Conduct disorder

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Conduct disorder is controversial psychiatric category to describe a pattern of repetitive behavior where the rights of others or the social norms are violated. Possible symptoms are over-aggressive behavior, bullying, physical aggression, cruel behavior toward people and pets, destructive behavior, lying, truancy, vandalism, and stealing.

After the age of 18, a conduct disorder may develop into antisocial personality disorder.

Diagnosis

The diagnostic criteria for Conduct Disorder (codes 312.xx, with xx representing digits which vary depending upon the severity, onset, etc. of the disorder) as listed in the DSM-IV-TR are as follows:

1. 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 6 months:
   1. Aggression to people and animals
      1. often bullies people, 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
   2. 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).
   3. Deceitfulness or theft
      1. has broken into someone else's 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 a victim (e.g., shoplifting, but without breaking and entering; forgery)
   4. 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 parental or parental surrogate home (or once without returning for a lengthy period)
      3. is often truant from school, beginning before age 13 years
2. The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.
3. If the individual is age 18 years or older, criteria are not met for Antisocial personality disorder.

Criticism

Some critics of psychiatry allege that individuals exhibiting symptoms of a 'conduct disorder' (similar to oppositional defiant disorder) may be reacting to an abnormal circumstance, or may simply be committing criminal and/or uncivil acts out of selfishness. Critics of this disorder also may state that the coming of age of an individual does not automatically signify a new disorder. It has also been noted that the criteria for diagnosis can often be subjective and that only exemplifying a few of the above behaviors may just indicate normal teenage rebellion.

See also

• Antisocial personality disorder
• Oppositional defiant disorder
• Psychopathy
• Bullying