Conduct disorder is characterized by the following symptoms:
- Aggression to people and animals, which includes:
- Bullying, threatening, or intimidating others
- Initiating physical fights
- Using a weapon that can cause serious physical harm to others
- Being physically cruel to people or animals
- Stealing while confronting a victim (e.g., mugging)
- Forcing someone into sexual activity
- Destruction of property, which includes:
- Deliberate fire setting with the intention of causing serious damage
- Deliberate destruction of others’ property
- Deceitfulness or theft, which includes:
- Breaking into someone else’s house, building, or car
- Lying or “conning” to obtain goods or favors or to avoid obligations
- Stealing items of nontrivial value without confronting a victim (e.g., shoplifting).
- Serious violations of rules, which includes:
- Staying out at night despite parental prohibitions, beginning before age 13 years
- Running away from home overnight
- Being truant from school, beginning before age 13 years
Children and adolescents with this disorder have difficulty following rules and behaving in a socially acceptable way. Associated features of conduct disorder may include an inability to appreciate the importance of others' welfare and little guilt or remorse about harming others. Personality features of children and adolescents with conduct disorder may include trait negative emotionality and poor self-control, poor frustration tolerance, irritability, temper outbursts, suspiciousness, insensitivity to punishment, thrill seeking, and recklessness. Adolescents with conduct disorder often develop skills in outwardly verbalizing remorse to obtain favor or avoid punishment, but do not experience any apparent guilt. Children and adolescents are likely to show a variety of cognitive and attributional deficits and distortions including problem-solving skills, attributions of hostile intent to others, and resentment and suspiciousness. As a result, they may lash out preemptively, and aggression may appear unprovoked.
Very few children and adolescents with conduct disorder exhibit characteristics that qualify for the "with limited prosocial emotions" specifier. This specifier indicates that children and adolescents display limited prosocial emotions in multiple settings and relationships. They reflect the child or adolescent’s overall pattern of functioning, not just occasional occurrences in some situations. Children and adolescents who qualify for this specifier have been described as exhibiting callous and unemotional traits in research. Other personality features, such as thrill seeking, fearlessness, and insensitivity to punishment, may also distinguish those who fall under this specifier. Children and adolescents described in this specifier may be more likely than others with conduct disorder to engage in aggression that is planned for instrumental gain.
Conduct disorder is comprised of three subtypes- childhood onset, adolescent onset, and unspecified onset. Behaviors that are typical of childhood onset conduct disorder include physical aggression toward others, have disturbed peer relationships, may have had oppositional defiant disorder during early childhood, and usually have symptoms that meet full criteria for conduct disorder prior to age 10. Many children with this subtype also have concurrent attention-deficit/hyperactivity disorder (ADHD) or other neurodevelopmental difficulties. Individuals with adolescent-onset conduct disorder are less likely to display aggressive behaviors and tend to have more normative peer relationships.