The Interplay of Parenting Styles and Attachment Patterns in the Development of Conduct Disorder: A Case Study

Abstract

Background: Conduct disorder (CD) is a severe behavioral condition in adolescents, often arising from insecure attachment patterns and maladaptive parenting. Despite extensive literature on its etiology, limited research exists examining these factors in real-life clinical settings, particularly within non-Western cultural contexts. This study addresses this gap by exploring how parenting styles and attachment disruptions contribute to CD and how targeted intervention can mitigate its symptoms. Objective: The study aimed to evaluate the interplay between attachment patterns and parenting styles in the development of conduct disorder in a 14-year-old boy and assess the effectiveness of a multimodal intervention on executive functioning and behavioral regulation. Methods: A single-subject observational case study design was utilized (n = 1). The participant was selected based on DSM-5 diagnostic criteria for CD, excluding those with comorbid neurodevelopmental disorders. Data were collected using standardized tools including the BRIEF, SPM, BGT, and CARS-2. The 12-session intervention integrated CBT, REBT, Play Therapy, and parental training. Pre- and post-intervention data were analyzed using SPSS v27, with descriptive comparisons of raw and T-scores across executive functioning domains. Ethical procedures adhered to the Declaration of Helsinki, with informed consent obtained from the participant’s guardian. Results: Post-intervention, the participant showed clinically significant improvements across BRIEF domains: Inhibit (↓7 points), Emotional Control (↓9), and Monitor (↓7), reflecting enhanced impulse control, emotional regulation, and self-awareness. Cognitive deficits persisted (SPM = 5th percentile), but behavioral outbursts and emotional reactivity notably declined, suggesting therapeutic effectiveness. Conclusion: This study demonstrates that attachment-informed, family-centered interventions can significantly improve emotional and behavioral functioning in adolescents with CD. The findings support integrating parenting support and cognitive-behavioral strategies into early treatment protocols, with implications for scalable healthcare models and cross-cultural applications.