Running head: CONDUCT DISORDER

Conduct Disorder in Childhood and Adolescence

Jordyn A. Williams

Youngstown State University

CONDUCT DISORDER 2

Aggression is a natural human expression that frequently manifests in

young children. Through the guidance of parents and the community, these

children typically grow out of these aggressive tendencies, begin socializing

with others around them, and eventually inhibit their aggressive behaviors.

However, there are some children that never do grow out of these aggressive

manifestations of behavior; they do not learn to socialize with peers and

inhibit rule-breaking behavior. These are the children that may be eligible for

a diagnosis of Conduct Disorder.

According to Mental Health America (n.d.), children and adolescents

with Conduct Disorder can experience significant impairment in social,

academic, and family functioning. Many children and adolescents with

Conduct Disorder experience issues such as, empathetic expression, remorse,

and understanding social cues (Mental Health America, n.d.). It is common

for these children and adolescents to misinterpret the actions of others as

being hostile and to respond aggressively. According to the Children’s

Hospital of Wisconsin (2015), the prevalence of Conduct Disorder in children

varies, with ranges of approximately 6% to 16% for males and 2% to 9% for

females. Conduct Disorder is more common in males than females by a 4:1

ratio.

The most fundamental feature of Conduct Disorder is a “repetitive and

persistent pattern of behavior by a child or teenager in which the basic rights of

others or major age-appropriate societal norms or rules are violated” (Grohol, 2013,

p. 1). These behaviors are categorized into four domains: aggressive behavior that

CONDUCT DISORDER 3

results in or threatens physical harm to other individuals or animals, nonaggressive

behavior that results in property damage or loss, deceitfulness or theft, and

repetitious violations of rules. To be diagnosed, three or more of these behaviors

must manifest within the past 12 months, with at least one present within the past 6

months. The domain, aggression to people and animals, includes behaviors such as,

bullying and threatening others, initiating physical fights, and forcing someone into

sexual activity. The domain, destruction of property, includes deliberately engaging

in arson and deliberately destroying others’ property. The domain, deceitfulness or

theft, involves breaking and entering another’s home or car, lying for personal gain,

and theft. Finally, the domain, serious violations of rules, includes running away

from home at least twice while living at home and truancy from school (Grohol,

2013).

There are two subtypes of Conduct Disorder, according to Grohol (2013).

These subtypes are separated based on the age of symptom onset. They differ in

characteristics of presenting problems, developmental course, and gender

demographics. Childhood-Onset Type is defined by the presence of at least one

criterion prior to 10 years of age (Grohol (2013). These individuals are typically

male, frequently display physical aggression, may have had Oppositional Defiant

Behavior during early childhood, and are at higher risk for persistent Conduct

Disorder and Adult Antisocial Personality Disorder, than those with Adolescent-

Onset Type. Adolescent-Onset Type, according to Grohol (2013), is defined by the

absence of any criterion prior to 10 years of age. These individuals are less likely to

display aggressive behavior, compared to those with Childhood-Onset Type. These

CONDUCT DISORDER 4

individuals are more likely to have normative peer relationships, but often display

inappropriate behavior in the presence of others). These individuals are at a lower

risk for the development of persistent Conduct Disorder or adult Antisocial

Personality Disorder. The ratio of males to females with diagnosed Adolescent-

Onset Type Conduct Disorder is lower than diagnosed Childhood-Onset Type

Conduct Disorder (Grohol, 2013).

According to Scott (2008), childhood conduct disorders have predictive value

for numerous issues later in adulthood such as, serious difficulties in work,

education, and finances, abuse, homelessness, substance abuse and dependence,

poor physical health, compromised immune functioning, dental and respiratory

problems, and suicidal behavior (Moffitt et al., 2002 as cited in Scott, 2008).

However, with treatment and effective intervention, reasonable work and social

adjustment can be made by adulthood (UCLA, 2008).

