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Conductive disorder in children: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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Conduct disorder is repetitive or persistent behavior that infringes on the rights of others or basic age-appropriate social norms and rules. Diagnosis is based on history. There is no proven treatment, and many children require significant monitoring.
The prevalence of conduct disorder (CD) is approximately 10%. The disorder is usually observed in older children and adolescents, and is more common in boys. The etiology involves a complex interaction of hereditary and environmental factors. Parents of adolescents with conduct disorder often abuse drugs, commit antisocial acts, and often have a history of ADHD, mood disorders, schizophrenia, or antisocial personality disorder. However, conduct disorder can occur in children from prosperous, healthy families.
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Symptoms of conduct disorder in children
Children and adolescents with conduct disorders have little or no sensitivity to the feelings and well-being of others and mistakenly perceive others' behavior as threatening. They may engage in aggression by bullying, threatening or using weapons, physically assaulting others, or coercing others into sexual acts, with little or no remorse or compassion. In some cases, their aggression and cruelty are directed toward animals. These children and adolescents may engage in property destruction, cheating, and stealing. They have poor tolerance for frustration and are often irresponsible, violating parental rules and prohibitions (e.g., running away from home, skipping school frequently). Aberrant behavior differs between males and females: boys are more likely to fight, vandalize, and steal; girls are more likely to lie, run away, and engage in prostitution. Both sexes often have difficulties in school and are prone to substance abuse. Suicidal thoughts are common and suicide attempts should be taken seriously.
Conduct disorder is diagnosed if a child or adolescent has exhibited 3 or more signs in the past 12 months and at least 1 in the past 6 months. The symptoms or behaviors must be severe enough to interfere with social, school, and work relationships.
Prognosis and treatment of conductive disorder in children
In most cases, behavior normalizes with age, but in about one-third of cases, symptoms persist. Many patients meet criteria for antisocial personality disorder. Early onset is associated with a worse prognosis. Some go on to develop mood disorders, somatoform and anxiety disorders, substance use disorders, and psychotic disorders that begin at a young age. Children and adolescents with conduct disorder are more likely to have physical and other mental illnesses.
Treatment of comorbid disorders with medication and psychotherapy may improve the patient's self-esteem and self-control and ultimately improve control of the conduct disorder. Moralizing and reproaching are ineffective and should be avoided. Individual psychotherapy, including cognitive therapy and behavior modification, may be effective. Often, only isolation from the environment, discipline, and ongoing behavioral therapy offer hope for success.