New research highlights structural brain differences in children with conduct disorder, shedding light on the potential impact of early life experiences.

New findings suggest that brain scans could help detect conduct disorder (CD) in children, a mental health condition often associated with disruptive behaviours such as bullying, fighting, rule-breaking, and a lack of remorse. The study, published in The Lancet Psychiatry, reveals significant structural differences in the brains of children diagnosed with CD.

Lead researcher Dr Yidian Gao, from the University of Birmingham’s School of Psychology and Centre for Human Brain Health, explained that this research offers the most compelling evidence yet that CD is linked to widespread differences in brain structure. “Our findings provide strong evidence that CD is more than just poor behaviour,” Dr Gao said, highlighting the importance of recognising it as a mental health issue, not merely “naughty” actions.

The study, the largest of its kind, involved brain scans of nearly 2,500 children, including 1,185 diagnosed with CD and 1,253 without the condition. Researchers found that the outer layer of the brain, the cortex, was significantly thinner in children with CD, and deep brain structures that control emotional regulation, reasoning, and language were also smaller in volume.

While the causes of these differences are still unclear, scientists speculate that early adversities, such as childhood maltreatment, might contribute to these brain changes. Dr Marlene Staginnus, joint lead author from the University of Bath, emphasised that it is vital to move away from labelling children with CD as “naughty” and instead focus on providing appropriate treatment and understanding.

Children with CD, which affects around 5% of children aged five to 16 in the UK, often display aggressive and violent behaviours that go beyond typical childhood mischief. Yet, despite its prevalence and impact, conduct disorder remains one of the least researched psychiatric conditions. This new study aims to address the gap in knowledge, showing the importance of further research to understand and treat this condition.

Dr Stephanie de Brito, from the University of Birmingham, pointed out that while various risk factors for CD are being studied, early experiences like maltreatment seem to play a crucial role in the development of these brain differences. “Understanding how CD is linked to later outcomes such as criminal behaviour, anxiety, and depression is key to helping these children and their families,” Dr de Brito added.

The research highlights the need for greater investment in the study of conduct disorder, akin to the focus on other conditions like ADHD and autism, to improve outcomes for children and prevent long-term mental health issues.