Development

According to Bernstein (2014), signs of disturbances of conduct can be found

as early as the age of two years. An early predictor of aggression in early childhood

is the presence of diversity of antisocial behavior (UCLA, 2008). Early symptoms

typically involve inattentive and impulsive behavior, irritable temperament, poor

attachment, hyperactivity, and poor compliance. Development of Conduct Disorder

in childhood has an increased chance of occurrence with the presence of negative

environmental factors such as, parental rejection and neglect, inconsistent and

harsh discipline, physical or sexual child abuse, lack of supervision, and frequent

changes of caregivers (UCLA, 2008). In some cases of Conduct Disorder

CONDUCT DISORDER 5

development, a genetic and environmental factor is involved with parent(s) who

have a history of psychopathology and conduct problems. In many cases,

symptomology of Conduct Disorder is perpetuated by ineffective parenting styles of

parents and caregivers. These styles involve parenting behavior that is inconsistent,

punitive, and impatient. As a result of stressful environmental conditions, such as

financial problems, marital issues, lack of parenting skills, and issues with child

temperament, parents may struggle to effectively and consistently set limits and

emotionally support their child (Bernstein, 2014). From this behavior, a negative

cycle can begin in which the child’s temperamental difficulties can increase. This can

result in noncompliance with requests, increased punitive action from the parents

attempting to increase compliance, and eventual relinquishment of control from the

parents. If this happens, the child’s defiant behaviors are reinforced. Consequently,

parents oftentimes become isolated from external support and, following increased

negative interaction with their child, may spend less and less time with him or her.

This behavior, as a result, provides the child with decreased support and inadequate

opportunity to learn accurate identification of his or her emotions and self-control

skills (Bernstein, 2014).

According to Bernstein (2014), advancement to elementary school age for a

child with Conduct Disorder can yield increased behavioral aggression with others.

Children, in their elementary school years, who have Conduct Disorder typically

display behaviors such as hostility, inattention to social cues, misinterpretation of

others’ intentions, and an inability to solve complex social situations (Bernstein,

2014). Children with Conduct Disorder are also likely to exhibit impulsivity and

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poor self-control. As children with Conduct Disorder progress to early adolescence,

their hostility may develop into episodes of intense anger and aggressive action. As

this behavior begins to occur, these children typically blame others for their

aggressive actions, rarely taking personal responsibility (Bernstein, 2014).

According to Patterson and Forgatch (1987; as cited in Bernstein, 2014),

three clusters of behavior begin to emerge as children with Conduct Disorder reach

middle-school age. These behaviors consist of: noncompliance to commands,

emotional overreaction, and failure to take responsibility for personal actions. As

aforementioned, in many cases, parents spend less time with their children, which

may result diminished cognitive stimulation and, consequently, decreased

achievement in academic areas. Diminished cognitive stimulation can also be the

result of poor teacher-child relationships from repeated instances of noncompliance

and hostility towards adults. An intensification of behavioral problems can also

result in poor peer relationships and complete rejection from peer groups. This

defiant behavior can also result in rejection by teachers and even parents. According

to Bernstein (2014), this rejection not only leads to emotional damage but also to

increased unsupervised and unstructured time. As a result, children with Conduct

Disorder, often times, will loss all motivation to excel academically, develop a

negative self-image, and associate with peers who exhibit negative influence and

share similar deficits in socialization, empathy, and self-regulation (Bernstein,

2014).

By early high school, adolescents with Conduct Disorder, if left untreated,

typically display signs of depression as a result of continuous academic and social

CONDUCT DISORDER 7

failures (Bernstein, 2014). These adolescents are at high risk of joining deviant peer

groups, such as gangs. If no interventions are put in place, these adolescents will

likely become completely isolated from family systems, positive school orientation,

and all other pro-social groups. According to Bernstein (2014), continuous

association with deviant peer groups is likely to result in criminal and delinquent

actions. As adolescents with Conducted Disorder are poorly bonded to family, peers,

school, or general social norms, they may come to the attention of the juvenile

justice system. If incarcerated, it is likely that their delinquent behaviors and

attitudes will be left to further intensify (Bernstein, 2014).

Described above is one scenario of a student with Conduct Disorder who

escaped the eye of those who were in the position to intervene. While it is estimated

that 5 out of every 100 teenagers in the United States suffer from Conduct Disorder

(Bernstein, 2014), it is possible to prevent the above scenario for each one through

the implementation of researched-based prevention and intervention techniques.

Medical Diagnostic Considerations

Conduct Disorder is defined by the Diagnostic and Statistical Manual of

Mental Disorders– 5th Edition (DSM – V) as “ a repetitive and persistent pattern of

behavior in which the basic rights of others or major age-appropriate societal norms

or rules are violated” (Bernstein, 2014; American Psychiatric Association, 2013). In

order to be diagnosed with Conduct Disorder, the client must display a

manifestation of at least 3 of 15 criteria in the past 12 months, with at least one

criterion manifesting within the past six months. These criteria are organized into

four clusters: aggression to people and animals, destruction of property,

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deceitfulness or theft, and serious violations of rules. In order to be diagnosed with

conduct disorder, the individual must experience significant impairment in social,

academic, or occupational functioning, as a direct result of symptomology

(American Psychiatric Association, 2013).

