Disruptive, Impulse-Control, and Conduct Disorders Flashcards
Question
What significant structural change occurred in the DSM-5 regarding Disruptive, Impulse-Control, and Conduct Disorders?
Answer
In DSM-5, Disruptive, Impulse-Control, and Conduct Disorders were placed in their own chapter, separate from the Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence category in DSM-IV.
Question
What are the changes to Oppositional Defiant Disorder (ODD) from DSM-IV to DSM-5?
Answer
In DSM-5, ODD criteria were expanded to include three types of symptoms: angry/irritable mood, argumentative/defiant behavior, and vindictiveness. Additionally, a severity rating (mild, moderate, severe) was introduced based on the number of settings in which symptoms occur.
Question
How did the criteria for Conduct Disorder (CD) change from DSM-IV to DSM-5?
Answer
DSM-5 added a specifier for Conduct Disorder called “with limited prosocial emotions,” to identify individuals who display a lack of remorse or guilt, callousness, and a lack of empathy or concern for performance.
Question
What changes were made to Intermittent Explosive Disorder (IED) in DSM-5?
Answer
DSM-5 expanded the criteria for Intermittent Explosive Disorder to include verbal aggression and non-destructive/non-injurious physical aggression occurring twice weekly on average for three months, in addition to the DSM-IV criterion of three outbursts involving damage or injury within a 12-month period.
Question
Were there any changes to Pyromania and Kleptomania in DSM-5?
Answer
There were no significant changes to the diagnostic criteria for Pyromania and Kleptomania from DSM-IV to DSM-5. These disorders remain largely unchanged.
Question
What is the rationale for listing Antisocial Personality Disorder (ASPD) in both the “Personality Disorders” and “Disruptive, Impulse-Control, and Conduct Disorders” chapters in DSM-5?
Answer
The dual listing of ASPD reflects its overlap with both personality pathology and disruptive behavior disorders, recognizing its chronic and pervasive patterns of antisocial behavior that begin in childhood or early adolescence and continue into adulthood.
Q: Disruptive, Impulse-Control, and Conduct Disorders
A:
The disorders in this category involve “problems in the self-control of emotions and behaviors” (American Psychiatric Association, 2013, p. 461) and include oppositional defiant disorder, conduct disorder, and intermittent explosive disorder.
Q: Oppositional Defiant Disorder Diagnosis
A:
The diagnosis of oppositional defiant disorder (ODD) requires a recurrent pattern of an angry/irritable mood, argumentative/defiant behavior, and/or vindictiveness. Four or more characteristic symptoms must occur during interactions with at least one person who is not a sibling and must have lasted for at least six months.
Q: Oppositional Defiant Disorder Symptoms
A:
Symptoms include often losing temper, being angry and resentful, often deliberately annoying others, and often blaming others for one’s mistakes or misbehavior. Symptoms must cause distress for the individual or others or negatively impact the individual’s functioning.
Q: Oppositional Defiant Disorder Prevalence and Treatment
A:
In young children, ODD is more common in boys but occurs equally in boys and girls in older children and adolescents. About 30% of children with ODD may eventually be diagnosed with conduct disorder. The most effective treatment is multimodal and tailored to the child’s or adolescent’s age, symptoms, and comorbidities, often involving evidence-based psychosocial interventions.
Q: Conduct Disorder Diagnosis Criteria
A:
The diagnosis of conduct disorder (CD) requires a persistent pattern of behavior that violates the basic rights of others and/or age-appropriate social norms or rules. It is evidenced by at least three characteristic symptoms during the past 12 months and at least one symptom in the past six months. Symptoms fall into four categories: aggression to people and animals, destruction of property, deceitfulness or theft, and serious violation of rules.
Q: Conduct Disorder Symptoms and Age Factor
A:
Symptoms of CD must cause significant impairment in functioning. The diagnosis cannot be assigned to individuals over age 18 who meet the criteria for antisocial personality disorder. This disorder is more common in males and symptoms usually emerge between middle childhood and middle adolescence.
Q: Conduct Disorder Symptoms and Age Factor
A:
Symptoms of CD must cause significant impairment in functioning. The diagnosis cannot be assigned to individuals over age 18 who meet the criteria for antisocial personality disorder. This disorder is more common in males and symptoms usually emerge between middle childhood and middle adolescence.
Q: Conduct Disorder Subtypes
A:
The DSM-5 specifies three subtypes for CD:
Childhood-onset type: at least one symptom before age 10
Adolescent-onset type: no symptoms before age 10
Unspecified onset: onset is unknown
Childhood-onset type is associated with greater aggressiveness and a higher risk for future antisocial personality disorder and substance-related disorders.
Q: Etiology of Conduct Disorder
A:
Conduct disorder is linked to multiple biological and environmental factors such as heredity, brain abnormalities, neurotransmitter and neuroendocrine abnormalities, prenatal exposure to substances, and negative parenting practices. Reduced serotonin and dopamine contribute to increased aggression and risk-taking behaviors.
