Disruptive, Impulse Control, and Conduct Disorders

Disruptive, impulse control, and conduct disorders include conditions involving problems in the self-control of emotions and behaviors. A few common disorders include Oppositional Defiant DisorderIntermittent Explosive DisorderConduct DisorderAntisocial Personality DisorderPyromania, and Kleptomania. The DSM-5 created a new chapter on disruptive, impulse control, and conduct disorders that brought together disorders previously classified as disorders usually first diagnosed in infancy, childhood, or adolescence (ODD, CD) and impulse-control disorders not elsewhere classified. These disorders are unified by the presence of difficult, disruptive, aggressive, or antisocial behavior. Disruptive, aggressive, or antisocial behavior usually is a multifaceted behavior, often associated with physical or verbal injury to self, others, or objects or with violating the rights of others. These behaviors can appear in several forms and can be defensive, premedi­tated, or impulsive.1 Oppositional defiant disorder is defined as defiant, hostile, and disobedient behavior, usually directed at authority figures. Conduct disorder is repetitive aggression toward others that may include physical abuse and destruction of property. Intermittent explosive disorder is repeated, out-of-proportion temper tantrums. And antisocial personality is a pattern of disregard for the rights, feelings, and safety of others.2 According to a review article on these disorders, published in Frontiers in Psychiatry, the core characteristic that links them together is a compulsive need to engage in behaviors that are harmful to self and others. These disorders have been called behavioral addictions because they tend to have strong aspects of compulsion, craving, loss of control, and hedonistic release.3

Cognitive-behavioral therapy (CBT) is basically one of the only treatments that can be used for all types of impulse-control disorders. This may include training to become aware of behavioral triggers and strategies to control them. Older children who are disruptive at school may require intensive behavior management.4 Other than CBT, finding successful treatment options is a work in progress. For example, experts disagree about using medication as treatment, and there are no FDA-approved drugs for these disorders.

Conduct Disorder

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  1. http://www.currentpsychiatry.com/home/article/choosing-a-treatment-for-disruptive-impulse-control-and-conduct-disorders/24e4a10cdd001b5cdcc7ce671de32be9.html
  2. The Albert Ellis Institute. “Disruptive, Impulse-Control and Conduct Disorders.” Retrieved on November 4, 2014, from http://albertellis.org/disruptive-impulse-control-conduct-disorders/.
  3. “Impulse Control Disorders: Updated Review of Clinical Characteristics and Pharmacological Management.”Front Psychiatry. 2011; 2:1.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3089999/.
  4. American Academy of Pediatrics. “Disruptive Behavior Disorders.” 2013, Retrieved on November 4, 2014, from http://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Disruptive-Behavior-Disorders.aspx.
  5. Image source: https://s-media-cache-ak0.pinimg.com/originals/14/ac/a7/14aca73df7e73d141c26edae1abc78e8.jpg