Conduct Disorder

  • Melissa Castle HeatlyEmail author
  • Phyllis Lee


Conduct disorder (CD) is a serious and persistent behavioral disorder that is characterized by hostile and sometimes physically violent behavior, callous disregard for others and societal norms, and persistent violation of rules and the rights, feelings, or personal space of other people (APA, 2013; Kazdin, 2007; Kimonis, Frick, & McMahon, 2014). Children and adolescents with CD may find aggression, coercion, deceit, and harming others gratifying and energizing and may even “get a rise” out of these behaviors. Signs that an older youth may have CD include picking fights, cheating and stealing, trespassing and vandalism, and abusive behavior including forced sex or using weapons to coerce others. For younger children, signs of CD are similarly coercive and may include intentional harm to peers or even animals, relentless bullying, and lying or stealing with little to gain aside from a power differential. These behaviors are differentiated from more typical “acting out” by their chronicity, persistence, severity, and appearance across a wide range of settings. Estimated prevalence rates range from 2 to 12% (Costello, Egger, & Angold, 2005), with higher prevalence in males than females (Nock, Kazdin, Hiripi, & Kessler, 2006).


Pediatrics Conduct disorder Treatment Behavioral intervention Primary care 


  1. Achenbach, T. M., & Rescorla, L. (2001). Manual for the ASEBA school-age forms and profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families.Google Scholar
  2. American Academy of Pediatrics. (1998). Guidance for effective discipline. Pediatrics, 101(4), 723–728.CrossRefGoogle Scholar
  3. Alexander, J. F., Robbins, M. S., & Sexton, T. L. (2000). Family-based interventions with older, at-risk youth: From promise to proof to practice. The Journal of Primary Prevention, 21(2), 185–205.Google Scholar
  4. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.CrossRefGoogle Scholar
  5. Auxier, A., Runyan, C., Mullin, D., Mendenhall, T., Young, J., & Kessler, R. (2012). Behavioral health referrals and treatment initiation rates in integrated primary care: A collaborative care research network study. Translational Behavioral Medicine, 2(3), 337–344.CrossRefPubMedPubMedCentralGoogle Scholar
  6. Barry, K. L., Fleming, M. F., Manwell, L. B., & Copeland, L. A. (1997). Conduct disorder and antisocial personality in adult primary care patients. Journal of Family Practice, 45(2), 151–158.PubMedGoogle Scholar
  7. Bronfenbrenner, U. (1986). Ecology of the family as a context for human development: Research perspectives. Developmental Psychology, 22(6), 723–742.CrossRefGoogle Scholar
  8. Campbell, M., Gonzalez, N. M., & Silva, R. R. (1992). The pharmacologic treatment of conduct disorders and rage outbursts. Psychiatric Clinics of North America, 15(1), 69–85.PubMedGoogle Scholar
  9. Chorpita, B. F., & Weisz, J. R. (2009). MATCH-ADTC: Modular approach to therapy for children with anxiety, depression, trauma, or conduct problems. Satellite Beach, FL: PracticeWise.Google Scholar
  10. Conners, C. K., Pitkanen, J., & Rzepa, S. R. (2011). Conners 3rd Edition (Conners 3; Conners 2008). New York, NY: Springer.CrossRefGoogle Scholar
  11. Costello, E. J., Egger, H., & Angold, A. (2005). 10-year research update review: The epidemiology of child and adolescent psychiatric disorders: I. Methods and public health burden. Journal of the American Academy of Child & Adolescent Psychiatry, 44(10), 972–986.CrossRefGoogle Scholar
  12. Dishion, T. J., & McMahon, R. J. (1998). Parental monitoring and the prevention of child and adolescent problem behavior: A conceptual and empirical formulation. Clinical Child and Family Psychology Review, 1(1), 61–75.CrossRefPubMedGoogle Scholar
  13. Dodge, K. A., & Pettit, G. S. (2003). A biopsychosocial model of the development of chronic conduct problems in adolescence. Developmental Psychology, 39(2), 349–371.CrossRefPubMedPubMedCentralGoogle Scholar
