How is conduct disorder related to other mental health conditions?

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). 

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. 

What mental health conditions are linked to conduct disorder?

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.
• 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: 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: Children who have a history of trauma may struggle with impulsivity and self-regulation, symptoms associated with CD.  

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. 

How can you manage conduct disorder and related 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:

• 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. 

Find care with Rula

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. 

With Rula, you can explore a diverse network of over 10,000+ therapists including some who specialize in conduct disorder and related mental health conditions. With just a few clicks, you can meet with a therapist via live video as soon as tomorrow.

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