Research on Conduct Disorder and Deficits in Interpersonal Behavior

A study published in Child and Adolescent Psychiatry and Mental Health examined the interpersonal behavior of children and adolescents with conduct disorder (CD) — particularly how they respond to social cues in a virtual reality setting.

It assessed both explicit and implicit interpersonal behaviors, such as adjusting interpersonal distance and walking speed based on emotional cues. The key finding was that participants with CD did not adjust their interpersonal distance based on the facial expressions of their virtual peers, unlike the control group who kept a greater distance from angry classmates.

While the control group adjusted their behavior based on emotional expressions, participants with conduct disorder (CD) did not show this difference, especially when encountering angry expressions.

It also revealed that social anxiety (SA) and callous-unemotional (CU) traits affected how closely participants approached others in various emotional situations. Some kids with CD may have callous-unemotional (CU) traits, which means they don’t feel sorry for hurting others and have trouble making good friendships.

Understanding the Research

The study involved 46 inpatients aged 10 to 14 years, diagnosed with Conduct Disorder (CD) according to the International Classification of Diseases. In addition, 32 typically developing (TD) children were recruited from high schools.

It also employed different measures to assess the participants’ psychological and emotional traits, including parent and self-reports.

The participants also took part in a Virtual Interpersonal Distance (IPD) task to assess their automatic reactions to approach or avoid others. Using virtual reality (VR), they interacted with virtual agents showing different emotions, while their distance from the agents and walking speed were recorded. This measured how emotional cues affected their behavior.

These were the findings:

• While both groups walked at similar speeds and didn’t change their distance based on emotions in some situations, CD children stood closer to angry virtual classmates than TD children did.
• Those in the CD group showed more traits associated with being callous and unemotional (CU traits). They also had higher levels of mental health problems, including internal issues (like depression or anxiety) and external issues (like aggressive behavior). Interestingly, they also showed signs of social anxiety (SA).
• CD children may not notice or react to emotions like anger the way others do. This can make it harder for them to make friends and could lead to them being left out
• The researchers also suggested that children with CD might not react to angry faces because they have become “used to” aggression, possibly because they grew up in tough, stressful family situations where they were often exposed to anger or conflict.

Practical Strategies for Parents and Caregivers

As parents and caregivers, we can understand that children with CD may not be ignoring others or trying to be distant on purpose. Instead, they may have trouble recognizing or responding to emotions from others. Knowing this can help us find better ways to support their social growth.

Consider these strategies:

Teach kids and teens about emotions and how to identify them

Being able to identify emotions in others is important because it allows children to empathize and respond appropriately. For example, if a classmate looks sad, they might offer kind words, a listening ear, or ask if their classmate needs help. These small but meaningful actions can strengthen friendships.

Parents and caregivers can teach kids about emotions by naming feelings, like saying, “You look upset. Do you want to talk?” They can also use stories or this emotions poster set to help kids understand and respond to emotions.

Reward prosocial behaviors

Prosocial behaviors are positive actions that benefit others. These behaviors include helping, sharing, cooperating, and showing empathy. Parents can and should reward prosocial behaviors in children because it reinforces these positive actions.

One way to reward prosocial behavior is to offer praise, such as, “You did a great job sharing your toy with your friend. That was very kind!” Other rewards may include stickers or extra playtime.

Encourage positive relationships with their peers

Arrange for supervised playdates or group activities with their peers who model healthy social behaviors. Team sports are also a great way to teach kids social skills like being a good sport and problem-solving. They also help children learn to take turns and build friendships in a fun setting.

The researchers suggest that follow-up studies should replicate the results with larger samples that include female participants, given that CD is more commonly diagnosed in boys than in girls.

For resources to help young people build positive interactions, check out our Feelings and Emotions Worksheets and Social Skills Worksheets.