Impact on Academics

According to Bernstein (2014), deficits in cognitive functioning and academic

performance are widely reported as educational correlates of Conduct Disorder.

Research on the topic has resulted in inconclusive data as to the definitive link

between poor academic performance and Conduct Disorder. However, researches

have theorized that delinquency could be the result of progression from academic

failure to antisocial behavior. This theory postulates that academic failure can result

in decreased self-esteem and helplessness, and, escape from academics via acting

out or dropping out of school (Bernstein, 2014). Another theory, described by

Bernstein (2014), hypothesized that Conduct Disorder and poor academic

achievement are a result of dysfunctional external variables; i.e., socioeconomic

status, familial support, environment. These external variables serve as supports for

conduct problems and inhibitors of academic achievement. In a third theory, it is

believed that some individuals with Conduct Disorder and poor academic

achievement have a comorbid disorder of cognitive processing known as, Hebb

Repetition Effect. This involves selective impairment in cognitive tasks of serial

order processing (Bernstein, 2014).

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Special Education Eligibility Considerations

Conduct Disorder itself is not a category for special education eligibility

under the Individuals with Disabilities Education Act (IDEA) (2004). However,

Conduct Disorder is frequently comorbid with learning disabilities or Attention

Deficit Hyperactivity Disorder (ADHD). As a result, students with Conduct Disorder

may be eligible for special education services under the categories of Other Health

Impairment, Specific Learning Disability, or Emotional Disturbance.

IDEA (2004) defines the category of Other Health Impairment (OHI) as,

“Having limited strength, vitality, or alertness, including a heightened

alertness to environmental stimuli, that results in limited alertness with

respect to the educational environment, that: (i) is due to chronic or acute

health problems such as asthma, attention deficit disorder or attention deficit

hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead

poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, and

Tourette syndrome; and (ii) Adversely affects a child’s educational

performance.”

IDEA (2004) defines the category of Specific Learning Disability as,

“A disorder in one or more of the basic psychological processes involved in

understanding or in using language, spoken or written, that, may manifest

itself in the imperfect ability to listen, think, speak, read, write, spell, or to do

mathematical calculations, including conditions such as perceptual

disabilities, brain injury, minimal brain dysfunction, dyslexia, and

developmental aphasia. SLD does not include learning problems that are

CONDUCT DISORDER 10

primarily the result of visual, hearing, or motor disabilities, or mental

retardation, of emotional disturbance, or of environmental, cultural, or

economic disadvantage.”

IDEA (2004) defines the category of Emotional Disturbance as,

“A condition exhibiting one or more of the following characteristics

over a long period of time and to a marked degree that adversely

affects a child’s educational performance: (A) An inability to learn that

cannot be explained by intellectual, sensory or health factors. (B) An

inability to build or maintain satisfactory interpersonal relationships

with peers and teachers. (C) Inappropriate types of behavior or

feelings under normal circumstances. (D) A general pervasive mood of

unhappiness or depression. (E) A tendency to develop physical

symptoms or fears associated with personal or school problems. The

term includes schizophrenia. The term does not apply to children who

are socially maladjusted, unless it is determined that they have an

emotional disturbance. “

Assessment Techniques

Conduct Disorder is diagnosable by a qualified mental health professional

through the collaboration and review of detailed records of the child’s behavior

from parents, caregivers, and teachers, observations, and psychological assessment.

There is a variety of scales and rating systems that can be utilized in the assessment

of students with Conduct Disorder.

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According to the Massachusetts General Hospital division of School

Psychiatry (2010), self-rating scales include the Conduct Disorder Scale (CDS) and

the Reynolds Adolescent Adjustment Screening Inventory (RAASI). The CDS is a

checklist that includes 40 items and requires approximately 5 to 10 minutes for

administration. The age range for this assessment is 5-22 years and it assesses

aggressive and non-aggressive behavior, deceitfulness, theft, and norm violations.

