Module 23: Disruptive, Impulse-Control disorders, and Conduct Disorder

Question 1

What are the different Disruptive, Impulse-Control disorders, and Conduct Disorders?

Answer 1

1. Oppositional Defiant Disorder
2. Intermittent Explosive Disorder
3. Conduct Disorder
4. Pyromania
5. Kleptomania

Question 2

Oppositional Defiant Disorder

Answer 2

+ angry irritable mood, argumentative/defiant behavior against authority figure for at least 6 months
+ annoys others
+ blames others for his/her mistakes

Question 3

How long should the duration of symptoms be for an individual to be diagnosed with ODD?

Answer 3

≥ 6 months

Question 4

What are the most co-occurring conditions with oppositional defiant disorder?

Answer 4

two of the most co-occurring conditions w ODD are ADHD and CD

Question 5

ODD precedes the later development of what disorder?

Answer 5

precedes the development of conduct disorder, common in children with the childhood-onset subtype

Question 6

Individuals with ODD are at risk for development of what disorders?

Answer 6

+ conveys risk for the development of anxiety disorders and MDD
+ increased risk for a number of problems in adjustment as adults

Question 7

What is the difference between ODD and CD?

Answer 7

less severe than CD and do not include aggression towards people, property (IED)

Question 8

When should diagnosis not be made for any conduct disorder not be made?

Answer 8

diagnosis should not be made if the symptoms occur exclusively during the course of a mood disorder

Question 9

When is Disruptive mood dysregulation disorder (DMDD) diagnosed in an individual instead of ODD?

Answer 9

if criteria for DMDD are met, then DMDD is given even if all criteria for ODD are met

Question 10

Intermittent Explosive Disorder

Answer 10

+ behavioral outburst, failure to control aggressive impulses
+ verbal aggression, physical aggression twice weekly for a period of 3 months

Question 11

How old are children who are diagnosed with Intermittent Explosive Disorder?

Answer 11

at least 6 yrs of age

Question 12

Can intermittent explosive disorder still be diagnosed when ADHD and other conduct disorders are present?

Answer 12

Yes, it’s quite common regardless of the presence of ADHD or other disruptive, impulse control, and conduct disorders

Question 13

What disorders are associated with intermittent explosive disorder?

Answer 13

depressive disorders, anxiety disorders, and substance use disorders are associated

Question 14

What is the biological explanation behind intermittent explosive disorder?

Answer 14

+ 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

Question 14

When should intermittent explosive disorder not be diagnosed?

Answer 14

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

Question 15

What are the requirements needed for a diagnosis of disruptive mood dysregulation disorder to be made?

Answer 15

+ 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

Question 16

What is the difference between oppositional defiant disorder and intermittent explosive disorder?

Answer 16

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

Question 17

What is intermittent explosive disorder comorbid with?

Answer 17

co-morbid with depressive disorders, anxiety disorders, PTSD, Bulimia, Binge-eating, and substance use disorder

Question 18

Conduct Disorder

Answer 18

+ 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

Question 19

When does the onset for conduct disorder occur?

Answer 19

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

Question 20

What is the most common precursor to the childhood-onset type?

Answer 20

ODD is the most common precursor to the childhood-onset type

Question 21

What kind of ODD symptoms occur in childhood?

Answer 21

Physically aggressive symptoms = childhood

Question 22

What kind of ODD symptoms occur in adolescence?

Answer 22

Nonaggressive symptoms = adolescence

Question 23

Can ODD be diagnosed in adults?

Answer 23

May be diagnosed in adults, though onset is rare after age 16 years

Question 24

What can ODD in childhood predict?

Answer 24

Childhood-onset type predicts a worse prognosis and an increased risk of criminal behavior in adulthood

Question 25

Can both ODD and CD occur in a person at the same time?

Answer 25

Yes. In fact, when criteria for both ODD and CD are met, both diagnoses can be given

Question 26

Can both ADHD and CD occur in a person at the same time?

Answer 26

Yes. In fact, when criteria for both ADHD and CD are met, both diagnoses can be given.

Question 27

What qualities will individuals with conduct disorder display?

Answer 27

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

Question 28

Can IED and CD both be diagnosed in a person?

Answer 28

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

Question 29

When can CD be diagnosed?

Answer 29

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

Question 30

Pyromania

Answer 30

+ 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.

Question 31

When is diagnosis of pyromania not given?

Answer 31

separate diagnosis is not given when fire setting occurs as part of CD, manic episode, or antisocial personality disorder

Question 32

What is pyromania comorbid with?

Answer 32

high co-occurrence of substance-use disorders, gambling, depressive and bipolar disorders, and other disruptive impulse-control, and conduct disorders

Question 33

Kleptomania

Answer 33

+ 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

Question 34

What is kleptomania comorbid with?

Answer 34

associated with compulsive buying and depressive, bipolar, anxiety, eating, personality, substance-use and other disorders