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When your adolescent shows repeated aggression, defiance, or disregard for rules, it can be deeply unsettling. These behaviors often raise serious questions about what’s going on beneath the surface. In this guide, you’ll learn how conduct disorder affects teens, what contributes to it, and how you can respond in ways that support both your child and your family.
Key takeaways
- Conduct disorder is a serious mental health condition involving repeated aggression, rule-breaking, and a lack of empathy.
- It often develops from a mix of genetics, brain differences, trauma, and unstable family or peer relationships.
- Without support, CD can worsen with age and lead to long-term problems with the law, relationships, and emotional health.
- Harsh discipline, emotional distance, or inconsistent parenting often make symptoms worse.
- Treatment for conduct disorder includes supportive strategies like consistent rules, warm connections, therapy, and trauma-informed care.
What is conduct disorder (CD)?
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), conduct disorder is a mental health condition that involves a consistent pattern of rule-breaking, aggression, and disregard for others.
It’s different from other mental health concerns in a few important ways:
- Involves risk to others: Teens with CD may act in ways that are physically or emotionally harmful to other people or animals, which is not typical in most other disorders.
- Not the same as oppositional defiant disorder (ODD): ODD usually involves arguing, defiance, or anger at authority figures, but conduct disorder includes more severe actions like hurting others, stealing, or damaging property.
- Not caused by a mood disorder: While mood disorders like anxiety, depression, and bipolar disorder can lead to irritability or outbursts, conduct disorder involves a deeper pattern of violating others’ rights and social rules.
Symptoms of conduct disorder
To meet the clinical criteria for conduct disorder, a teen must show at least three of the following behaviors in the past year, with at least one present in the past six months:
- Aggression toward people or animals: Includes bullying, threatening, initiating fights, using weapons, physical cruelty to people or animals, or forcing someone into sexual activity.
- Destruction of property: May involve setting fires deliberately or damaging property on purpose.
- Deceitfulness or theft: Includes lying to get something, breaking into buildings or cars, or stealing without directly confronting the victim (e.g., shoplifting or forgery).
- Serious rule violations: Staying out at night before age 13, running away from home overnight at least twice, or skipping school regularly before age 13.
What causes conduct disorder?
There’s rarely just one cause. Conduct disorder tends to emerge from a mix of early experiences, emotional challenges, and biological factors that shape how a teen reacts to the world. Below are some of the most common contributing factors:
Environmental and family influences
Many teens with CD have experienced instability, conflict, or neglect at home.
A 2022 study found that being rejected by peers or mistreated in childhood, especially when a teen tends to dwell on anger, might contribute to more intense conduct problems. These environmental and relational factors may include:
- Unstable home life: Frequent arguments, separation, or low marital satisfaction can lead to increased stress on teens.
- Negative peer experiences: Being excluded or bullied can lead to acting out aggressively.
- Inconsistent discipline: Teens may test limits when consequences are unclear or conflicting.
- Lack of emotional support: A teen who doesn’t feel emotionally safe or understood may act out in frustration.
- Exposure to violence: Witnessing or experiencing violence at home or in the community can normalize aggressive responses.
Brain and emotional differences
Adolescents with conduct disorder often have trouble managing emotions and reading social cues due to what goes on inside their brains.
A 2024 neuroimaging review found that CD isn’t linked to one brain area, but to a network that includes the brainstem and cingulate cortex—regions tied to emotion and behavior regulation. This pattern of brain activity might lead to:
- Overreactions to minor conflicts: A teen may yell, threaten, or lash out even when others meant no harm because their brain treats the moment like danger.
- Difficulty with empathy: It can be hard for them to understand how someone else feels, especially in tense situations or arguments.
- Emotional numbness: Some teens seem cold or uncaring after hurting others, not because they don’t feel, but because their emotional system may not respond the same way.
- Impulsive reactions: They may hit, run away, or break rules without stopping to think, acting before the brain’s “brake system” can kick in.
- Low frustration tolerance: Everyday stress, like being told “no” or making a mistake, might trigger intense anger or a total shutdown.
Biological traits and related conditions
Some teens may be biologically more susceptible to CD.
A 2023 study found that CD shares genetic overlap with attention deficit hyperactivity disorder (ADHD) and depression.
It also found that stress from experiences like bullying can increase the effects of these inherited risks, making some teens more likely to develop serious behavior problems. Biological causes include:
- Family history of mental health issues: Teens are more likely to develop CD if close family members have had aggressive behaviors, ADHD, or depression.