The RAASI is a screening measure of psychological adjustment that includes 32

items. It requires approximately 5 minutes for administration and is for student’s

ages 12 to 19 years. This assessment measures antisocial behavior, anger control,

emotional distress, and self-esteem and social inhibition.

According to the Massachusetts General Hospital division of School

Psychiatry (2010), there are also a number of scales and rating systems for teachers

and parents of the student. These include the Adjustment Scales for Children and

Adolescents (ASCA) and the Social Skills Rating System (SSRS). The ASCA is an

assessment for student’s ages 5-17 years that includes 156 items. It measures

positive and problem behaviors in situations involving peers, smaller or weaker

youths, authority, recreation, confrontation, and learning. It requires approximately

10 to 20 minutes to complete and should be administered to a teacher who knows

the student well. The SSRS is a questionnaire that can be used to screen and classify

students suspected of having a social behavioral problem. It evaluates teacher-

student relationships, academic performance, and peer acceptance. The SSRS

requires about 10 to 25 minutes to complete. It includes a student self-report

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measure for students 8 to 18 years of age, a measure to be completed by a parent of

the student, and a measure to be completed by a teacher of the student.

Implications on the Family System

Conduct Disorder is one of the most difficult behavioral disorders to treat

and can have significant impact on the family of the child affected. According to

UCLA (2008), children and adolescents with Conduct Disorder and their families

often benefit from services that include, family therapy, parental training on how to

handle child or adolescent behavior, problem solving skills training, and

community-based services that focus on the child or adolescent within the context

of their family. Parents and caregivers of children with Conduct Disorder may

experience a range of conflicting emotions such as, anger, fear, grief, anxiety, love,

and depression. Feelings such as these are not unusual; parents and caregivers have

reported emotional support from family, friends, and support groups to be

significantly helpful in coping with these emotions (UCLA, 2008). Research has

found individual, couple, and family therapy to be helpful in providing guidance and

emotional support for the family of children with Conduct Disorder (UCLA, 2008).

Instructional Prevention and Intervention

According to Scott (2008), effective academic interventions include

programs that promote self-management and self-reinforcement training. The goal

of this training is to increase the child’s time spent on a task and to encourage him

or her to complete assignment quickly and accurately. Many of these programs were

created with the idea that students with antisocial and conduct concerns who are

struggling academically are likely to have parents who are not involved with their

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education (Scott, 2008). Approaches utilized by these programs include the

encouragement of home-school cooperation by improving the parent-teacher

relationship, involvement of parents in their child’s academics, and the use of

effective methods to reduce these children’s academic difficulties (Scott, 2008).

According to Levendoski & Cartledge (2000) as cited by Scott (2008), research into

the effectiveness of these programs has found moderate to large effects.

Medical Intervention

According to Scott (2008), it is highly likely that children with conduct

disorder will require clinical intervention to assist in the prevention and burden of

poor health and social maladjustment in adulthood.

Some pharmacological approaches for Conduct Disorder target reactive

aggression and overarousal (Scott, 2008). Treatments for these conditions often

include mood stabilizers (i.e., lithium and carbamazepine) and medications that

target affect dysregulation (i.e., buspirone and clonidine) (Scott, 2008). Research

into pharmaceutical treatments for Conduct Disorder have found methylphenidate,

and in one case, lithium, to be effective in reducing aggressiveness. Research has

also found lithium to be effective in reducing drug and alcohol cravings in

adolescents with Conduct Disorder (Swartout and White, 2010 as cited by

Bernstein, 2014). According to Bernstein (2014), studies have also shown

carbamazepine and guanfacine to be effective in the reduction of aggressive

behavior.

The first choice in pharmaceutical treatment, however, is stimulant

medication, which has been shown to be much safer. According to Bernstein (2014),

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stimulant medication has been shown to be effective in controlling symptoms of

inattention, impulsivity, and hyperactivity. According to Scott (2008), the use of

psychostimulants (i.e., methylphenidate and dexamfetamine) is amongst the best-

studied pharmacological interventions for children and adolescents with Conduct

Disorder, comorbid with Attention Deficit Hyperactivity Disorder (ADHD). Research

has found evidence that supports the claim that psychostimulants reduce

hyperactivity, impulsivity, and conduct problems; however, insufficient evidence

has been found to assert that stimulants reduce aggression when there is an absence

of ADHD (Scott, 2008).

