Conduct Disorder

The Nature of Conduct Disorder

Conduct disorder, as defined by the DSM-IV-TR, is a persistent and recurring pattern of behavior in which an individual violates the basic rights of others or major age-appropriate societal norms or rules. It is important to note that although behaviors such as lying, aggression, and defiant behaviors occur throughout typical childhood development, the behaviors that are associated with conduct disorder significantly interfere with social, academic, or occupational functioning of the individual and are more severe than those associated with normal developmental stages. The behaviors associated with conduct disorder are categorized into four main groups: aggression toward people and animals, destruction of property, deceitfulness or theft, and serious violations of rules. In order for an individual to be diagnosed with conduct disorder, three or more of the following criteria must have been met within the past 12 months, and at least one must have been present in the past 6 months: (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; (8) has deliberately engaged in fire setting with the intention of causing serious damage; (9) has deliberately destroyed others' property (other than by fire setting); (10) has broken into someone else's house, building, or car; (11) has lied often to obtain goods or favors or to avoid obligations (i.e., cons others); (12) has stolen items of nontrivial value without confronting a victim (e.g., shoplifting, but without breaking and entering; forgery); (13) often stays out at night despite parental prohibitions, beginning before age 13 years, (14) 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); and (15) is often truant from school, beginning before age 13 years.

There are generally thought to be two types of conduct disorder: childhood-onset and adolescent-onset. The childhood-onset type occurs when the characteristics of conduct disorder begin prior to age 10; in the adolescent-onset type, symptoms occur after the age of 10. (Note: An individual who is 18 years or older may be diagnosed with a conduct disorder as long as criteria for antisocial personality disorder [APD]—a pattern of disregard for and violation of the rights of others occurring since age 15—are not met.) The presentation of conduct disorder in children or [Page 100]adolescents is multifaceted in terms of the number and types of symptoms, the risk factors and protective factors associated with the individual, and in the degree of severity of the behaviors.

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