
• Inconsistent discipline or lack of parental supervision.
• Association with delinquent peers.
• Community or household substance use disorder exposure. 

Conduct disorder vs. personality disorders

While conduct disorder is classified among disruptive behavior disorders, personality disorders reflect long-standing patterns of inner experience and behavior that deviate from cultural expectations. Understanding these differences helps mental health professionals in adolescent psychiatry and adult care plan appropriate interventions.

Similarities:

1. Both involve patterns of antisocial behavior, aggression, and disregard for others.

2. Both may stem from genetic and environmental factors, such as early trauma, neglect, or exposure to violence.

3. Both can result in problems with school, work, and relationships.

4. Both may coexist with substance use, depression, or bipolar disorder.

Differences:

1. Age of onset: Conduct disorder begins in childhood or adolescence, while personality disorders develop later into adulthood. 

2. Diagnostic focus: Conduct disorder focuses on outward behavior (fighting, stealing, rule-breaking), while personality disorders emphasize long-term emotional and interpersonal traits (manipulation, narcissistic tendencies, lack of empathy).

3. Treatment goals: Conduct disorder treatment often focuses on behavior modification and positive behaviors, while personality disorders require long-term psychotherapy to reshape personality patterns. 

Conduct disorder vs. antisocial personality disorder

Conduct disorder and antisocial personality disorder are closely related, but they are not the same. Conduct disorder is diagnosed in children and adolescents who consistently violate social norms, display aggression, and show disregard for others. Unlike antisocial personality disorder, which is diagnosed in adults, conduct disorder occurs before age 18 and focuses on outward behavioral patterns rather than deeply ingrained personality traits. 

In ASPD, the lack of empathy, manipulation, and chronic disregard for the rights of others are part of a fixed personality disorder that persists into adulthood. Conduct disorder, on the other hand, still allows room for change, as early treatment and intervention can help prevent the behaviors from solidifying into a long-term personality pattern. According to the American Psychiatric Association, a person must have shown symptoms of conduct disorder before age 15 to be diagnosed with ASPD as an adult.

Conduct disorder symptoms

These symptoms often cause severe disruption at home, school, and in peer relationships. Common symptoms of conduct disorder include:

1. Aggression toward people or animals (fighting, bullying, cruelty).

2. Destruction of property or vandalism.

3. Serious rule violations (staying out late, running away, truancy).

4. Lack of remorse or empathy.

5. Frequent hostility, impulsivity, or irritability.

6. Trouble managing mood or emotion.

7. Engaging in risky or early sexual activity.

8. Using drugs, alcohol, or showing signs of substance use disorder.

9. Difficulty in school, including academic difficulty and behavioral problems.

How is conduct disorder diagnosed? Conduct disorder criteria

The diagnosis of conduct disorder follows criteria outlined by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). To receive a diagnosis of conduct disorder, a child must show at least 3 of the following behaviors in the past year, with at least one occurring in the past six months:

1. Aggression toward people or animals

2. Destruction of property

3. Deceitfulness or theft

4. Serious violations of rules

The disorder is classified by onset type:

1. Childhood-onset: At least one symptom before age 10

2. Adolescent-onset: No symptoms before age 10

3. Unspecified onset: Onset age unclear

Severity levels are based on the number and impact of symptoms, ranging from mild (minor rule violations) to severe (causing serious harm to others or property).

Treatment for conduct disorder

Treatment for conduct disorder involves a combination of therapy, family support, and sometimes medication for coexisting mental health disorders like ADHD or depression.

1. Therapy 

Therapy is an important first step to help children with conduct disorder build emotional awareness and self-control. One commonly used approach is cognitive-behavioral therapy (CBT), which teaches children how to recognize negative thought patterns that lead to aggressive or impulsive behavior. Through CBT, they learn to pause before acting, manage anger, and make better decisions in stressful situations. A child psychiatrist or psychologist may also teach coping tools for emotion regulation and guide the child in practicing empathy and positive behaviors, both at home and school.

2. Family therapy and support

The support and knowledge of a child’s family also play a vital role in the treatment of conduct disorder. Approaches like multisystemic therapy (MST) address the child’s behavior within the broader context of family, school, and community, promoting change across all areas of life. Additionally, parent management training helps caregivers reinforce positive behaviors, set clear expectations, and apply consistent discipline. Through family therapy, parents and children work together to improve communication, rebuild trust, and strengthen emotional bonds, creating a more stable, supportive home environment that encourages long-term recovery.

3. Medication

While there is no specific medication approved to treat conduct disorder, certain types can help manage related symptoms and co-occurring mental health disorders. A child psychiatrist may prescribe medications to reduce impulsivity, stabilize mood, or treat underlying conditions such as bipolar disorder, depression, or attention deficit hyperactivity disorder (ADHD). When combined with therapy and family support, these medications can help children think more clearly, regulate their emotions, and respond to situations with greater self-control.

4. Environmental support

Positive lifestyle adjustments and environmental support are essential for helping children with conduct disorder recover and thrive. Creating stable routines, maintaining a safe home environment, and surrounding the child with positive role models provide structure and emotional security. Schools and community programs that encourage teamwork, accountability, and positive behaviors can also make a lasting difference. Furthermore, reducing exposure to substance use, violence, or abuse helps minimize triggers for aggressive behavior and supports healthier emotional development.

Conduct disorder test

There is no single medical test for conduct disorder, although diagnosis relies on a thorough evaluation by a child psychiatrist or mental health professional. Early diagnosis and intervention are essential to prevent long-term effects. The diagnosis process typically includes: 

1. Detailed interviews with the child and parents.

2. Observation of the child’s behavior at home and school.

3. Psychological assessments to evaluate mood, impulsivity, and social functioning.

4. Screening for related conditions like oppositional defiant disorder, ADHD,  and depression.

How Charlie Health can help

If you or a loved one is struggling with a mental health disorder, Charlie Health is here to help. Charlie Health’s virtual Intensive Outpatient Program (IOP) provides more than once-weekly mental health treatment for dealing with serious mental health conditions. Our expert clinicians incorporate evidence-based therapies into individual counseling, family therapy, and group sessions. With treatment, managing your mental health is possible. Fill out the form below or give us a call to start healing today.