Conduct disorder involves structural and functional brain alterations including reduced gray matter volume in the prefrontal cortex and amygdala, decreased serotonin activity, and elevated cortisol reactivity. These neurobiological changes impair executive function, emotional regulation, and moral reasoning. Adverse childhood experiences create epigenetic modifications that further dysregulate the hypothalamic-pituitary-adrenal (HPA) axis, maintaining a chronic state of fight-or-flight that manifests as aggression and defiance. The nurse performs comprehensive behavioral assessments, implements evidence-based behavioral interventions, coordinates multidisciplinary care, and evaluates treatment effectiveness.