Conduct disorder (CD) is a mental health condition that’s characterized by aggressive behavior, harm toward others or animals, lying, and severe bullying.
CD and other mental health conditions like depression, attention-deficit hyperactivity disorder (ADHD), and learning disorders frequently appear together.
Treating CD alongside co-occurring conditions requires a comprehensive approach. This may include talk therapy, family therapy, behavioral intervention, and, sometimes, medication.
Hearing that your child is having problems in school or bullying others can be hard for parents. It’s even more frustrating when the behavior persists or escalates.
Occasionally acting out is normal in childhood as kids gain independence and develop their unique personalities. But if your child consistently demonstrates aggressive, disruptive, or harmful behaviors that don’t improve with positive reinforcement and other parenting techniques, consult a mental health professional for an assessment for conduct disorder (CD) and any related or co-occurring conditions.
CD is a mental health condition that affects 2% to 8% of children and teens and is characterized by acting aggressively toward people or animals, breaking rules, and engaging in other destructive or disruptive behaviors. Parenting a child with CD can be stressful, but this condition is treatable.
Most commonly associated conditions
CD often co-occurs with other psychiatric conditions like attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). A coexisting behavior disorder can sometimes complicate an accurate diagnosis, so it’s important to work with a trained mental health professional to get a correct diagnosis and create a treatment plan that’s effective for your child. Treatment for CD and any coexisting mental health conditions can include behavior therapy, family therapy, and, in some instances, medication.
To be diagnosed with conduct disorder, a child or teen must demonstrate at least three or more symptoms during the past 12 months and at least one symptom during the previous six months. Symptoms can include:
Acting aggressively toward people or animals
Destroying property
Setting fires
Skipping school
Disregarding rules
Running away from home
Using drugs or alcohol
Engaging in sexual behaviors at a young age
Some people with conduct disorder also have overlapping symptoms of other mental health conditions. These include:
Oppositional defiant disorder: A behavior disorder, ODD shares overlapping symptoms with CD, including defiant and hostile behavior toward authority figures and having difficulty with following rules. An estimated 30% of children and teens with ODD meet the criteria for conduct disorder.
Attention-deficit hyperactivity disorder (ADHD): Approximately 30% to 50% of children with ADHD also have conduct disorder. Overlapping symptoms can include resisting rules and disobedience. Left untreated, the two disorders can increase the risk of substance use or legal problems.
Depression and anxiety disorders: Some children with depression and anxiety may develop CD as a way of coping with their feelings. Depression and conduct disorder also share risk factors like genetics, neglect, and negative childhood experiences.
Substance use disorders (SUDs): Conduct disorder is frequently diagnosed in teens with substance use disorder. Research shows that teens with mental health disorders had high rates of alcohol and drug use.
Antisocial personality disorders: Children and teens diagnosed with conduct disorder are at risk of developing antisocial personality disorders as adults. Symptoms of these mental health conditions include a disregard for the rights, feelings, and desires of others.
Learning disabilities: Children with reading and/or spelling problems have an increased rate of CD.
Bipolar disorder: Conduct disorder frequently occurs with bipolar disorder. Genetics, family dynamics, and difficulty with social norms are risk factors for both conditions.
Post-traumatic stress disorder (PTSD): Children who have a history of trauma may struggle with impulsivity and self-regulation, symptoms associated with CD.
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Why does conduct disorder frequently co-occur with other conditions?
The exact cause of conduct disorder and why it often co-occurs with other conditions isn’t known. But researchers believe several factors can increase the risk of developing CD and other conditions. Factors include:
Genetics: Having a family history of mental health disorders, like CD, ADHD, depression, or substance use, can lead to a higher risk of both conditions.
Trauma: Children who experienced early trauma, including physical or emotional abuse, are at a higher risk of developing conduct disorder and a mental health condition such as post-traumatic stress disorder (PTSD), depression, or anxiety.
Sex: Boys are more likely to be diagnosed with CD and are at a higher risk of developing co-occurring disorders such as ADHD and substance use disorder.
Temperament: Highly irritable and impulsive children, even from infancy, may be more prone to developing CD along with mood and anxiety disorders.
Family environment: Children who experience poverty, poor parental supervision, harsh parenting, or domestic violence are at a greater risk of CD and coexisting depression or substance use disorder.
