What Are Disruptive Behavior Disorders (DBD)?
Most children and adolescents have occasional temper tantrums or emotional outburst. However, when such behavioral/emotional outburst repeatedly occur, it can cause disruption to their academic and social functioning and cause family distress. Disruptive behavior disorders (DBD) are a group of behavioral disorders that are often characterized by a lack of self-control in behavior and emotions. While disruptive behaviors may present in a variety of ways, they commonly manifest as temper tantrums, physical and verbal aggression, violating the rights of others, defiance, and resistance to authority. DBD often include the following diagnoses: Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD). Although Attention Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder, ADHD is often comorbid with ODD and CD. According to the Centers for Disease Control and Prevention, about one in four children with ADHD have a diagnosed behavior disorder. Individuals who have both conditions tend to experience more difficulty in their daily functioning because of the defiant behavior that leads to numerous conflicts.
Oppositional Defiant Disorder (ODD)
Oppositional defiant disorder is defined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) as persistent symptoms of “negativistic, defiant, disobedient, and hostile behaviors toward authority figures.” The essential feature of this condition is a frequent and persistent pattern of angry/irritable mood and defiant behavior or vindictiveness. It is difficult to differentiate between a child who is strong willed or emotional from one who has this condition, as it can be developmentally appropriate to exhibit oppositional behavior at certain stages in child development. Signs of ODD can begin as early as preschool years, but almost always before early teen years. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), symptoms of ODD include:
- loses temper
- angry/resentful
- argumentative with adults
- active defiance and refusal to comply with adult requests and rules
- deliberate attempts to annoy or upset people
- blaming others for his or her mistakes or misbehavior
- often being touchy or easily annoyed by others
- spiteful attitude and revenge seeking
Individuals with this condition often display symptoms at home and in other social settings such as school. However, it is not uncommon for such individuals to display symptoms only at home. While the exact causes of ODD are unknown, researchers have noted that biological, psychological, and social factors may play a role.
Conduct Disorder (CD)
Conduct disorder is a progressive form of ODD; however, the difference between the disorders lies in the level of intensity. Conduct disorder is said to have more serious ramifications. As defined in the DSM-V, conduct disorder is “a repetitive and persistent pattern of behavior in which the basic rights of others or major age appropriate social rules are violated.” These behaviors tend to fall into four categories: aggressive conduct, destruction, deceitfulness and serious violations of rules. Like ODD, the disturbance in behavior tends to cause significant impartment in social, academic, or occupational functioning. Individuals with this condition tend to misperceive the intentions of others as more threatening and hostile. As a result, they can become defensive and guarded toward others, making it difficult to empathize. Personality features tend to include negative emotionality, poor self-control, suspiciousness, insensitivity to consequences/punishments, thrill seeking, and recklessness. The signs and symptoms of this condition include:
- Aggression to people or animals
- bullying others
- physical aggression/fighting behavior
- cruelty toward people or animals
- Destruction of property
- fire setting
- destroying the property of others
- Deceitfulness
- stealing
- lying to obtain goods
- Rule violation
- run away from home
- school truancy
- deliberate attempt to defy against rules (i.e., home, school, work)
The onset of CD may occur as early as the preschool years, but more significant symptoms usually emerge during middle childhood through middle adolescence. ODD is thought to be a precursor to the onset of CD. The symptoms of this disorder tend to vary with age as children mature physically, cognitively, and sexually.
Causes of DBD
The etiology of disruptive behavior disorders is said to be related to a combination of biological, environmental (social), and psychological factors.
Effects of DBD
Untreated ODD and CD can lead to a number of lifelong effects that include the development of more serious mental health conditions as well as negative consequences (e.g., legal trouble, substance use, academic, occupational, and social difficulties).
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