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Disruptive disorders are characterized by antisocial behavior and, as such, seem to be a collection of behaviors rather than
a coherent pattern of mental dysfunction. These behaviors are also frequently found in children who suffer from attention-
deficit/hyper-activity disorder. Children who develop the more serious conduct disorders often show signs of these disorders at
an earlier age. Although it is common for a very young children to snatch something they want from another child, this kind of
behavior may herald a more generally aggressive behavior and be the first sign of an emerging oppositional defiant or conduct
disorder if it occurs by the ages of 4 or 5 and later. However, not every oppositional defiant child develops conduct
disorder, and the difficult behaviors associated with these conditions often remit.
Some of the common types of disruptive disorders are:
Oppositional Defiant Disorder (ODD):
ODD is a psychiatric disorder that is characterized by two different sets of problems. These are aggressiveness and a tendency
to purposefully bother and irritate others. It is often the reason that people seek treatment. When ODD is present with ADHD,
depression, Tourette's syndrome, anxiety disorders, or other neuropsychiatric disorders, it makes life with that child far more
difficult. Diagnostic criteria for ODD include:
- A pattern of negativistic, hostile, and defiant behavior lasting at least six months during which four or more of
the following are present:
- Often loses temper
- Often argues with adults
- Often actively defies or refuses to comply with adults' requests or rules
- Often deliberately annoys people
- Often blames others for his or her mistakes or misbehavior
- Is often touchy or easily annoyed by others
- Is often angry and resentful
- Is often spiteful and vindictive
- The disturbance in behavior causes clinically significant impairment in social, academic, or occupational
functioning.
ODD is typically associated with:
- Learning Problems
- Depressed Moods
- Hyperactivity
- Addiction
- Dramatic/Erratic/Antisocial Personality
Conduct Disorder (CD):
This is a repetitive and persistent pattern of behavior in which the basic rights of others or major society rules are
violated. Conduct disorder is a complicated group of behavioral and emotional problems in youngsters. Children and
adolescents with this disorder have great difficulty following rules and behaving in a socially acceptable way. They are
often viewed by other children, adults and social agencies as "bad" or delinquent, rather than mentally ill. Children or a
dolescents with conduct disorder may exhibit some of the following behaviors:
- Aggression to people and animals
- bullies, threatens or intimidates others
- often initiates physical fights
- has used a weapon that could cause serious physical harm to others (e.g. a bat, brick, broken bottle,
knife or gun)
- is physically cruel to people or animals
- steals from a victim while confronting them (e.g. assault)
- forces someone into sexual activity
- Destruction of Property
- deliberately engaged in fire setting with the intention to cause damage
- deliberately destroys other's property
- Deceitfulness, lying, or stealing
- has broken into someone else's building, house, or car
- lies to obtain goods, or favors or to avoid obligations
- steals items without confronting a victim (e.g. shoplifting, but without breaking and entering)
- Serious violations of rules
- often stays out at night despite parental objections
- runs away from home
- often truant from school
Without treatment, many youngsters with conduct disorder are unable to adapt to the demands of adulthood and continue
to have problems with relationships and holding a job. They often break laws or behave in an antisocial manner. Many
factors may contribute to a child developing conduct disorder, including brain damage, child abuse, genetic vulnerability,
school failure, and traumatic life experiences. Treatment of children with conduct disorder can be complex and
challenging. Treatment can be provided in a variety of different settings depending on the severity of the behaviors.
Adding to the challenge of treatment are the child's uncooperative attitude, fear and distrust of adults. In developing a
comprehensive treatment plan, a child and adolescent psychiatrist may use information from the child, family, teachers,
and other medical specialities to understand the causes of the disorder.
Impulse Control Disorder:
Impulse-Control Disorders are disorders in which a person acts on a certain impulse, that is potentially
harmful, but ones that they are unable to resist. The classification of Impulse-Control Disorders is reserved
for those disorders in which the defining characteristic is the inability to inhibit an impulse which might be
harmful to oneself or others.
There are five distinct Impulse Disorders:
- Intermittent Explosive Disorder is evidenced by episodes of acting out aggression and causing
bodily harm and/or property destruction.
- Kleptomania is evidenced by acting out the impulse to misappropriate objects without the motive
of monetary gain.
- Pyromania is evidenced by setting fires for hedonistic purposes.
- Pathological Gambling is evidenced by habitual, self destructive gambling.
- Tricotillomania is evidenced by recurrent hair pulling resulting in significant hair loss with a
motivation of self gratification or tension release.
The causes of impulse control disorders are unknown. However, a person who has had a head injury may be at
higher risk for developing this disorder. Someone with temporal lobe epilepsy is also at higher risk for
developing an impulse control disorder. There is no known way to prevent an impulse control disorder.
Diagnosis of impulse control disorder is only made after all other medical and psychiatric disorders that
might account for the symptoms have been ruled out. If no other disorder can account for the symptoms, then
an impulse control disorder is considered.
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