  14. Emmons, K. M., & Rollnick, S. (2001). Motivational interviewing in health care settings: Opportunities and limitations. American Journal of Preventive Medicine, 20(1), 68–74.CrossRefPubMedGoogle Scholar
  15. Fisher, P. A., & Gilliam, K. S. (2012). Multidimensional treatment foster care: An alternative to residential treatment for high risk children and adolescents. Psychosocial Intervention, 21(2), 195–203.CrossRefPubMedPubMedCentralGoogle Scholar
  16. Frick, P. J., Lahey, B. B., Loeber, R., Stouthamer-Loeber, M., Christ, M. A. G., & Hanson, K. (1992). Familial risk factors to oppositional defiant disorder and conduct disorder: Parental psychopathology and maternal parenting. Journal of Consulting and Clinical Psychology, 60(1), 49–55.CrossRefPubMedGoogle Scholar
  17. Gardner, W., Murphy, M., Childs, G., Kelleher, K., Pagano, M. E., Jellinek, M., … Sturner, R. (1999). The PSC-17. Ambulatory Child Health, 5(3), 225–236.Google Scholar
  18. Hawes, D. J., & Dadds, M. R. (2005). The treatment of conduct problems in children with callous-unemotional traits. Journal of Consulting and Clinical Psychology, 73(4), 737–741.CrossRefPubMedGoogle Scholar
  19. Henderson, E. (2015). Potentially dangerous patients: A review of the duty to warn. Journal of Emergency Nursing, 41(3), 193–200.CrossRefPubMedGoogle Scholar
  20. Henggeler, S. W., Clingempeel, W. G., Brondino, M. J., & Pickrel, S. G. (2002). Four-year follow-up of multisystemic therapy with substance-abusing and substance-dependent juvenile offenders. Journal of the American Academy of Child & Adolescent Psychiatry, 41(7), 868–874.CrossRefGoogle Scholar
  21. Ingoldsby, E. M. (2010). Review of interventions to improve family engagement and retention in parent and child mental health programs. Journal of Child and Family Studies, 19(5), 629–645.CrossRefPubMedPubMedCentralGoogle Scholar
  22. Kaufman, J., Birmaher, B., Brent, D., Rao, U., Flynn, C., Moreci, P., … Ryan, N. (1997). Schedule for affective disorders and schizophrenia for school-age children—Present and lifetime version (KSADS-PL): Initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 980–988.CrossRefPubMedGoogle Scholar
  23. Kazdin, A. E. (1997). Practitioner review: Psychosocial treatments for conduct disorder in children. Journal of Child Psychology and Psychiatry, 38(2), 161–178.CrossRefPubMedGoogle Scholar
  24. Kazdin, A. E. (2007). Psychosocial treatments for conduct disorder in children and adolescents. In P. E. Nathan & J. M. Gorman (Eds.), A guide to treatments that work (3rd ed., pp. 71–104). New York: Oxford University Press.Google Scholar
  25. Kimonis, E., Frick, P. J., & McMahon, R. J. (2014). Conduct and oppositional defiant disorders. In E. J. Mash & R. A. Barkley (Eds.), Child psychopathology (pp. 145–179). New York, NY: Guilford Press.Google Scholar
  26. Knight, J. R., Sherritt, L., Shrier, L. A., Harris, S. K., & Chang, G. (2002). Validity of the CRAFFT substance abuse screening test among adolescent clinic patients. Archives of Pediatrics & Adolescent Medicine, 156(6), 607–614.CrossRefGoogle Scholar
  27. Lilienfeld, S. O. (2007). Psychological treatments that cause harm. Perspectives on Psychological Science, 2(1), 53–70.CrossRefPubMedGoogle Scholar
  28. McMahon, R. J., & Frick, P. J. (2007). Conduct and oppositional disorders. In E. J. Mash & R. A. Barkley (Eds.), Assessment of childhood disorders (pp. 132–183). New York, NY: Guilford Press.Google Scholar
  29. Miller-Johnson, S., Coie, J. D., Bierman, K., Maumary-Gremaud, A., & CPPRG. (2002). Peer rejection and aggression and early starter models of conduct disorder. Journal of Abnormal Child Psychology, 30, 217–230.CrossRefPubMedPubMedCentralGoogle Scholar
  30. Moffitt, T. E., & Caspi, A. (2001). Childhood predictors differentiate life-course persistent and adolescence-limited antisocial pathways among males and females. Development and Psychopathology, 13(2), 355–375.CrossRefPubMedGoogle Scholar
  31. Monshat, K., Vella-Brodrick, D., Burns, J., & Herrman, H. (2012). Mental health promotion in the internet age: A consultation with Australian young people to inform the design of an online mindfulness training programme. Health Promotion International, 27(2), 177–186.CrossRefPubMedGoogle Scholar
