Disruptive, Impulse-Control, and Conduct Disorders Flashcards
Oppositional Defiant Disorder Diagnostic Criteria
A. A pattern of angry/irritable mood, argumentative/defiant behaviour, or vindictiveness lasting ≥6 months as evidenced by ≥4 of the following, and exhibited during interaction with ≥1 individual who is not a sibling.
Angry/Irritable Mood
1. Often loses temper.
2. Is often touchy or easily annoyed
3. Is often angry and resentful
Argumentative/Defiant Behaviour
4. Often argues with authority figures
5. Often actively defies or refuses to comply with requests from authority figures or with rules
6. Often deliberately annoys others
7. Often blames other for their mistakes or misbehaivour
Vindictiveness
8. Has been spiteful or vindictive ≥2 times in the last 6 months
B. Causes distress in the individual or others in their immediate social context or causes functional impairment
C. Does not occur exclusively during psychosis, substance use, mood disorders, and DMDD criteria not met.
Oppositional Defiant Disorder Specifiers
Specify current severity:
* Mild: Symptoms are confined to only one setting
* Moderate: Symptoms present in 2 settings
* Severe: Symptoms are present in ≥3 settings
Differentiation between ODD and Conduct Disorder
- ODD behaviours are normally less severe in nature and do not include aggression toward people or animals, destruction of property, or a pattern of theft or deceit.
- ODD includes problems of emotional dysregulation, which are not included in the CD definition
Intermittent Explosive Disorder Diagnostic Criteria
A. Recurrent behavioural outbursts representing a failure to control aggressive impulses, as manifested by either of the following:
1. Verbal aggression (e.g., temper tantrums, tirades, verbal arguments) or physical aggression towards property, animals, or other indeividuals, occuring 2/week on avg for 3 months. Aggression does NOT result in damage to property or physical injury.
2. 3 beahvioural outburts involving damage or destruction of property and/or physical assault involving injury occurring within a 12-month period.
B. Magnitude of aggressiveness is grossly out of proportion to the trigger or precipitating psychosocial stressors
C. Outburts are not premeditated and are not committed to achieve an objective.
D. Causes either marked distress/functional impairment for the individual or is associated with financial/legal consequences
E. Age is ≥6 years
F. Not better explained by another mental disorder, other medical condition, substances, medication
Dx can be made in addition to ADHD, CD, ODD, or ASD if outbursts are in excess of what is explained by those disorders
Conduct Disorder Diagnostic Criteria
A. A repetitive/persistent pattern of behaviour in which the basic rights of others or major age-appropriate societal norms/rules are violated, as manifested by ≥3 of the following 15 crtieria, in the last 12 months, with ≥1 present in the past 6 months:
Aggression to People or Animals
1. Often bullies, threatens, or intimidates others
2. Often initiates physical fights
3. Has used a weapen that can cause serious physical harm
4. Has been physically cruel to people
5. Has been physically cruel to animals
6. Has stolen while confronting a victim
7. Has forced someone into sexual activity
Destruction of Property
8. Has deliberately set fires with the intention of causing serious damage
9. Has deliberately destroyed others’ property (other than fire setting)
Deceitfulness or Theft
10. Has broken into someone else’s house, building, or car
11. Often lies to obtain goods or favors to avoid obligations
12. Has stolent items of nontrivial value without contronting a victim
Serious Violations of Rules
13. Often stays out at night despite parental prohibitions (beginning before age 13)
14. Has run away from home overnight ≥2 times while living with caregivers or once w/o returning for a lengthy period
15. Is often truant from school (beginning before age 13)
B. Causes clinically significant functional impairment
C. If age ≥18, criteria for APD not met
Conduct Disorder Specifiers
Specify whether:
* Childhood-onset type: ≥1 symptom before age 10
* Adolescent-onset type
* Unspecified onset
Specify if:
* With limited prosocial emotions: ≥2 of the following characteristics persistently over last 12 months and in multiple settings.
* Lack of remorse or guilt
* Callous – lack of empathy
* Unconcerned about performance
* Shallow or deficient affect: Does not express feelings much except in ways that seem shallow or insincere or when emotional expressions are used for gain
Specify current severity:
* Mild: Few if any conduct problems in excess of those required to make disorder present. Causes relatively minor harm to others.
* Moderate: Between mild and severe
* Severe: Many conduct problems in excess of those required to make the diagnosis present and/or they cause considerable harm to others.
Pyromania Diagnostic Criteria
A. Deliberate and purposeful fire setting on >1 occasion
B. Tension or affective arousal before the act
C. Fascination with, interest in, curiosity about, or attraction to fire and its situational contexts
D. Please, gratification, or relief when setting fires or when witness or participating in their aftermath
E. Not done for monetary gain, political protest, to conceal criminal activity, anger or vengence, to improve one’s living circumstances, in response to a delusion or hallucination, or as a result of impaired judgement.
F. Not better explained by CD, manic episode, or APD
Kleptomania Diagnostic Criteria
A. Recurrent failure to resist impulses to steal objects that are not needed for personal use or their monetary value.
B. Increasing sense of tension immediately before committing the theft
C. Pleasure, gratification, or relief when committing the theft.
D. Not to express anger/vengence and not in response to a delusion or hallucination.
E. Not better explained by CD, a manic episode, or APD
