In order to meet the diagnostic criteria for conduct disorder, a youth must exhibit at least 3 symptoms from the following checklist over a period of at least 6 months (isolated incidents of antisocial behavior do not qualify):
Aggression toward people and/or animals…
__: Has at any point used a weapon that could cause serious physical harm to others (e.g., a knife, rock, bat, broken bottle, etc.)
__: Displays physical cruelty to other people (i.e., cutting or burning a victim or seeming to enjoy inflicting pain)
__: Exhibits physical cruelty towards animals
__: Frequently bullying others
Destruction of property…
__: Deliberately destroys the property of others (other than by fire-setting)
__: Intentionally sets fires with a risk or intention of causing serious damage.
__: Deceitfulness or theft…
__: Frequently lies or breaks promises to either secure benefits for oneself or to avoid obligations
__: Steals objects of value without confronting the victim (e.g., swiping cash, shoplifting, burglary, stealing from kids at school)
__: Breaking into someone else’s home, building or car.
Rule breaking or serious violations of norms…
__: Frequently stays out after dark despite parental prohibitions (prior to 13 years of age)
__: Frequent truancy from school, beginning before 13 years of age.
__: Has run away from parents or foster homes at least twice, or has run away at least once for more than a single night (excludes situations where they left to escape abuse)
__: Commits a crime involving confrontation with the victim (Mugging, extortion, etc.)
__: Forcing another person into sexual activity.
The diagnostic criteria is virtually identical between the American Diagnostic & Statistical Manual, published by the American Psychiatric Association, and the International Classification of Diseases (ICD-10), a diagnostic manual used by the rest of the world. The only difference is that the ICD-10 has several different subtypes of the diagnosis, which may have value for research purposes but has little real world use for parents and educators. The American DSM also has a qualifier that these behaviors must be causing significant impairment, whereas the ICD-10 only requires these symptoms to be present. The DSM also distinguishes between early onset (childhood) conduct disorder (which tends to be more serious of a problem), and late onset conduct disorder that arises during the teen years, which kids often grow out of.
There is no age limit for a diagnosis of conduct disorder, but it usually appears and is diagnosed in older children. In a child under 10, the repetitive presence of just 1 of the 15 behaviors listed in the DSM is sufficient for diagnosis. (Tynan, 2010)
Alternate possibilities for diagnosis
The symptoms associated with conduct disorder may be confused for the following conditions:
- Traumatic stress reactions
- Mood disorders, particularly bipolar disorder
- Autism spectrum disorders