Conduct problems and associated factors among governmental secondary school students in Dessie City, Northeast Ethiopia: a cross-sectional study

Conduct problems are behavioral and mental health disorders typically emerging in childhood or adolescence, characterized by persistent violations of others’ rights or societal norms, such as aggression, destruction, deceit, or theft. Despite significant impact, their prevalence among government secondary school students in Dessie City, Ethiopia, remains understudied. This study aimed to assess the prevalence and associated factors of conduct problems among these students in Northeast Ethiopia. An institution-based cross-sectional study was conducted from June 1–30, 2024, using multistage stratified sampling to select 570 government secondary school students. Data were collected via a self-administered questionnaire, measuring conduct problems with an adapted DSM-5-based parent-reported Disruptive Behavior Disorder (DBD) rating scale. Data were coded, entered into Epi Data 4.6, and exported to SPSS 26 for analysis using bivariable and multivariable logistic regression. Results are reported as adjusted odds ratios (AORs) with 95% confidence intervals (CIs), with significance set at p < 0.05. The prevalence of conduct problems was 7.4% (95% CI: 5.3–9.6). High levels of adverse childhood experiences were reported by 10.9% ( n = 62). Multivariable analysis identified significant associated factors: male gender (AOR = 2.52, 95% CI: 1.05–6.07), age 16–18 years (AOR = 4.07, 95% CI: 1.29–12.77), problematic substance use (AOR = 3.00, 95% CI: 1.31–6.91), adverse childhood experiences (AOR = 2.72, 95% CI: 1.02–7.26), low maternal education (AOR = 4.33, 95% CI: 1.19–15.63), and permissive parenting style (AOR = 3.53, 95% CI: 1.48–8.40). The prevalence of conduct problems among students in Dessie City is comparable to global rates. Key associated factors include male gender, older adolescence (16–18 years), problematic substance use, adverse childhood experiences, low maternal education, and permissive parenting. Interventions should focus on enhancing parental skills, promoting maternal education, preventing early substance use, and strengthening school-based counseling and help-seeking behavior to improve student resilience and impulse control.