- Early signs of emotional dysregulation: Strong mood swings or problems stopping themselves from doing something right away during early childhood may be warning signs of future emotional challenges.
- Overlap with other conditions: CD often coexists with ADHD, depression, or substance use, which can complicate diagnosis and management.
How is conduct disorder diagnosed?
Getting a clear diagnosis can help you better understand what your child is going through. It often involves trained professionals using multiple tools to assess patterns over time:
Who can diagnose
- Psychologists: These licensed mental health professionals often assess and diagnose CD through clinical interviews and observation.
- Child psychiatrists: Medical doctors who specialize in mental health and can also prescribe medications if needed.
- Clinical social workers: Professionals trained to recognize conduct disorder through behavior assessments and family context.
Tools used in assessment
Diagnosis usually includes structured tools to check for consistent behavior patterns:
- DSM-5 criteria: This standard diagnostic guideline is used to identify specific behaviors that have occurred over at least 12 months.
- PSCD scale: This rating scale helps identify patterns of rule-breaking, aggression, and unemotional traits by scoring behaviors reported by adults who know the child well.
- Clinical interviews and observations: Mental health professionals talk with the child, family, and sometimes teachers, while also observing behavior directly to understand emotional responses and social interactions.
- Behavior checklists: These forms ask parents and teachers to rate how often specific behaviors occur, helping to track consistency across different environments like home and school.
Why can diagnosis be delayed?
There are common reasons why conduct disorder may not be identified early:
- Limited training among teachers: Many educators lack the background to distinguish CD from other behavioral challenges like oppositional defiant disorder.
- Overlap with other issues: Symptoms of CD can look similar to ADHD, anxiety disorders, or trauma responses.
- Stigma or denial: Families may hesitate to seek help due to fear of being labeled or misinterpreting the signs.
If you’re worried that your teen might be showing signs of conduct disorder, talking to a mental health professional can get you the right answers. Getting help early will provide adequate support for your child and you. Remember, your teen is not a “bad kid,” and you are not a terrible parent; seeking help is an act of care and courage.
How conduct disorder develops over time
Conduct disorder can start small and become more serious over time. Many children show early signs that, if unaddressed, may lead to greater challenges as they grow. It’s helpful to understand how symptoms can change across different stages of life:
Early signs in childhood
Children who are drawn to risk at an early age may be more likely to develop conduct disorder over time. A 2024 study using data from the UK Millennium Cohort found that children who scored higher on risk-taking tasks at age 11 were more likely to show conduct disorder behaviors by age 17. At this age, you might notice:
- High tolerance for risky behavior: Willingness to ignore rules or warnings despite known consequences.
- Poor decision-making in high-stakes situations: Choosing actions that create problems for themselves or others.
- Lack of safety concern: Engaging in behavior that could lead to harm without appearing worried.
Changes during adolescence
As conduct disorder progresses into the teen years, symptoms often become more pronounced and risky. At this age, you might notice:
- Risk-taking behavior: May include reckless driving, drug use, or theft.
- Escalating aggression: Fights may involve more intent to harm or control others.
- Manipulative behavior: Lies or deception might focus on avoiding consequences or gaining an advantage.
- Clashing with authority at school: Frequent suspensions, conflict with teachers, or refusal to follow rules.
- Changing peer group suddenly: Forming friendships with others who engage in rule-breaking or antisocial behavior.
Long-term effects in adulthood
A 2023 study found that untreated CD can evolve into antisocial personality disorder and chronic emotional problems. Over time, conduct disorder in teens can lead to serious and lasting difficulties in daily life:
- Involvement with the justice system: Acts of aggression, theft, or repeated defiance of authority may result in legal consequences, including arrest or incarceration.
- Struggles in relationships or employment: Difficulty managing emotions and following rules can lead to conflict with partners, coworkers, or supervisors, which can make it harder to maintain stable relationships or jobs.
- Worsening mental health: Ongoing behavior problems may contribute to serious emotional struggles like substance use disorder.
Common parenting mistakes that make conduct disorder worse
Parents often try to correct CD with strong intentions, but some strategies can unintentionally backfire. Here are common pitfalls that worsen symptoms over time:
Using harsh or punitive discipline
Yelling, spanking, or shaming often escalates defiance instead of reducing it. A 2020 study found that harsh parenting increased aggression and antisocial behavior and was also linked to later suicidality. These approaches may lead to:
- Higher aggression levels: Teens may respond with physical fights, verbal threats, or retaliation because they feel attacked rather than guided.
