tings where patterns of disruptive behavior are viewed as near-normative (e.g., in very
threatening, high-crime areas or war zones). Therefore, the context in which the undesir-
able behaviors have occurr ed should be considered.
Gender-Related Diagnostic Issues
Males with a diagnosis of conduct disorder frequently exhibit fighting, stealing, vandalism,
and school discipline problems. Females with a diagnosis of conduct disorder are more likely
to exhibit lying, truancy, running away, subs tance use, and prostitution. Whereas males tend
to exhibit both physical aggression and relation al aggression (behavior that harms social re-
lationships of others), females tend to exhibit relatively more relational aggression.
Functional Consequences  of Conduct Disorder 
Conduct disorder behaviors may lead to sch ool suspension or expulsion, problems in
work adjustment, legal difficulties, sexually  transmitted diseases, unplanned pregnancy,
and physical injury from accidents or fights . These problems may preclude attendance in
ordinary schools or living in a parental or foster home. Conduct disorder is often associ-
ated with an early onset of sexual behavior, alcohol use, to bacco smoking, use of illegal
substances, and reckless and risk-taking acts. Ac cident rates appear to be higher among in-
dividuals with conduct disord er compared with those without the disorder. These func-
tional consequences of conduct disorder may predict health difficulties when individuals
reach midlife. It is not uncommon for individu als with conduct disorder to come into con-
tact with the criminal justice system for engaging in illegal behavior. Conduct disorder is
a common reason for treatment referral and is frequently diagnosed in mental health fa-
cilities for children, especially in forensic practice. It is associated with impairment that is
more severe and chronic than that expe rienced by other clinic-referred children.
Differential Diagnosis