Disruptive, Impulse-Control, & Conduct Disorders

What is the core feature of disruptive, impulse-control, and conduct disorders?

Problems with self-control of emotions/behaviors that violate others’ rights or societal norms.

What makes these disorders different from other disorders with emotional dysregulation?

The behaviors violate others’ rights or societal rules (e.g., aggression, theft)

What is the developmental relationship between ODD and Conduct Disorder?

• CD often follows ODD

• BUT most individuals with ODD do NOT develop CD

What broader personality spectrum are these disorders linked to?

Externalizing spectrum:

• High disinhibition

• High negative emotionality

• Low constraint & agreeableness

Typical onset and gender pattern?

• Onset: Childhood/adolescence

• More common in males

Key diagnostic consideration across all disorders in this category?

Behavior must be:

• Frequent

• Persistent

• Across settings

• Impairing

• Outside developmental norms

What must always be considered when diagnosing?

Whether behavior exceeds what is normative for age, gender, and culture

Duration and symptom requirement for ODD?

• ≥ 6 months

• ≥ 4 symptoms (from any category)

Core features of ODD?

• Angry/Irritable Mood

• Argumentative/Defiant Behavior

• Vindictiveness

With whom must ODD symptoms be exhibited?

At least one person who is NOT a sibling.

Examples of ODD angry/irritable symptoms?

• Loses temper

• Easily annoyed

• Angry/resentful

Examples of ODD defiant behavior?

• Argues with authority

• Refuses rules

• Deliberately annoys others

• Blames others

Vindictiveness criterion?

Spiteful/vindictive ≥2 times in 6 months

Key distinction of ODD vs Conduct Disorder?

• ODD = defiance + irritability

• CD = serious rule violations + harm to others

ODD severity specifier?

Based on number of settings:

• Mild = 1

• Moderate = 2

• Severe = 3+

Q: What frequency is required for ODD symptoms in children under 5?

Most days for at least 6 months.

What frequency is required for ODD symptoms in individuals 5+?

At least once per week for 6 months.

What is required for ODD beyond symptoms?

Distress or impairment in functioning.

Core feature of IED?

Impulsive, disproportionate aggressive outbursts.

Two types of aggression patterns in IED?

1. Verbal/physical aggression 2x/week for 3 months (no injury/damage)

2. 3 serious outbursts in 12 months

What do serious outbursts involve in IED?

Damage or destruction of property and/or physical assault involving physical injury against animals or other individuals

Are IED outbursts premeditated?

No, they are impulsive and not goal-directed.

How does the intensity of aggression in IED compare to the trigger?

It is grossly out of proportion.

What is the minimum age for IED diagnosis?

6 years old.

Can IED be diagnosed alongside other disorders like ADHD or ODD?

Yes, if aggression exceeds what is typical for those disorders.

What is the defining feature of conduct disorder?

Persistent violation of others’ rights or major societal norms.

How many symptoms are required for conduct disorder?

At least 3 in 12 months, with 1 in the past 6 months.

What are the four symptom categories in conduct disorder?

Aggression, destruction, deceit/theft, rule violations.

Which conduct disorder category includes bullying, threatening, or intimidating others?

Aggression to people and animals.

A youth who initiates physical fights falls under which conduct disorder category?

Aggression to people and animals.

Using a weapon (e.g., knife, gun) in conduct disorder belongs to which conduct disorder category?

Aggression to people and animals.

Physical cruelty to animals is classified under which conduct disorder category?

Aggression to people and animals.

Stealing while confronting a victim (e.g., mugging) falls under which conduct disorder category?

Aggression to people and animals.

Forcing someone into sexual activity belongs to which conduct disorder category?

Aggression to people and animals.

Fire-setting with intent to cause damage falls under which conduct disorder category?

Destruction of property.

Deliberately destroying someone else’s property (non-fire) belongs to which conduct disorder category?

Destruction of property.

Breaking into a house, building, or car belongs to which conduct disorder category?

Deceitfulness or theft.

Lying to obtain goods or avoid obligations falls under which conduct disorder category?

Deceitfulness or theft.

Shoplifting without confronting a victim belongs to which conduct disorder category?

Deceitfulness or theft.

What category is stealing WITHOUT confrontation vs WITH confrontation?

Without = deceit/theft; with = aggression.

Staying out at night before age 13 despite parental rules belongs to which conduct disorder category?

Serious violations of rules.

Running away from home overnight falls under which conduct disorder category?

Serious violations of rules.

Truancy before age 13 belongs to which conduct disorder category?

Serious violations of rules.

What distinguishes childhood-onset vs adolescent-onset conduct disorder?

Childhood-onset = symptoms before age 10.

What are the 4 characteristics of the limited prosocial emotions specifier in conduct disorder?

Lack of remorse or guilt, callous (lack of empathy), unconcerned about performance, shallow or deficient affect

Qualification for the limited prosocial emotions specifier in conduct disorder?

2+ characteristics over 12 months in multiple settings/relationships

What must be present for a conduct disorder diagnosis beyond symptoms?

Clinically significant impairment.

Why can’t conduct disorder be diagnosed in adults with ASPD?

Because antisocial personality disorder takes precedence after age 18.

What is the key behavior in pyromania?

Deliberate, repeated fire setting.

What emotional state occurs before fire setting in pyromania?

Tension or arousal.

What emotional outcome follows fire setting in pyromania?

Pleasure, gratification, or relief.

What distinguishes pyromania from criminal fire setting?

No external motive (e.g., money, revenge, ideology).

What is the core feature of kleptomania?

Failure to resist impulses to steal unnecessary items.

What emotional pattern occurs in kleptomania?

Tension before theft → relief after theft.

Are items stolen in kleptomania for value or need?

No, they are not needed or valuable.

What distinguishes kleptomania from typical theft?

It is impulsive and not motivated by gain or revenge.