DSM- Disruptive, Impulse-Control, and Conduct Disorders

What is the high-yield picture of Oppositional Defiant Disorder?

Angry/irritable mood, argumentative/defiant behavior, or vindictiveness toward non-siblings.

Timeline/onset: 6+ months

Spectrum/severity: Yes: mild/moderate/severe by settings

Important note: Frequency varies by age.

What timeframe, age, or number is most important for Oppositional Defiant Disorder?

6+ months

How do you differentiate Oppositional Defiant Disorder on an exam vignette?

Vs. conduct disorder: ODD lacks serious aggression, property destruction, theft, or major rights violations.

What is the high-yield picture of Intermittent Explosive Disorder?

Recurrent impulsive aggressive outbursts grossly out of proportion and not premeditated.

Timeline/onset: 2x/week for 3 months OR 3 damaging/injurious episodes in 12 months

Spectrum/severity: No

Important note: Verbal/physical aggression 2x weekly or damaging assaults 3x yearly.

What timeframe, age, or number is most important for Intermittent Explosive Disorder?

2x/week for 3 months OR 3 damaging/injurious episodes in 12 months

How do you differentiate Intermittent Explosive Disorder on an exam vignette?

Vs. conduct disorder: IED is impulsive anger, not a persistent pattern of rule/rights violations.

What is the high-yield picture of Conduct Disorder?

Persistent pattern violating basic rights or major age-appropriate norms: aggression, destruction, deceit/theft, or serious rule violations.

Timeline/onset: 3 behaviors in 12 months, including 1 in past 6 months

Spectrum/severity: Yes: mild/moderate/severe

Important note: Childhood- or adolescent-onset; with limited prosocial emotions

What timeframe, age, or number is most important for Conduct Disorder?

3 behaviors in 12 months, including 1 in past 6 months

How do you differentiate Conduct Disorder on an exam vignette?

Vs. antisocial PD: conduct disorder is diagnosed before 18; ASPD requires age 18+ and conduct history before 15.

What is the high-yield picture of Pyromania?

Repeated deliberate fire setting with tension before and fascination/relief afterward, not for gain, revenge, ideology, or concealment.

Timeline/onset: No fixed minimum

Spectrum/severity: No

Important note: Rare; diagnose only after rule-outs.

What timeframe, age, or number is most important for Pyromania?

No fixed minimum

How do you differentiate Pyromania on an exam vignette?

Vs. conduct disorder: pyromania is driven by fascination/tension relief, not broader antisocial behavior.

What is the high-yield picture of Kleptomania?

Recurrent failure to resist stealing unneeded items, tension before, and pleasure/relief during theft.

Timeline/onset: No fixed minimum

Spectrum/severity: No

Important note: Not motivated by anger, revenge, delusion, or material gain.

What timeframe, age, or number is most important for Kleptomania?

No fixed minimum

How do you differentiate Kleptomania on an exam vignette?

Vs. ordinary theft/conduct disorder: items are not needed and behavior is urge-driven.