Behavioral Prevention and Intervention

According to Scott (2008), conduct disorders can result in considerable

distress for children, families, and schools. Conduct problems, often times, result in

social and educational impairment (Lahey et al., 1997 as cited in Scott, 2008). School

personnel have a tendency to view punishment as the only response when dealing

with a student with chronic problems of conduct (UCLA, 2008). Oftentimes, in an

effort to control the aggressive student, school personnel see only punishments such

as, doing something the student does not want done (i.e., removal a privilege or

engagement in an undesirable activity), suspension, and expulsion as effective

responses (UCLA, 2008). With no treatment or interventions effectively

implemented, long-term negative outcomes such as criminal and violent offending,

incarceration, and development of antisocial personality disorder may occur (Scott,

2008).

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Methods for prevention of behavioral issues include the expansion of social

programs and improvement of school environments. According to UCLA (2008),

prevention techniques for social programs expansion include an increase in

economic opportunities for adolescents from low-income families, augmentation of

health and safety maintenance, and extension of quality day care and early

education. Prevention techniques for school improvement include the

personalization of classroom instruction to accommodate diversity in motivational

and developmental levels, increased utilization of “status” opportunities for

students with social difficulties (i.e., special jobs in the classroom), and early

identification and intervention of children with skill deficits (UCLA, 2008).

Immediately following acts of misbehavior, the function of the behavior should be

identified in order to prevent future occurrences.

According to Bernstein (2014), Parent Management Training has been shown

to be a highly effective treatment for coercive behavioral patterns in children. This

treatment involves training parents to effectively alter their child’s behavior in-

home. According to Scott (2008), Parent Management Training was designed to

improve the behavior management skills of parents and to promote a positive, high

quality relationship between the parent and child. As research has shown that a

major trigger for the escalation of childhood defiance is ineffective, inconsistent

parenting practices, this treatment aims to educate the child’s parents in the use of

specific procedures to alter negative interactions with the child, encourage pro-

social behavior, and to reinforce desirable behaviors. Key target skills promoted by

this intervention include: promotion of play, use of praise and rewards to encourage

CONDUCT DISORDER 16

desirable social behavior, use of clear rules and directions, use of consistent and

calmly executed consequences for undesirable behavior, and reorganization of the

child’s routine to prevent issue (Scott, 2008). Recent research has suggested that the

severity of the child’s behavior is predictive of the treatments success or failure. To

promote success of this method, according to Rehberg, Fürstenau, & Rhiner (2011)

as cited in Bernstein (2014), treatment should be highly structured and use specific

goals and established behavioral techniques.

Cognitive Behavioral Therapy, utilized in either individual or group therapy

sessions, has been demonstrated as an effective intervention for preschool and

school-aged individuals with Conduct Disorder (Scott, 2008). The most common

skills targeted for child therapy interventions are the promotion of prosocial

interaction (i.e., participation in group activities, starting conversation, sharing,

listening, negotiating, and cooperating), the reduction of aggressive behavior (i.e.,

shouting and pushing), improvement of emotional regulation and self-control

problems (to reduce the occurrence of impulsivity, explosiveness, and emotional

lability), and correction of cognitive deficiencies, distortions, and incorrect self-

evaluation (Scott, 2008). One program that utilizes this intervention is Problem-

Solving Skills Training (PSST-P) (Kazdin, 1996; as cited by Scott, 2008). This

training program was designed for children ages 7 and over and involves individual

training in interpersonal cognitive problem-solving techniques. This training

focuses on identifying problem situations and learning how to apply problem-

solving steps. Children are reinforced using a token system and therapeutic

strategies include games, modeling, and role-play. According to Scott (2008), PSST-P

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has been shown to significantly decrease deviant behavior and increase prosocial

behavior in children involved.

Anger Control Training is an evidence-based cognitive-behavioral

intervention that has been shown to be effective with elementary school aged

children with conduct problems (Eyberg, Nelson, & Boggs, 2008). This intervention

requires students to meet once per week during the school day for 40 to 50 minutes.

Students are split into separate groups of approximately 6 children. During group

sessions, students are involved in activities such as, creating specific goals,

discussing vignettes of social encounters with peers, social cues and possible

motives of individuals in the vignettes. Other sessions involve activities such as,

teaching problem solving strategies for anger-provoking social situations, practicing

appropriate social responses, practicing self-statements in response to different

problem situations, and awareness of feelings. Later in training, the group involves

the students engaging in anger-inducing role-play and providing support for their

use of taught anger control strategies (Eyberg, et al. 2008). Studies on effectiveness

of this intervention found it to be superior to no-treatment control groups in

reducing disruptive behavior (Eyberg, et al. 2008).