  32. Nock, M. K., Kazdin, A. E., Hiripi, E., & Kessler, R. C. (2006). Prevalence, subtypes, and correlates of DSM-IV conduct disorder in the National Comorbidity Survey Replication. Psychological Medicine, 36(5), 699–710.CrossRefPubMedPubMedCentralGoogle Scholar
  33. Patterson, G. R. (1982). Coercive family process. Eugene, OR: Castalia.Google Scholar
  34. Paolucci, E. O., & Violato, C. (2004). A meta-analysis of the published research on the affective, cognitive, and behavioral effects of corporal punishment. The Journal of psychology, 138(3), 197–222.Google Scholar
  35. Quay, H. C. (1987). Patterns of delinquent behavior. In H. C. Quay & J. S. Werry (Eds.), Handbook of juvenile delinquency (pp. 118–138). New York, NY: Wiley & Sons.Google Scholar
  36. Reynolds, C. R., & Kamphaus, R. W. (2004). BASC-2: Behavior assessment system for children. Pearson: Bloomington, MN.Google Scholar
  37. Rotheram-Borus, M. J., Swendeman, D., & Chorpita, B. F. (2012). Disruptive innovations for designing and diffusing evidence-based interventions. American Psychologist, 67(6), 463–476.CrossRefPubMedPubMedCentralGoogle Scholar
  38. Searight, H. R., Rottnek, F., & Abby, S. L. (2001). Conduct disorder: Diagnosis and treatment in primary care. American Family Physician, 63(8), 1579–1588.PubMedGoogle Scholar
  39. Sexton, T. L., & Alexander, J. F. (2003). Functional family therapy: A mature clinical model for working with at-risk adolescents and their families. In T. L. Sexton, G. R. Weeks, & M. S. Robbins (Eds.), Handbook of family therapy: The science and practice of working with families and couples (pp. 323–348). New York, NY: Brunner-Routledge..Google Scholar
  40. Shaw, D. S., & Shelleby, E. C. (2014). Early-onset conduct problems: Intersection of conduct problems and poverty. Annual Review of Clinical Psychology, 10, 503–528.CrossRefPubMedPubMedCentralGoogle Scholar
  41. Simonoff, E., Elander, J., Holmshaw, J., Pickles, A., Murray, R., & Rutter, M. (2004). Predictors of antisocial personality. Continuities from childhood to adult life. The British Journal of Psychiatry, 184, 118–127.CrossRefPubMedGoogle Scholar
  42. Snyder, J., Schrepferman, L., Oeser, J., Patterson, G., Stoolmiller, M., Johnson, K., & Snyder, A. (2005). Deviancy training and association with deviant peers in young children: Occurrence and contribution to early-onset conduct problems. Development and Psychopathology, 17(2), 397–413.CrossRefPubMedGoogle Scholar
  43. Szapocznik, J., & Williams, R. A. (2000). Brief strategic family therapy: Twenty-five years of interplay among theory, research and practice in adolescent behavior problems and drug abuse. Clinical Child and Family Psychology Review, 3(2), 117–134.CrossRefPubMedPubMedCentralGoogle Scholar
  44. Taylor, E. F., Genevro, J., Peikes, D., Geonnotti, K., Wang, W., & Meyers, D. (2013, April). Building quality improvement capacity in primary care: Supports and resources. Rockville, MD: Agency for Healthcare Research and Quality. Retrieved from
  45. Vander Stoep, A., Adrian, M., Mc Cauley, E., Crowell, S. E., Stone, A., & Flynn, C. (2011). Risk for suicidal ideation and suicide attempts associated with co-occurring depression and conduct problems in early adolescence. Suicide and Life-threatening Behavior, 41(3), 316–329.CrossRefPubMedGoogle Scholar
  46. Waschbusch, D. A. (2002). A meta-analytic examination of comorbid hyperactive-impulsive attention problems and conduct problems. Psychological Bulletin, 128(1), 118–150.CrossRefPubMedGoogle Scholar
  47. Wolraich, M. L., Lambert, W., Doffing, M. A., Bickman, L., Simmons, T., & Worley, K. (2003). Psychometric properties of the Vanderbilt ADHD diagnostic parent rating scale in a referred population. Journal of Pediatric Psychology, 28(8), 559–568.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Pediatric Behavioral Health and WellnessUniversity of Rochester Medical CenterRochesterUSA
  2. 2.University of Connecticut Health CenterFarmingtonUSA

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