What is Conduct Disorder?

A diagnosis of “conduct disorder” is given to an individual with a repetitive and persistent pattern of behavior in which the basic rights of others or age-appropriate societal norms or rules are violated, as demonstrated by at least three of the following criteria in the past 12 months, including one in the past 6 months:

• Often bullies, threatens, or intimates others.
• Often initiates physical fights.
• Has used a weapon that can cause serious physical harm to others (e.g., a bat, brick, broken bottle, knife, gun).
• Has been physically cruel to people.
• Has been physically cruel to animals.
• Has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery).
• Has forced someone into sexual activity.
• Has deliberately engaged in fire setting with the intention of causing serious damage.
• Has deliberately destroyed others’ property.
• Has broken into someone else’s house, building, or car.
• Often lies to obtain goods or favors or to avoid obligations (i.e., “cons” others).
• Has stolen items of trivial value without confronting a victim (e.g., shoplifting, but without breaking and entering; forgery).
• Often stays out at night despite parental prohibitions, beginning before age 13.

The behavior causes significant impairment in social, academic, or occupational functioning. If the individual is 18 years or older, criteria are not met for antisocial personality disorder.

What are treatments for Conduct Disorder?

Treatment strategies for young children that focus on increasing social behavior and social competence are believed to reduce aggressive behavior. Studies show that cognitive-behavioral therapy can result in significant reductions in conduct disorder symptoms in children and adolescents. Parental education is also important.

Pharmacotherapy may be helpful in treating aggression in youth associated with disruptive behavior disorders. Risperidone has proven effective for this purpose. Conduct disorder, including impulsivity and aggression, may occur in many childhood psychiatric disorders, ranging from ADHD to major depression to bipolar disorder and specific learning disorders. Mood disorders are often present in children who demonstrate irritability and aggressive behavior. Antipsychotics can decrease aggressive and assaultive behaviors in children with a variety of psychiatric disorders. Atypical antipsychotics, including risperidone (Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), and ziprasidone (Geodon), and aripiprazole (Abilify) are often effective and well-tolerated. Selective serotonin reuptake inhibitors (SSRIs) including fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and citalopram (Celexa) are used to target symptoms of impulsivity, irritability, and mood swings, which frequently accompany conduct disorder.