Conduct Disorder in Children

Learn the most common signs of ADHD and conduct disorder, including aggressive behavior in children, based on DSM – IV criteria. Behavior Disorders in children are referred for mental health treatment services more than any others and are the most commonly diagnosed. Unfortunately, many families lack the resources for bad behavior problems and adequate treatment.

Precursors generally include ADHD symptoms and oppositional defiant disorder (ODD). Although a significant percentage of individuals will move on to be diagnosed with Antisocial Personality Disorder, for most children it diminishes by adulthood.

For many parents having your child get to the point of having symptoms of conduct disorder is very discouraging. Especially for children with signs of ADHD, that are constantly having problems in school as well. Asking for professional help is the best place to start, so that your child doesn't end up doing something that could get him/her into serious trouble.

Conduct Disorder DSM - IV Diagnostic Criteria

Photo by J Anderson

child looking angry and displaying symptoms of conduct disorder

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) by the American Psychiatric Association uses the following criteria to diagnose:

A. A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of three (or more) of the following criteria in the past 12 months, with at least one criterion present in the past six months:

Aggression to people and/or animals

1. Often bullies, threatens or intimidates others.
2. Often initiates physical fights.
3. Has used a weapon that can cause serious physical harm to others (e.g., a bat, brick, broken bottle, knife, gun).
4. Has been physically cruel to people.
5. Has been physically cruel to animals.
6. Has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery).
7. Has forced someone into sexual activity.

Destruction of property

1. Has deliberately engaged in fire setting with the intention of causing serious damage.
2. Has deliberately destroyed others' property (other than by fire setting).

Deceitfulness or theft

1. Has broken into someones house, building or car.
2. Often lies to obtain goods or favors or to avoid obligations (i.e., “cons” others).
3. Has stolen items of nontrivial value without confronting the victim (e.g., shoplifting, but without breaking and entering; forgery).

Serious violations of rules

1. Often stays out at night despite parental prohibitions, beginning before age 13 years.
2. Has run away from home overnight at least twice while living in a parental or parental surrogate home (or once without returning for a lengthy period).
3. Is often truant from school, beginning before age 13 years.

B. The disturbance in behavior causes clinically significant impairment in social, academic or occupational functioning.

C. If the individual is age 18 years or older, criteria are not met for antisocial personality disorder.

Specify severity:

Mild: few if any conduct problems in excess of those required to make the diagnosis, and conduct problems cause only minor harm to others.
Moderate: number of conduct problems and effect on others intermediate between “mild” and “severe.”
Severe: many conduct problems in excess of those required to make the diagnosis, or conduct problems cause considerable harm to others.

Conduct Disorder Treatment

Treatment will involve psychotropic medications, positive behavior supports and parent skills training. I have some pages with techniques for dealing with aggressive behavior in children and defiant children that may also be helpful.

Getting support from qualified professionals in this area is extremely important. This may mean working with a Behavior Analyst, certified mental health provider, and psychiatrist to ensure your child is on the right track. Usually a local community mental health organization will have resources available to families. Conduct disorder treatment will also most likely involve ADHD treatment since the two are typically coexisting disorders.

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1. Barkoukis, A., Reiss, N. S., Dombeck, M. (2008). Childhood Mental Disorders and Illnesses. Disorders of Childhood: Attention-Deficit and Disruptive Behavior Disorders. 11-30-09.

2. American Psychiatric Association. (2000). Attention Deficit and Disruptive Behavior disorders - Conduct Disorder. In Diagnostic and statistical manual of mental disorders (Fourth edition---text revision (DSM-IV-TR). Washington, DC: American Psychiatric Association,93-99.

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