North Carolina Neurological Foundation (NCNF)

Adjustment Disorder With Disturbance of Conduct

Adjustment disorder with disturbance of conduct involves maladaptive behavioral responses to identifiable stressors, including aggression, vandalism, truancy, or oppositional behaviors. Etiology often includes psychosocial stressors such as family conflict, academic pressure, or peer difficulties, superimposed on temperamental or personality vulnerabilities. Clinically, individuals demonstrate significant social, academic, or occupational impairment due to rule-breaking, defiance, or disruptive behavior. Diagnosis requires the temporal association with a stressor, disproportionate response to the stressor, and exclusion of conduct disorder or other psychiatric conditions. Management emphasizes psychotherapy, behavioral interventions, and family counseling, with pharmacologic therapy rarely indicated except for comorbid conditions. Prognosis is typically good with early intervention and structured psychosocial support.