Abnormal Psychology

Childhood Disorders 649

characterized mainly by problems with attention but

sometimes by disruptive behavior as well). As we’ll see,

symptoms of these three disorders commonly—though

not always—occur together.

What Is Conduct Disorder?

The hallmark of conduct disorder is a violation of the

basic rights of others or of societal norms that are ap-

propriate to the individual’s age (American Psychiatric

Association, 2000). As outlined in Table 14.10, 15 types

of behaviors are listed in the diagnostic criteria for

conduct disorder; these behaviors are sorted into four

categories:

• aggression to people and animals;


• destruction of property;


• deceitfulness or theft; and


• serious violation of rules.

Just as the criteria for antisocial personality disor-

der (Chapter 13) focus almost exclusively on behavior

that violates the rights of others, so do the criteria for

conduct disorder. To be diagnosed with antisocial per-

sonality disorder, the individual must be at least 18 years

old. Although adults may be diagnosed with conduct

disorder, it is most commonly diagnosed in children.

DSM-IV-TR requires the presence of a minimum of

3 out of the 15 types of behavior listed in Criterion A

within the last 12 months; at least one type of behavior

must have occurred during the last 6 months. Although

the diagnosis requires impaired functioning in some

area of life, it does not require distress.

Most individuals diagnosed with conduct disor-

der are under 18 years old; if the behaviors persist into

adulthood, the individual usually meets the criteria for

antisocial personality disorder; in some cases, however,

an individual may not meet all the criteria for that dis-

order and so retains the diagnosis of conduct disorder.

Like people with antisocial personality disorder,

people with conduct disorder appear to lack empathy

and concern for others, and they don’t exhibit genuine

remorse for their misdeeds. In fact, when the intent of another person’s behavior

is ambiguous, an individual with conduct disorder is likely to (mis)attribute the

other’s motives as threatening or hostile and then feel justifi ed in his or her own ag-

gressive behavior. People with conduct disorder typically blame others for their in-

appropriate behaviors (“He made me do it”). And though appearing self-confi dent,

some people with conduct disorder may, in fact, have low self-esteem; however,

other people with this disorder have overinfl ated self-esteem. Outbursts of anger,

recklessness, and poor frustration tolerance also frequently occur, although these

characteristics are not part of the DSM-IV-TR criteria.

DSM-IV-TR specifi es three levels of intensity for the symptoms of conduct disorder;

the symptoms may progress from mildly disruptive to severely disruptive behaviors:

• Mild. The individual has only the minimum number of symptoms to meet the

criteria, and the disruptive behaviors cause minimal harm to others (for example,

lying or staying out after curfew).

Table 14.10 • DSM-IV-TR Diagnostic Criteria

for Conduct Disorder

A. A repetitive and persistent pattern of behavior in which the basic rights of others

or major age-appropriate societal norms or rules are violated, as manifested by the

presence of three (or more) of the following criteria in the past 12 months, with at

least one criterion present in the past 6 months:

Aggression to people and animals

(1) often bullies, threatens, or intimidates others;

(2) often initiates physical fi ghts;

(3) has used a weapon that can cause serious physical harm to others (e.g., a bat,

brick, broken bottle, knife, gun);

(4) has been physically cruel to people;

(5) has been physically cruel to animals;

(6) has stolen while confronting a victim (e.g., mugging, purse snatching,

extortion, armed robbery);

(7) has forced someone into sexual activity.

Destruction of property

(8) has deliberately engaged in fi re setting with the intention of causing serious

damage;

(9) has deliberately destroyed others’ property (other than by fi re setting).

Deceitfulness or theft

(10) has broken into someone else’s house, building, or car;

(11) often lies to obtain goods or favors or to avoid obligations (i.e., “cons” others);

(12) has stolen items of nontrivial value without confronting a victim (e.g., shop-

lifting, but without breaking and entering; forgery).

Serious violations of rules

(13) often stays out at night despite parental prohibitions, beginning before age

13 years;

(14) 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);

(15) is often truant from school, beginning before age 13 years.

B. The disturbance in behavior causes clinically signifi cant impairment in social,

academic, or occupational functioning.

C. If the individual is age 18 years or older, criteria are not met for Antisocial Person-

ality Disorder [discussed in Chapter 13].

Source: Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders,

Text Revision, Fourth Edition, (Copyright 2000) American Psychiatric Association.

Conduct disorder

A psychological disorder that typically arises

in childhood and is characterized by the

violation of the basic rights of others or of

societal norms that are appropriate to the

individual’s age.