Overview
The Clinical Pattern and Developmental Meaning
Conduct disorder is a persistent pattern of behaviour that violates the rights of other people or major age appropriate societal norms.
Conduct disorder is a persistent pattern of behaviour that violates the rights of other people or major age-appropriate societal norms. DSM-5 diagnosis requires at least 3 of 15 specified behaviours during a 12-month period, with at least 1 occurring in the preceding 6 months. The behaviours fall into four recognizable groups: aggression toward people or animals, destruction of property, deceitfulness or theft, and serious violations of rules. Repeated assault, cruelty, fire-setting, breaking and entering, deliberate property damage, or prolonged truancy carry more diagnostic weight than a single argument, impulsive outburst, or missed curfew. The pattern must be recurrent and clinically meaningful; “difficult,” “rude,” or “noncompliant” is not a diagnosis. The behaviour often reflects interacting developmental, family, school, and environmental influences rather than one isolated cause. Difficulties with impulse control, emotional regulation, problem-solving, and anticipating consequences can make aggressive or rule-breaking behaviour more likely. Coercive cycles may then reinforce it: the child threatens, the caregiver gives in, and the immediate removal of conflict rewards the threatening behaviour. Maltreatment, unstable caregiving, community violence, prenatal substance exposure, parental psychopathology, and comorbid ADHD may...