Conduct Disorder

In the previous post, we saw how the angry outbursts of Intermittent Explosive Disorder can even culminate in physical aggression. The next step is the inability to control behavior, which may lead to harming others (through aggression, theft, or property destruction) with a possible lack of concern for the consequences of one’s actions. This is the case of Conduct Disorder.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Conduct Disorder is characterized by the presence of behaviors that violate the rights of others or contravene social norms, causing significant distress even for the individual engaging in them. For individuals over the age of 18, this is not considered Antisocial Personality Disorder.

These violations are defined by showing at least three of the following 15 criteria within a one-year period, with at least one present during the past six months:

Aggression toward people and/or animals 1. Bullies, threatens, or intimidates others
2. Initiates physical fights
3. Has used a weapon capable of causing serious physical harm
4. Has been physically cruel to people
5. Has been physically cruel to animals
6. Has stolen while confronting the victim directly
7. Has forced someone into sexual activity

Destruction of property
8. Has deliberately set fire with intent to cause serious damage
9. Has deliberately destroyed others’ property

Deceitfulness or theft
10. Has broken into someone’s house, building, or car
11. Frequently lies to obtain goods or favors, or to avoid obligations
12. Has stolen items of value without confronting the victim (e.g., shoplifting)

Serious violations of rules
13. Before the age of 13, often stays out at night despite parental prohibitions
14. Has run away from home overnight at least twice (or once without returning for a long period)
15. Before the age of 13, frequently skips school (truancy)

It can also be specified whether the individual presents limited prosocial emotions if, consistently over the past year, they have shown at least two of the following characteristics:

• Lack of remorse or guilt regarding harmful actions
• Lack of empathy, i.e., disregard for others’ feelings
• Indifference to performance (in school or at work)
• Shallow or deficient affect toward others

Sources:

• American Psychiatric Association (2013) – Diagnostic and Statistical Manual of Mental Disorders (5th ed.)
• Bernhill, J. W. (2014) – DSM-5 Clinical Cases

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