Module 23: Disruptive, Impulse-Control disorders, and Conduct Disorder Flashcards
What are the different Disruptive, Impulse-Control disorders, and Conduct Disorders?
- Oppositional Defiant Disorder
- Intermittent Explosive Disorder
- Conduct Disorder
- Pyromania
- Kleptomania
Oppositional Defiant Disorder
+ angry irritable mood, argumentative/defiant behavior against authority figure for at least 6 months
+ annoys others
+ blames others for his/her mistakes
How long should the duration of symptoms be for an individual to be diagnosed with ODD?
≥ 6 months
What are the most co-occurring conditions with oppositional defiant disorder?
two of the most co-occurring conditions w ODD are ADHD and CD
ODD precedes the later development of what disorder?
precedes the development of conduct disorder, common in children with the childhood-onset subtype
Individuals with ODD are at risk for development of what disorders?
+ conveys risk for the development of anxiety disorders and MDD
+ increased risk for a number of problems in adjustment as adults
What is the difference between ODD and CD?
less severe than CD and do not include aggression towards people, property (IED)
When should diagnosis not be made for any conduct disorder not be made?
diagnosis should not be made if the symptoms occur exclusively during the course of a mood disorder
When is Disruptive mood dysregulation disorder (DMDD) diagnosed in an individual instead of ODD?
if criteria for DMDD are met, then DMDD is given even if all criteria for ODD are met
Intermittent Explosive Disorder
+ behavioral outburst, failure to control aggressive impulses
+ verbal aggression, physical aggression twice weekly for a period of 3 months
How old are children who are diagnosed with Intermittent Explosive Disorder?
at least 6 yrs of age
Can intermittent explosive disorder still be diagnosed when ADHD and other conduct disorders are present?
Yes, it’s quite common regardless of the presence of ADHD or other disruptive, impulse control, and conduct disorders
What disorders are associated with intermittent explosive disorder?
depressive disorders, anxiety disorders, and substance use disorders are associated
What is the biological explanation behind intermittent explosive disorder?
+ presence of serotogenic abnormalities, globally and in the brain, specifically in areas of limbic system and orbitofrontal cortex
+ amygdala responses to anger stimuli are greater
+ volume of gray matter in several frontolimbic regions is reduced
When should intermittent explosive disorder not be diagnosed?
should not be made in children and adolescents ages 6-18 years, when the impulsive aggressive outbursts occur in the context of an adjustment disorder
What are the requirements needed for a diagnosis of disruptive mood dysregulation disorder to be made?
+ A diagnosis of DMDD can only be given when the onset of recurrent, problematic, impulsive aggressive outburst is before age of 10 years
+ A diagnosis of DMDD should be made for the first time after 18 years
What is the difference between oppositional defiant disorder and intermittent explosive disorder?
Aggression in ODD is typically characterized by temper tantrums and verbal arguments with authority figures, whereas IED are in response to a broader array of provocation and include physical assault
What is intermittent explosive disorder comorbid with?
co-morbid with depressive disorders, anxiety disorders, PTSD, Bulimia, Binge-eating, and substance use disorder
Conduct Disorder
+ repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated
+ often bullies, initiates fights, physically cruel, destroying properties, theft, serious violation of rules
When does the onset for conduct disorder occur?
onset may occur as early as the preschool years, but the first significant symptoms usually emerge during the period from middle childhood through middle adolescence
What is the most common precursor to the childhood-onset type?
ODD is the most common precursor to the childhood-onset type
What kind of ODD symptoms occur in childhood?
Physically aggressive symptoms = childhood
What kind of ODD symptoms occur in adolescence?
Nonaggressive symptoms = adolescence
Can ODD be diagnosed in adults?
May be diagnosed in adults, though onset is rare after age 16 years
What can ODD in childhood predict?
Childhood-onset type predicts a worse prognosis and an increased risk of criminal behavior in adulthood
Can both ODD and CD occur in a person at the same time?
Yes. In fact, when criteria for both ODD and CD are met, both diagnoses can be given
Can both ADHD and CD occur in a person at the same time?
Yes. In fact, when criteria for both ADHD and CD are met, both diagnoses can be given.
What qualities will individuals with conduct disorder display?
Individuals with conduct disorder will display substantial levels of aggressive or nonaggressive conduct problems during periods in which there is no mood disturbance, either historically or concurrently
Can IED and CD both be diagnosed in a person?
Yes, but if criteria for both IED and CD has been met, the diagnosis of IED should be given only when the recurrent impulsive aggressive outbursts warrant independent clinical attention
When can CD be diagnosed?
CD is diagnosed only when the conduct problems represent a repetitive and persistent pattern that is associated with impairment in social, academic, or occupational functioning
Pyromania
+ purposeful fire setting on more than one occasion
+ make considerable advance prep for starting a fire
+ arousal before the act
+ fascination to fire and its situational context
+ not done for monetary gain or etc.
When is diagnosis of pyromania not given?
separate diagnosis is not given when fire setting occurs as part of CD, manic episode, or antisocial personality disorder
What is pyromania comorbid with?
high co-occurrence of substance-use disorders, gambling, depressive and bipolar disorders, and other disruptive impulse-control, and conduct disorders
Kleptomania
+ failure to resist impulses to steal objects that are not need for personal use
+ there is an attempt to resist the impulse to steal, and they are aware that the act is wrong and senseless
+ increase tension before committing the theft
+ pleasure after committing the theft
+ often feels depressed or guilty about the thefts
What is kleptomania comorbid with?
associated with compulsive buying and depressive, bipolar, anxiety, eating, personality, substance-use and other disorders
