Conduct disorder

What it is

Conduct disorder is a persistent pattern of behavior in children and adolescents in which the rights of others, or age appropriate social norms, are violated. These behavior patterns can be seen in a variety of settings: at home, at school, and in social situations. It is characterized by aggression toward people and animals, deceitfulness, destruction of property and violation of rules. The line to hold is that all conduct disorder behaviors are illegal or very harmful.

Causes and risk

Conduct disorder is more common in boys, with studies indicating that the rate among boys in the general population ranges from 6% to 16%.

The four symptom groups, and the duration that makes the diagnosis

The signs and symptoms fall into four groups, and the diagnosis is built from them by a rule of number and time.

• Aggressive behavior that threatens or harms people or animals, such as bullying or intimidating others, initiating physical fights, or abusing animals
• Deceitfulness or theft, such as breaking into someone's house or car, or lying or conning others
• Nonaggressive conduct that causes property loss or damage, that is vandalism or fire-setting
• Serious rule violations, like running away from home overnight or school truancy

At least three or more of the above must be present within the last 12 months, with at least one criterion present within the last 6 months. That pair of periods is the whole duration rule.

Two cases carry it. A 13-year-old boy over the past year has been suspended from school three times, once for fighting with another student and twice for stealing; his mother has also begun receiving calls from the local truancy officer, reporting his repeated absences from school; and he was recently arrested by the police for breaking into a neighbor's car. He previously had a normal developmental course. A 14-year-old boy is brought by his mother after the police caught him stealing a neighbor's bicycle; he is performing poorly at school, is suspected of being involved in a recent arson, that is setting a fire, in the adjacent neighborhood, and has a history of fighting and truancy at school since age of 10. In each case three or four different groups are present, not one behavior three times over.