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Disruptive, Impulse Control,  and Conduct Disorders

Fabiola  Ramirez  Natalie  Ramirez Elizabeth Ramirez

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What are Disruptive, Impulse-Control,  and Conduct Disorders ?

Include problems in the self-control of emotions and behaviors Definition:  “ Disruptive, impulse-control and conduct disorders refer to a group of disorders that include oppositional defiant disorder, conduct disorder, intermittent explosive disorder, kleptomania and pyromania. These disorders can cause people to behave angrily or aggressively toward people or property. They may have difficulty controlling their emotions and behavior and may break rules or laws”

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How do they affect a  child’s behavior ?

Since these disorders i nvolve problems with self-control of emotions and behaviors, it can result in: Behaviors that violate others’ basic rights  Cause significant conflict with societal norms or authority figures Outbursts of anger Break rules or laws Defiant behavior

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Oppositional defiant disorder (ODD) Angry/irritable mood Argumentative/defiant behavior Vindictiveness Intermittent explosive disorder frequent impulsive, aggressive, angry outbursts Conduct disorder  A more serious disorder than ODD, involving ongoing behavior that breaks social rules Repetitive and persistent behaviors that violate others’ basic rights Antisocial personality disorder disregard for or violation of other people’s rights  Pyromania Fascination with fires Purposeful fire setting Kleptomania Stealing objects that are not needed Other specified disruptive, impulse-control, and conduct disorders Unspecified disruptive, impulse-control, and conduct disorders

Conduct Disorder
Intermittent Explosive
Disorder
Kleptomania
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oppositional Defia /
Disorder
Disruptive, Impulse-control,
and Conduct Disorders
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Oiker specified Disruptive,
Impulse—control, and Conduct Disorder
Unspecified Disruptive,
Impulse—control, and Conduct Disorder
romania

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Come up with intervention strategies for the student: TSS Meeting  school psychologist* (may need to assess the student) behavioral   interventionist administrators teacher parents Develop intervention plan for behavior Execute plan and observe improvements Refer to other types of treatment

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Therapy focusing on behaviors, thoughts  and feelings.  Individual or group family therapy Cognitive-behavioral therapy (CBT) Medication Not intended to target the disorder directly  ( no FDA-approved drugs for these disorders) C an be useful if the child has also been diagnosed with another disorder, like ADHD, OCD, anxiety, or depression

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Assessment/Data Collection for Identification of  Disruptive, Impulse Control, and Conduct Disorders

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Assessments/ Data Collection for Assessment

The accurate diagnosis requires an assessment involving at least two different methods behavior rating scales from multiple informants  structured diagnostic interviews  family’s history and the caregivers’ child-rearing practices course of the child’s development  oppositional or aggressive behavior that is not age-appropriate.  A functional behavior analysis  (FBA)  assist in making an appropriate diagnosis  also aid in developing an effective treatment plan

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Assessments/ Data Collection  for Assessment of the Most Common Types of Disorders

Diagnosis of ODD/CD requires a comprehensive diagnostic evaluation Standardized reporting tools can be used, but no tool is thought to be specific No biological markers No questionnaires are specifically designed for diagnosing ODD/CD, but multiple tools can aid in diagnosis while assessing for other psychiatric conditions . Conners 3 and Vanderbilt ADHD diagnostic rating scales have comorbidity screening scales that can help identify ODD and CD Interviews with child, parent, teachers Observations in multiple settings Professional judgement is used

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DSM-5  Other Criteria to Consider for Assessment of the Most Common Types of Disorders

Conduct Disorder (CD): provider must ascertain whether the child or adolescent has shown at least three major symptoms in the past twelve months, with one of the symptoms having occurred in the last six months Individuals with CD are likely to underreport their symptoms, so clinicians must often rely on additional informants Oppositional Defiant Disorder (ODD): a pattern of negative, hostile, and defiant behavior must be present may or may not be accompanied by a negative or irritable mood ODD frequently occurs prior to presentation of childhood-onset CD Intermittent Explosive Disorder (IED): Aggressiveness must be “grossly out of proportion” to the provocation and accompanying psychosocial stressors at least six years old or older Children should not be diagnosed with IED if their impulsive and aggressive outbursts occur in the context of an adjustment disorder

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Parental management training. Peer group support intervention. Social awareness and supervision. Cognitive behavior therapy such as perspective taking, problem-solving  skills training, assertive training, and anger management training. Functional family therapy

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Use positive reinforcement and praise students  when they respond positively. Establish classroom rules. Provide daily schedule  and consequences for the student’s behavior. Make sure academic work is at the appropriate level. When students have completed an activity they dislike, reward them with  something less difficult. Teach social skills, such as anger management and conflict resolution strategies. Discuss strategies students may use to calm themselves when they feel their angry. Provide a photo or written schedule of the day. Provide a classroom environment with minimal visual/auditory distractions. Give the student a certain amount of minutes before a transition takes place.

