Problems with oppositional, defiant, and aggressive behaviors are not uncommon for children with ADHD. Sometimes these behaviors escalate to the point where a child meets the diagnostic criteria for Oppositional Defiant Disorder (ODD) or Conduct Disorder (CD). Though ADHD and other disruptive behavior disorders such as ODD and CD are distinct conditions with different core symptoms, they do appear to share a common factor -- impulsivity.
Understanding Conduct Disorder
Conduct disorder is characterized by a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated. The behaviors may be physically aggressive causing harm to other people or animals, using dangerous weapons, the deliberate destruction of property, or they may be non-aggressive in nature such as deceitfulness, theft, and serious violation of rules. The severity of symptoms can range from mild (e.g., lying, truancy, staying out after dark without permission) to severe (e.g., forced sex, physical cruelty, use of a weapon, stealing while confronting a victim, breaking and entering). Approximately 6 to 16 percent of boys and 2 to 9 percent of girls meet the diagnostic criteria for conduct disorder. The incidence of conduct disorder increases from childhood to adolescence.
Many factors may contribute to the development of conduct disorder including biological and genetic causes, family history of antisocial behavior and mental illness such as antisocial personality disorder, mood, anxiety, or substance use disorders, exposure to pervasive family conflict, neglect, abuse, or violence, and chronic social adversity.
Symptoms of Conduct Disorder
Below are the symptoms of conduct disorder as specified in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Children or teens with conduct disorder may exhibit some of the following behaviors:
Aggression to people and animals
- often bullies, threatens, or intimidates others
- often initiates physical fights
- has used a weapon that can cause serious physical harm to others (e.g., a bat, brick, broken bottle, knife, gun)
- has been physically cruel to people
- has been physically cruel to animals
- has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery)
- has forced someone into sexual activity
Destruction of property
- has deliberately engaged in fire setting with the intention of causing serious damage
- has deliberately destroyed others' property (other than by fire setting)
Deceitfulness or theft
- has broken into someone else’s house, building, or car
- often lies to obtain goods or favors or to avoid obligations (i.e., “cons” others)
- has stolen items of nontrivial value without confronting a victim (e.g., shoplifting, but without breaking and entering; forgery)
Serious violations of rules
- often stays out at night despite parental prohibitions, beginning before age 13 years
- has run away from home overnight at least twice while living in parental or parental surrogate home (or once without returning for a lengthy period)
- is often truant from school, beginning before age 13 years
Read About: Conditions That Can Produce “ADHD-Like” Symptoms
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). American Psychiatric Association
ADHD Comorbidities: Handbook for ADHD Complications in Children and Adults, Edited by Thomas E. Brown. American Psychiatric Publishing, Inc. 2009.
H. RUSSELL SEARIGHT, PH.D.; FRED ROTTNEK, M.D.; STACEY L. ABBY, PHARM.D.; Conduct Disorder: Diagnosis and Treatment in Primary Care. Am Fam Physician. 2001 Apr 15;63(8):1579-1589.