Overview – Disruptive, Impulse-Control, and Conduct Disorders, Part 1
Disruptive, Impulse-Control, and Conduct Disorders are a group of psychiatric disorders that can cause individuals to behave violently or aggressively toward other people, creatures, or property. They are characterized by impulsivity, failure to resist a temptation, urge, or impulse; or an inability to control emotions and behaviors. This can result in a lack of compliance with rules and instructions, violence, and/or trouble with the law. These disorders are identified by the presence of difficult, disruptive, defensive, aggressive, or antisocial behaviors, and frequently are associated with physical or verbal injury to the self, others, or objects, or with a violation of the rights of others. Behaviors that harm or endanger others, such as other children or animals, require urgent, immediate care.
A precise cause is unknown although common risk factors include a combination of genetic, environmental, emotional, and familial factors. These disorders tend to be first diagnosed in infancy, childhood, or adolescence and are more common in males than females.
A lifetime prevalence for any of these disorders is estimated at 24.8 percent. Disruptive Behavior Disorders are the most frequent referral problems for the child and adolescent psychiatrists. They account for one-third to one-half of all cases seen in mental health clinics. Adult sociopathy is almost always preceded by a Disruptive, Impulse-Control, or Conduct Disorder in childhood.
Approximately 40 percent of individuals diagnosed with a Conduct Disorder eventually meet the criteria for a diagnosis of Antisocial Disorder. An estimated 6.0 percent of children are affected by Oppositional Defiant Disorder or Conduct Disorder.
Disruptive, Impulse-Control, and Conduct Disorders, Part 1, presents information on four types of disorders, one type each day for four days. These are:
Oppositional Defiant Disorder
Oppositional Defiant Disorder is a serious psychiatric disorder. It is characterized by three subtypes lasting or least six months. They are evidenced by at least four symptoms from any of the following three categories and exhibited during interaction with at least one individual who is not a sibling.
Angry and/or Irritable Mood
- Often loses temper
- Often is touchy or easily annoyed
- Often is angry or resentful
Argumentative and/or Defiant Behavior
- Often arguing with authority figures, or in children/adolescents with adults
- Often actively defies/refuses to comply with rules/requests from authority figures
- Often deliberately annoys others
- Often blames others for his or her own mistakes or misbehavior
- Has been vindictive (spiteful, intending to cause anguish or hurt or get back at someone) at least twice within the past six months
Conduct Childhood Disorder
Conduct Childhood Disorder is a behavioral, emotional, and psychiatric disorder that tends to begin in childhood, often during the pre-school years. It is believed that Conduct Childhood Disorder is a precursor to Antisocial Disorder. Conduct Childhood Disorder is characterized by repetitively exhibited disruptive and violent behavior. These children are more apt to have a continuous conduct disorder that develops into Adult Antisocial Disorder than individuals with Adolescent Onset.
The symptoms usually meet the full criteria for Conduct Childhood Disorder before puberty. Children younger than age ten must have a minimum of one criterion in order to be diagnosed with the disorder:
- Show physical aggressiveness to others.
- Have disturbed relationships with peers.
- Had Oppositional Defiant Disorder when a youngster.
Conduct Adolescent Disorder
Conduct Adolescent Disorder, also commonly referred to as juvenile delinquency, is a behavioral, emotional, and psychiatric disorder that has its onset from middle childhood to mid-adolescence and usually diagnoses under the age of 18. It is characterized by the habitual violation of the rights of others, and a refusal to conform their behavior to the law or social norms appropriate for their chronological age. The adolescent may show a lack of remorse, guilt, or empathy, with mild, moderate, or severe levels of severity. Oppositional Defiant Disorder is a common premorbid condition.
When compared to individuals with childhood-onset, the person with adolescent-onset is less likely to show aggressive behaviors. Adolescents usually exhibit more normal peer relationships, tend to show conduct problems while they are with others, and are less likely to have persistent Conduct Disorder or develop an adult Antisocial Disorder. Severity is defined as mild, moderate, or severe.
Conduct Unspecified Disorder
A diagnosis of Conduct Unspecified Disorder may be assigned by the clinician when the exhibited behaviors resemble those of a Conduct Disorder in part but either do not meet the full definition or it is unknown when the symptoms first appeared. There may be no definite history that would point specifically to Conduct Childhood Disorder or Conduct Adolescent Disorder.
Many of the symptoms found in Conduct Disorder show up in Conduct Unspecified Disorder but there may not be sufficient evidence to make a clear diagnosis.
It is more common and more frequently diagnosed in boys due to their tendency to act out violently. Girls tend to act out in interpersonal relationships such as social rejection of disliked peers, non-confrontation of a victim through malicious postings on a social networking site.
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