Clinical Medicine I: Disruptive, Impulse-control, and Conduct Disorders

Disruptive, Impulse-control, and Conduct Disorders cause people to....

behave angrily or aggressively toward people or their property

Disruptive, Impulse-control, and Conduct Disorders are directed towards

someone else

3 phases of impulsive disorders

1) increasing tension

2) pleasure, relief, satisfaction during act

3) guilt or regret after act

intermittent explosive disorder

several discrete episodes of failure to resist aggressive impulses

Treatment for intermittent explosive disorder

cognitive behavioral therapy, pharmacotherapy

Pyromania

deliberate and purposeful fire setting on more than one occasion

Treatment for pyromania

cognitive behavioral therapy, early intervention programs, aggressive treatment of co-morbid psychiatric disorders, repeat behavior common

Kleptomania

recurrent failure to resist impulse to steal objects that are not needed

treatment for kleptomania

SSRI's, lithium

Two types of conduct disorders

oppositional defiant disorder, conduct disorder

oppositional defiant disorder

children are defiant towards authority but NOT associated with physical aggression, violating others basic rights or breaking laws

What age does oppositional defiant disorder begin?

before age 8

What are high comorbidities of oppositional defiant disorder?

ADHD, mood disorders, substance abuse

Treatment for oppositional defiant disorder

combination of therapy and training for child and training for parents

Conduct disorder

persistent pattern of behaviors that deviate sharply from the age-appropriate norms AND violates right individuals and animals

What is needed for a conduct disorder diagnosis?

persistent pattern of behavior that violates basic rights of others or social norms

Conduct disorder may progress to what disorder in adulthood?

antisocial personality disorder

conduct disorder treatment

environmental and behavioral modifications, functional family therapy, pharmacotherapy