Conduct Disorders in Children and Adolescents
Susan E. Gottlieb MD1
Stanford B. Friedman MD2
1 Assistant Professor of Pediatrics, North Shore University Hospital, Cornell University Medical Center, 444 Community Dr, Suite 202, Manhasset, NY 11030
2 Professor of Pediatrics, North Shore University Hospital, Cornell University Medical College
Conduct disorder is the most prevalent psychopathologic condition of childhood. It is characterized by a persistent and repetitive pattern of aggressive, noncompliant, intrusive, and poorly self-controlled behaviors that violate either the rights of others or age-appropriate societal norms.1 These behaviors have a significant impact on the daily functioning of the child or adolescent and on the ability of parents and other adults to manage them.
The specific behavioral criteria for the diagnosis of conduct disorder can be conceptualized as either aggressive or nonaggressive in type (Table 1). Examples of aggressive behaviors are physical fighting and bullying, assault, vandalism, purse snatching, physical cruelty to persons or animals, breaking and entering, and arson. More serious aggressive behaviors are armed robbery, rape, and extortion.
Nonaggressive behaviors of conduct disorder include substance abuse, persistent truancy, running away from home overnight, frequent lying in a variety of social settings, theft not involving a confrontation with a victim, and chronic violation of rules or the basic rights of others.
Three subtypes of conduct disorder are identified in the Diagnostic and Statistical Manual of Mental Disorders, revised 3rd edition.1 These are descriptions of the functional contexts in which the particular behavior problems occur. The group type involves problematic behaviors that occur as part of an activity with peers.
