AP Week 10 Disruptive, Impulse Control, and Conduct Disorders

Oppositional-Defiant Disorder Hallmark Features

• Pattern or angry/irritable mood

• Argumentative/defiant behavior 

• Vindictiveness 

Minimum duration of symptoms for ODD 

At least 6 months 

Symptoms of ODD

At least four of the following: 

• Loosing temper

• Argues with or defies authority

• Touchy 

• Angry 

• Deliberately annoys others

• Blames others for own behavior 

Behavior of ODD causes distress….

To the individual OR others in the immediate social context or impacts important areas of functioning 

ODD Severity Specifiers

Mild: confined to one setting, not uncommon to only be in the home 

Moderate: symptoms in at least two settings 

Severe: symptoms in three or more settings 

ODD Additional Considerations for Vindictiveness 

• Younger than 5 years old 

  • Behavior should occur on most days for a period of at least 6 months

• Older than 5 years old 

  • Behavior should occur at least once per week for at least 6 months 

ODD often precedes the development of which disorder?

Conduct Disorder

Intermittent Explosive Disorder Hallmark Features

• Recurrent behavioral outbursts as a result of failure to control aggressive impulses 

• Verbal or physical aggression occurring 2x/week for at least 3 months (no physical injury, destruction, or damage of space) OR 

• Three behavioral outbursts involving damage, injury, or destruction within a 12-month period 

Features of IED Outbursts

• Outburst is grossly out of proportion to provocation or precipitating factors 

• Outbursts are IMPULSIVE, not premeditated, and not for secondary gain 

• Outbursts cause distress in an individual or impairment in functioning 

Minimum age for diagnosis of IED

At least 6 years old

Hallmark Features of Conduct Disorder

• A pattern of behavior in which basic rights of others or major societal rules are violated 

• Aggression towards people or animals, destruction of property, deceitfulness or theft, and serious violations of rules 

Minimum Duration of Symptoms for Conduct Disorder

At least 3 criteria in the past 12 months, with at least one criterion in the past 6 months. 

Can Conduct Disorder be assigned to individuals over age 18?

Yes, ONLY IF the criteria for ASPD are NOT met

Specifier Onset for Conduct Disorder

Childhood, adolescence, or unspecified

Limited Prosocial Emotions Specifier for Conduct Disorder

2 of the following: Lack of remorse/guilt, empathy, unconcerned about performance, OR shallow/deficit affect

Severity Specifier for Conduct Disorder

Mild, moderate, OR severe based upon the number of symptoms and degree of effect

How much more likely are boys to be diagnosed with CD than girls?

2-3 times more likely

Children from ___ families are more likely to be diagnosed with CD.

Low-income

Boys diagnosed with CD were 3x more likely to have an ___ disorder and ___ ___ disorder, and be dependent on ___ compared to boys without CD 

Anxiety, Major Depressive, Alcohol 

Which racial group of children are more likely to be diagnosed with CD?

African American 

Treatment for ODD, IED, and CD

• Parent skills training 

• Parent-child interaction therapy (PCIT)

• Family therapy 

• Cognitive problem-solving training 

• Social skills training 

Hallmark Feature of Pyromania

• Repeated deliberate and purposeful fire setting on 1+ occasions

• Fascination/interest/curiosity with fire, its paraphernalia, uses, and/or consequences  

What do individuals with pyromania experience before the act of setting a fire?

Tension or arousal 

What do individuals with pyromania experience when setting a fire, witnessing fire, or participating in the aftermath of a fire?

Pleasure, gratification, relief

What other reasons for deliberately setting a fire must you rule out for Pyromania?

• Responding to delusion/hallucination (psychosis) 

• Monetary gain (insurance money) 

• Covering up criminal activity 

• Expressing anger/vengeance 

• Substance use 

• Intellectual disability 

• Manic episode 

Difference between Pyromania and Arson?

• Pyromania is a mental health disorder

• Arson is a criminal act

  • Both are intentional, but Pyromania is compulsive/pathological, and arson might not be 

Treatment for Pyromania 

• CBT

• Covert sensitization: picturing yourself setting a fire and then facing negative consequences, such as hurting yourself or your property 

• Aversion therapy: practice mildly painful techniques, like holding your breath until you become uncomfortable, when you get the urge to set a fire 

• Medication such as SSRIs and/or anti-anxiety meds 

Youth diagnosed with conduct disorder often have a history of…?

Exposure to trauma