Which adult diagnosis can CD develop into?
Some children with conduct disorder (CD) see their behavior improve as they grow and get support. But for others, the behaviors may continue into adulthood. When this happens, CD can sometimes develop into antisocial personality disorder. Antisocial personality disorder is a condition in adults that involves ignoring the rights, feelings, and safety of others.
Not all children with CD will go on to develop antisocial personality disorder. Many do better over time — especially when they get help early. Early intervention matters because it can lower harmful behaviors, teach better coping skills, and support healthier relationships at home, at school, and later in life.
If you’re worried about ongoing behavior problems, reaching out to a mental health professional can help you understand what’s happening and find the right support for your child.
Treatments for CD and co-occurring conditions
Learning your child has conduct disorder and a coexisting mental health condition might feel overwhelming. You might worry about worsening symptoms as they get older or that they won’t be successful in school or develop healthy relationships. These are all reasonable concerns, but know that many kids with CD can learn to successfully manage their symptoms.
Starting therapy for concerning behaviors is an important first step in supporting your child’s mental health and can reduce challenges at home and school. Early support helps them learn how to manage their symptoms and gives them a treatment plan, setting them on a path to thrive.
Keep in mind that what works for one child may differ for another. Discuss with a therapist the specific behaviors you’d like to address and which treatment options might best suit your family.
These options may include therapy approaches, parent-focused interventions, and, in some cases, medication when recommended by your provider:
Parent management training (PMT): Research has shown parent training is effective in treating CD and coexisting conditions. PMT teaches positive reinforcement for appropriate behavior while setting limits for inappropriate behavior.
Anger management: Children can learn how to control their outbursts and anger issues or co-occurring conditions like ADHD.
Cognitive behavioral therapy (CBT): This form of talk therapy teaches children how to communicate and handle stress as well as problem-solving skills and emotional regulation.
Parent child interaction therapy (PCIT): This type of therapy works best with young children between the ages of two and seven. Parents learn how to provide consistent consequences for negative behavior and pay more attention to positive behavior while remaining calm.
As a therapist, I always remind parents that a child’s behavior is communication. Conduct issues can feel scary, but they’re often a sign that a child is overwhelmed, hurting, or missing key skills — not that they’re a ‘bad kid.’ With the right support, kids can learn healthier ways to cope and connect.
Brandy Chalmers, LPC
Clinical reviewer
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If you notice your child is showing signs of CD, a coexisting mental health condition, or both, there are treatment options available. You can learn how to support your child and your child can learn how to manage their symptoms in healthy ways. A combination of therapy and parental support can make a big difference in a child’s development.
At Rula, we’re here to help you feel better. Rula makes it easy to find a licensed therapist or psychiatric provider who takes your insurance. That way, you don’t have to choose between great care and a price you can afford.
Rula patients pay about $15 per session with insurance, and 93% say they feel better after getting care through Rula. We have 21,000+ providers, and appointments are available as soon as tomorrow. We’re here to help you take the next step — wherever you are in your mental health journey.
Linda Childers
Linda is an award-winning medical writer with experience writing for major media outlets, health companies, hospitals, and both consumer and trade print and digital outlets.
Her articles have appeared in the Washington Post, USA Today, WebMD, AARP, Brain+Life, HealthyWomen.org, The Rheumatologist, California Health Report, Everyday Health, HealthCentral, and many other media outlets.
While juggling the responsibilities of being part of the “sandwich generation” and caring for both her toddler son and terminally ill mother, a nurse friend encouraged her to seek therapy, which helped her to learn coping strategies and manage her depression. Linda hopes her work will help to destigmatize mental health conditions and encourage others to get the help they need.
Elise Miller, MA, LPC
Elise received her Masters in Professional Counseling from Liberty University and went on to become a Licensed Professional Counselor-Supervisor in Texas and Colorado. She has served in many facets of the mental health field including inpatient psychiatric hospitals, intensive outpatient programs, hospice, and mental health tech. She is currently working as an outpatient therapist in private practice.
Elise is also a mom of three little ones and brings this experience into her counseling work with fellow moms. Elise’s work comes from a place of deep compassion and lived experience along with her extensive training and specialization.
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