- Worsened emotional dysregulation: Harsh discipline can trigger intense shame, making it harder for teens to calm down or think clearly when upset.
- Weakened trust: When teens feel constantly criticized or punished, they may withdraw emotionally or stop sharing their feelings and experiences.
Being inconsistent or overly permissive
Leniency or flip-flopping discipline sends mixed signals and fuels risky behavior.
A 2024 study found that 66% of parents using permissive styles had teens with higher CD symptoms.
When rules aren’t consistent, teens may become emotionally colder or stop caring how their actions affect others. Permissive parenting might lead to:
- More boundary testing: Teens may act out more often to see what they can get away with, since consequences seem unclear.
- Manipulative behavior: If rules shift from day to day, teens may lie or blame others to avoid punishment or responsibility.
- Escalating behavior: Without a steady structure, teens may feel ungrounded and continue to push boundaries to get attention or control.
Showing emotional detachment
Teens who feel emotionally disconnected from caregivers may act out more intensely.
Research shows that when teens don’t feel loved or emotionally close to their caregivers, it often leads to higher CD symptoms and callous-unemotional (CU) traits, which include a lack of guilt, low empathy, and shallow emotions:
- Withdrawal or rebellion: Teens may become distant, angry, or aggressive as a way to cope with feeling emotionally alone.
- More lying and secrecy: A lack of warmth can make teens feel unsafe opening up, leading them to hide behaviors or problems.
- Low empathy: Teens may mimic the coldness they experience, making it harder for them to care about how their actions affect others.
Relying on “tough love” approaches
Strict control without warmth can temporarily suppress symptoms, but often fuels resentment. Research shows authoritarian styles increase rebellion, lying, and emotional shutdown.
- Surface compliance: Teens might follow rules to avoid punishment, not because they understand or agree with them.
- Increased lying or defiance: They may hide behaviors or break rules secretly, especially if they feel misunderstood or powerless.
- Poor long-term outcomes: Without emotional connection, teens may not learn how to manage feelings or make positive choices on their own.
How is conduct disorder treated?
It can feel overwhelming to know where to start when your teen is struggling. Fortunately, some therapeutic techniques support a child with conduct disorder:
Focus on behavioral support
Therapy that focuses on behavior patterns can help teens reduce aggression and make safer choices. Research shows that cognitive-behavioral therapy and parent training programs can significantly reduce conduct disorder symptoms. You can apply some of the same techniques used in cognitive-behavioral therapy and parent training programs at home:
- Reinforce positive behavior: Praise small wins and improvements right when they happen so your teen knows what they’re doing well.
- Set consistent consequences: Make rules clear in advance and follow through calmly when they’re broken.
- Practice skill-building at home: Teach your teen how to name their feelings and come up with simple solutions to everyday problems.
- Use time-outs calmly: Give your teen a short break to cool off when needed, without yelling or shame, and explain why the time-out is happening.
- Model the behavior you want to see: Stay calm during conflict, use respectful words, and show how to manage frustration.
- Give clear instructions: Speak in short, direct sentences so your teen knows exactly what to do, like “Please put your phone on the counter now.”
Try family therapy to improve communication.
Joining your teen in therapy and practicing better communication at home can rebuild trust and help them feel supported. A 2024 study found that family therapy improved emotional connection and reduced conflict in teens with conduct disorder.
- Attend sessions regularly: Show up for family therapy consistently, even if progress seems slow at first.
- Focus on active listening: Pay close attention to what your teen says, and respond with empathy instead of judgment.
- Create space for feedback: Invite your teen to share their thoughts and feelings, and react calmly without punishment or criticism.
- Practice skills learned in therapy at home: Use strategies discussed in therapy sessions, like calm problem-solving or setting respectful limits, during everyday situations.
- Work on shared goals as a family: Set clear, realistic goals together and check in on them regularly to build a sense of teamwork.
Trauma-informed therapy
Girls with conduct disorder may not always show obvious signs like aggression or rule-breaking. Research shows they often have strong emotional reactions and may carry hidden trauma that needs a different kind of support. To better support your daughter:
- Watch for internalizing behaviors: Girls may appear withdrawn or anxious instead of acting out, which can hide deeper struggles.