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12:30-
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APA (American Psychiatric Association).  Diagnostic and statistical manual of mental disorders, fifth edition.Washington, DC: APA; 2013. Achenbach, T., & Rescorla, L. (2001).  Manual for the ASEBA school-age forms & profiles.  Burlington, VT: University of Vermont, Research Center for Children, Youth, and Families. Boat, T. F., Wu, J. T., Committee to Evaluate the Supplemental Security Income Disability Program for Children with Mental Disorders, Board on the Health of Select Populations, Board on Children, Youth, and Families, Institute of Medicine, Division of Behavioral and Social Sciences and Education, & The National Academies of Sciences, Engineering, and Medicine (Eds.). (2015).  Mental Disorders and Disabilities Among Low-Income Children . National Academies Press (US). Christophersen, E., & Mortweet, S. (2001). Treatments that work with children: Empirically supported strategies for managing childhood problems. Washington, DC: American Psychological Association. Iliades, C. (2018, December 17).  Understanding Impulse Control and conduct disorders . Psychiatry Advisor. Retrieved September 30, 2021, from  https://www.psychiatryadvisor.com/home/topics/anxiety/understanding-impulse-control-and-conduct-disorders/ .   Understanding Impulse Control and Conduct Disorders Lenz, A. S., & Lancaster, C. (2016). Disruptive, impulse-control, and conduct disorders. In B. Flamez & C. J. Sheperis (Eds.), Diagnosing and treating children and adolescents: A guide for mental health professionals (pp. 386–412). John Wiley & Sons, Inc. Ghosh A, Ray A, Basu A. Oppositional defiant disorder: current insight. Psychol. Res. Behav. Manag. 2017;10:353-367.https://doi.org/10.2147/PRBM.S1205. What Are Disruptive, Impulse-Control and Conduct Disorders? American Psychiatric Association. (n.d.). Retrieved September 30, 2021, from  https://www.psychiatry.org/patients-families/disruptive-impulse-control-and-conduct-disorders/what-are-disruptive-impulse-control-and-conduct-disorders .

Disruptive, Impulse Control, 
and Conduct Disorders

 APA (American Psychiatric Association).  Diagnostic and statistical manual of mental disorders, fifth edition.Washington, DC: APA; 2013. Achenbach, T., & Rescorla, L. (2001).  Manual for the ASEBA school-age forms & profiles.  Burlington, VT: University of Vermont, Research Center for Children, Youth, and Families. Boat, T. F., Wu, J. T., Committee to Evaluate the Supplemental Security Income Disability Program for Children with Mental Disorders, Board on the Health of Select Populations, Board on Children, Youth, and Families, Institute of Medicine, Division of Behavioral and Social Sciences and Education, & The National Academies of Sciences, Engineering, and Medicine (Eds.). (2015).  Mental Disorders and Disabilities Among Low-Income Children . National Academies Press (US). Christophersen, E., & Mortweet, S. (2001). Treatments that work with children: Empirically supported strategies for managing childhood problems. Washington, DC: American Psychological Association. Iliades, C. (2018, December 17).  Understanding Impulse Control and conduct disorders . Psychiatry Advisor. Retrieved September 30, 2021, from  https://www.psychiatryadvisor.com/home/topics/anxiety/understanding-impulse-control-and-conduct-disorders/ .   Understanding Impulse Control and Conduct Disorders Lenz, A. S., & Lancaster, C. (2016). Disruptive, impulse-control, and conduct disorders. In B. Flamez & C. J. Sheperis (Eds.), Diagnosing and treating children and adolescents: A guide for mental health professionals (pp. 386–412). John Wiley & Sons, Inc. Ghosh A, Ray A, Basu A. Oppositional defiant disorder: current insight. Psychol. Res. Behav. Manag. 2017;10:353-367.https://doi.org/10.2147/PRBM.S1205. What Are Disruptive, Impulse-Control and Conduct Disorders? American Psychiatric Association. (n.d.). Retrieved September 30, 2021, from  https://www.psychiatry.org/patients-families/disruptive-impulse-control-and-conduct-disorders/what-are-disruptive-impulse-control-and-conduct-disorders . 

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