According to Scott (2008), the most effective classroom behavioral

interventions focus on promoting positive behaviors (i.e., compliance and following

established classroom rules), preventing problem behaviors (i.e., talking

inappropriately and fighting), teaching social and emotional skills (i.e., problem

solving and conflict resolution), and preventing the escalation of aggressive

behavior and acting out. Students should be aware of the consequences for acts of

CONDUCT DISORDER 18

misconduct. These consequences should be perceived by students as logical, fair,

and reasonable and should be used with consistence (UCLA, 2008). In order for

students with Conduct Disorder to perceive consequences as logical and socially

agreed upon and not as personal attacks or acts of power, steps must be taken to

increase an understanding of behavioral norms. Steps must be taken to teach these

students right from wrong, to teach them to respect the rights of others, and to

accept responsibility for their actions (UCLA, 2008).

Minimally intrusive intervention techniques that can be utilized in the

classroom include, signal interference, interest boosting, support from routine, and

self-management. Signal interference is an intervention that involves the use of cues

and signals to remind students that their behavior is inappropriate and disruptive.

These cues can be things such as, clearing of the throat, snapping of the fingers,

ringing a bell, or placing a warning sign on the board (UCLA, 2008). These nonverbal

cues can be used to minimize student embarrassment and can be decided on in

private by the student and teacher. According to UCLA (2008), interest boosting is

an intervention that involves maintaining the interest of the student by relating the

classroom activities to the student’s areas of interest. This can be accomplished by

obtaining interesting facts that relate to the lesson and the student’s interests, using

activity sheets related to the area of interest, and using educational games that

relate to the area of interest. Support from routine simply involves providing

students who have conduct problems with well-defined routines. For students with

Conduct Disorder, being in a predictable and structured environment, under the

supervision of a caring teacher, is very important (UCLA, 2008). One of the more

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obvious deficits of students with Conduct Disorder is in productive self-

management (UCLA, 2008). The self-management intervention should only be used

following the successful use of interventions such as the ones listed above. After the

student’s behavior improves to a more pro-social level, self-control techniques

should gradually be introduced. This training involves, self-selected behaviors to

change, self-determined reinforcements, self-administered reinforcements, and self-

monitored progress. According to UCLA (2008), students have a tendency to

respond well to programs when given control of their own development.

Conclusion and Summary

According to Buitelaar, Smeets, Herpers, Scheepers, Gellon , & Rommelse

(2013), compared to other childhood on-set psychiatric disorder, Conduct Disorder

has been student relatively less. It results in the significant impairment of social,

academic, and family functioning and is of serious concern due to the significant

impact on the child and their family. If left untreated, it can result in altercations

with the law, association with deviant peers, substance abuse, and academic failure.

The most fundamental feature of Conduct Disorder is a “repetitive and persistent

pattern of behavior by a child or teenager in which the basic rights of others or

major age-appropriate societal norms or rules are violated” (Grohol, 2013, p. 1).

While IDEA (2004) does not include special education eligibility for Conduct

Disorder, students frequently experience comorbid psychiatric disabilities and may

qualify for services under the categories of Other Health Impairment, Specific

Learning Disability, or Emotional Disturbance. Conduct Disorder is an impairment

that can have devastating effects on a child and family. However, through the use of

CONDUCT DISORDER 20

prevention and early identification behavioral, academic, and medical interventions

can be implemented to help the student succeed academically, behaviorally, and

socially.

CONDUCT DISORDER 21

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statistical manual of mental disorders (5th ed.). Washington, DC:

Author.

Bernstein, B.E. (2014). Conduct disorder. Retrieved from

http://emedicine.medscape.com/article/918213-overview

Buitelaar, J.K., Smeets, K.C., Herpers, P., Scheepers, F., Gellon, J., & Rommelse, N.N.J

(2013). Conduct disorders. European Child and Adolescent Psychiatry, 22,

S49-S54.

Center for Mental Health in Schools at UCLA. (2008). Conduct and Behavior Problems

Related to School Aged Youth. Los Angeles, CA: Author.

Conduct Disorder (CD). (2015). Children’s Hospital of Wisconsin. Retrieved from

http://www.chw.org/medical-care/psychiatry-and-behavioral-medicine/

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symptoms.

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