{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T03:04:06Z","timestamp":1789355046175,"version":"build-2803163510"},"reference-count":119,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T00:00:00Z","timestamp":1789257600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T00:00:00Z","timestamp":1789257600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acamh.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Child Psychology Psychiatry"],"abstract":"<jats:p>Conduct disorder (CD) is a common psychiatric disorder in youth, characterized by severe and recurrent aggressive and antisocial behaviors and associated with substantial healthcare and societal costs. Rates of CD increase during adolescence in both sexes, with the male\u2010to\u2010female ratio narrowing to approximately 1:1. Although earlier work suggested potentially distinct pathways to CD in girls versus boys, few studies were adequately designed to investigate sex differences, limiting generalizability of existing findings from predominantly male samples to girls. Recent large\u2010scale projects, such as the European multisite FemNAT\u2010CD study, have addressed these limitations by oversampling girls and explicitly examining sex\u2010specific characteristics. However, a systematic integration of these findings is lacking. This review therefore aims to synthesize current evidence on sex differences in CD across four core domains: clinical phenotype, risk factors, neurobiology, and treatment. It integrates key findings from FemNAT\u2010CD alongside other relevant literature, with particular emphasis on implications for theories of (female) CD. Overall, girls and boys with CD appear far more similar than different. Youth with CD of both sexes differ markedly from their typically developing peers in comparable ways, particularly in neurobiological characteristics (e.g. emotion functioning, brain structural changes, neuroendocrine stress responses). Differences between girls and boys with CD are most evident in the clinical phenotype, including age\u2010of\u2010onset, callous\u2010unemotional traits\/limited prosocial emotions, aggression subtypes, and cooccurring psychiatric disorders. Overall, sex differences in CD are subtle and difficult to detect. Remaining limitations of the current evidence base and ways to enhance the clinical relevance of research in this field are discussed.<\/jats:p>","DOI":"10.1111\/jcpp.70234","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T02:45:02Z","timestamp":1789353902000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Annual Research Review: Sex differences in conduct disorder \u2013 revisiting existing evidence and exploring future directions"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8864-1360","authenticated-orcid":false,"given":"Anka","family":"Bernhard","sequence":"first","affiliation":[{"name":"Department of Child and Adolescent Psychiatry and Psychotherapy, Faculty of Medicine Technische Universit\u00e4t Dresden, German Center for Child and Adolescent Health (DZKJ)  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9676-4782","authenticated-orcid":false,"given":"Christine M.","family":"Freitag","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy University Hospital Frankfurt am Main, Goethe University  Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Konrad","sequence":"additional","affiliation":[{"name":"Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy University Hospital RWTH Aachen  Aachen Germany"},{"name":"JARA\u2010Brain Institute II, Molecular Neuroscience and Neuroimaging, RWTH Aachen &amp; Research Centre Juelich  Juelich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8475-4050","authenticated-orcid":false,"given":"Lucres","family":"Jansen","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry &amp; Psychosocial Care Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health  Amsterdam Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas G.","family":"Chiocchetti","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy University Hospital Frankfurt am Main, Goethe University  Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Stadler","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry University of Basel Psychiatric Hospital  Basel 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