Conduct Disorder (CD) is diagnosed in children and teens who display persistent behavioral problems that also have an antisocial component to them, meaning they violate the rights of others. Conduct disorder is considered a more serious behavioral disorder, and it is often a precursor to juvenile delinquency and other serious problems in adulthood.
What is conduct disorder?
“Conduct disorder is described as a longstanding pattern of violations of rules and laws,” write Andrea Glenn & Adrian Raine, “including aggressive behavior, manipulativeness, deceitfulness, theft, forced sex, bullying, running away from home, and property destruction. Conduct disorder is typically diagnosed in older children and adolescents,” though it can also be diagnosed in younger children as well. (Glenn & Raine, 2011, p. 885)
Professionals also distinguish between childhood onset conduct disorder (arising prior to age 10) and adolescent onset conduct disorder. Adolescent onset conduct disorder is, generally speaking, far less serious, partly because many teens go through a phase where they engage in delinquent and antisocial behavior, and partly because such behavior in younger children is typically a sign of a more serious underlying problem. Of those with early onset (in this study defined as prior to age 8) about half persist with “serious problems into adulthood,” whereas “of those with adolescent onset, the great majority (over 85%) desist in their antisocial behavior by their early twenties.” (Scott, 2012, p. 17)
How many children have conduct disorder?
Prevalence rates for conduct disorder vary widely depending on the type of study and the sample group involved, but it’s generally estimated that anywhere between 2% and 8% of children have conduct disorders. (Scott, 2012) Estimates for boys range between 6% and 16%, compared to anywhere from 2% to 9% for girls. It’s believed there are approximately 4-10 males for every female with conduct disorder (Scott, 2012), yet rates among girls have been steadily rising in recent years.
Outcomes for children with conduct disorder
It’s estimated that approximately half of children with conduct problems outgrow the disorder and don’t develop antisocial personality characteristics as adults. (Robins, 1966; Moffitt, 2006) Other studies have found that anywhere from 25-40% of children with CD will go on to develop adult antisocial personality disorder. (Murphy, Cowan & Sederer, 2001; Zocolillo et al., 1992) So while it’s safe to say that more than half of kids who meet the criteria for CD will eventually outgrow their condition, the consequences of continuing on the current trajectory to adult antisocial personality disorder (which is generally associated with severe problems in life and/or imprisonment) are severe enough to warrant considerable attention.
Treatment for children with conduct disorder
The most successful treatment for children with conduct disorder is some type of parent-child interaction therapy that focuses on unhealthy patterns of interacting between adults and children. Family therapy or individual psychotherapy for the child is often helpful as well, since many conduct problems are rooted in unresolved hurt or resentment. There are no pharmaceutical treatments that have been shown to be effective in treating conduct disorder, so medication should be considered cautiously and only as a last resort if all other treatment methods have failed.