- Seek programs with trauma-informed care: Programs that understand how trauma affects behavior can help girls feel safer and more understood.
- Choose therapists experienced with girls: Look for providers who know how CD shows up in girls and tailor support to meet those needs.
Sources
- Heidari, F., Narimani, M., Aghajani, S., & Basharpoor, S. (2022). Causal Modeling of Conduct Disorder Signs Based on Childhood Maltreatment and Peer Rejection with the Mediating Role of Anger Rumination: A Descriptive Study. Journal of Rafsanjan University of Medical Sciences. https://doi.org/10.52547/jrums.21.4.377.
- Dugré, P., & Potvin, P. (2024). Mapping the Brain Network of Conduct Disorder: Heterogeneous fMRI findings converge on a Common Brain Circuit. https://doi.org/10.1101/2024.06.02.24308339.
- Tesli, N., Jaholkowski, P., Haukvik, U., Jangmo, A., Haram, M., Rokicki, J., Friestad, C., Tielbeek, J., Næss, Ø., Skardhamar, T., Gustavson, K., Ask, H., Fazel, S., Tesli, M., & Andreassen, O. (2023). Conduct disorder – a comprehensive exploration of comorbidity patterns, genetic and environmental risk factors. Psychiatry Research, 331. https://doi.org/10.1016/j.psychres.2023.115628.
- Cheung, C., Lewis, G., Lewis, G., & Srinivasan, R. (2024). Choices Today, Behaviours Tomorrow: Longitudinal Associations Between Childhood Risky Decision-making and Adolescent Conduct Disorder Behaviours – a Nationally Representative Prospective Cohort Study in the United Kingdom. BJPsych Open, 10, S3 – S3. https://doi.org/10.1192/bjo.2024.76.
- Giulio, P., Gianfranco, F., & Federica, P. (2023). The psychopathological evolution of “Behavior and Conduct Disorder in Childhood”: Deviant and criminal traits in preadolescence and adolescence. A review. Open Journal of Pediatrics and Child Health. https://doi.org/10.17352/ojpch.000051.
- Kemp, E., Boxer, P., Frick, P., & Frick, P. (2020). Treating Conduct Problems, Aggression, and Antisocial Behavior in Children and Adolescents. , 203-218. https://doi.org/10.1007/978-3-030-44226-2_14.
- Longo, V., Saadati, N., & Çobanoğlu, N. (2024). The Role of Family Therapy in Managing Adolescent Conduct Disorder. KMAN Counseling and Psychology Nexus. https://doi.org/10.61838/kman.psychnexus.2.2.2.
- Santaguida, E., Paparatto, G., Masi, G., Milone, A., Tolomei, G., & Muratori, P. (2023). [Conduct disorder in female adolescents: evidence from the FemNAT-CD Project.]. Rivista di psichiatria, 58 4, 175-182 . https://doi.org/10.1708/4064.40480.
- Kingsbury, M., Sucha, E., Manion, I., Gilman, S., & Colman, I. (2020). Pathways from parenting practices to adolescent suicidality: Evidence on the role of emotional and behavioral symptoms from a prospective cohort of Canadian children. Suicide & life-threatening behavior. https://doi.org/10.1111/sltb.12672.
- Mohamed, N., Abd-Elmageed, F., & Ramadan, R. (2024). Sounding the alarm regarding mental health of children and adolescents in relation to parenting style. Egyptian Pediatric Association Gazette. https://doi.org/10.1186/s43054-024-00285-z.
- Zheng, Y., Li, K., Zheng, H., & Pasalich, D. (2024). Daily Associations between Parental Warmth and Discipline and Adolescent Conduct Problems and Callous-Unemotional Traits.. Prevention science : the official journal of the Society for Prevention Research. https://doi.org/10.1007/s11121-024-01740-4.
- Ramsewak, S., Moty, N., Putteeraj, M., Somanah, J., & Nirmala, L. (2021). Parenting style and its effect on eating disorders and substance abuse across the young population. Discover Psychology, 2. https://doi.org/10.1007/s44202-022-00025-7.
Residential Treatment Program for Teens with Conduct Disorder
When your teen is angry all the time, breaks rules constantly, or shows no concern for others, it can leave you feeling helpless. Our residential treatment program is built to support teens in a safe, structured setting. Families living in Arizona and Idaho can access our Teen Programs: