Disruptive, Impulsive and Conduct Disorder, Slides of Clinical Psychology

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DISRUPTIVE, IMPULSE

CONTROL AND

CONDUCT DISORDER

DIC Disorders Include:

Oppositional Defiant Disorder

Conduct Disorder

Intermittent explosive Disorder

Kleptomania

Pyromania

Impulse control Disorder

Individuals with ODD might even deliberately annoy their family and friends,

purposefully defying anyone who tries to control their behavior.

Individuals with ODD have emotional dysregulation which can lead them to

feel irritable and resentful toward others. These emotions can lead to behaviors

like frequent arguments, angry outbursts, and refusing to go along with the

requests of authority figures- like teachers

It is defined by deviant behavior that is both persistent and willful and can be

thought of in terms of emotional, behavioral and cognitive patterns.

Cognitively, these individuals often fall into a pattern of vindictiveness and

spitefulness, believing others are to blame for their own behaviors.

Oppositional Defiant Disorder

Conduct Disorder

It has a lot of overlap with ODD with one key additional behavior - aggressive

behavior towards people and animals.

For example - individuals with conduct disorder might violently destroy property,

steal things, or hurt pets causing grief and frustration for those around them. These

are considered antisocial behaviors because they completely break the boundaries of

social norms.

There are two main types of conduct disorder, childhood-onset type, where the

abnormal behaviors begin before the age of 10 and adolescent-onset type, which starts

between the age of 10 and 18.

Typically the earlier the symptoms, the more severe the behavioral problems

Conduct disorder in children is very common and is observed more in boys in

comparison to girls.

It is characterized by recurrent explosive outbursts of intense anger and violence, sometimes causing injury to themselves or others. These outbursts are usually brief and not premeditated, can appear in response to any real or perceived provocation, and are almost always out of proportion to the situation. To diagnose IED, an individual has to be over 6 years old to distinguish these from temper tantrums, and must have these outbursts twice a week for at least three months, or have three outbursts in a year that results in physical injury or property damage. Intermittent Explosive Disorder

According to research Pyromania describes individuals who purposefully and repeatedly set fires, but unlike arsonists, who set fires to deliberately damage property or for political gain. Individuals with pyromania experience fire setting as a compulsion - feeling a strong impulse to set fires and feeling relief and often euphoria once they do These individuals are often fixated with anything might hang out around fire stations or even watch fire videos on youtube. Pyromania

Treatment The treatment is generally focused on changing behaviors through therapy rather than pharmaceutical treatments. In particular Cognitive Behavior Therapy (CBT) has been shown to be successful. Social skills management, as well as anger management, are also useful in helping decrease some of the problematic behavior seen in DIC disorders. Also, parent management training- teaching parents how to respond- can also be very effective

Case Study A distraught mother brought her six year-old son into a hospital emergency room because she was afraid that she could no longer prevent him from setting fires. She was especially afraid that he would set their house on fire while she and her 10 year-old daughter slept. Since the boy was four, he had shown an unhealthy fascination with fire. He had set several fires in the past two years, all of which his mother had found and extinguished. She noted that her son was sneaky about setting the fires, making it increasingly difficult for her to monitor. The boy told the doctor that he sets fires because a “man in his head” tells him to – and that he is afraid to disobey the man for fear of physical punishment. The mother does not take this reason seriously as he has given a variety of other reasons in the past, depending on to whom he was speaking. Both mother and son agreed that he started the fires in retaliation against his mom when he was angry with her.

Other than the fire-setting behaviour, no other aggressive behaviours were exhibited by the boy. He was occasionally difficult to discipline, but the mother said that was because he ignored her. The boy’s teacher was surprised to hear of the fires. The teacher described the six year-old as lovely, bright, and obedient – a student who worked and played well with others. The 26 year-old mother admitted to becoming violently angry at times, so much so that she was not able to control herself. She even said that she had made her son put his hand in a gas flame to teach him that fire hurts. Later, however, she denied this fact despite the fact that her son confirmed her original story. The boy, except for the burn, was physically healthy. Emotionally, however, he was guarded and distrustful when interviewed. This distrust was due, in part, to fear of his mother’s reaction. Eventually, he shared that he loves to talk about fires. Although he knew that he could get hurt or even killed by fire, he was fascinated by them. When speaking about fires, the boy’s affect was inappropriate. He laughed at the wrong times and/or have blunted emotion when he should have more passionate feelings. He also appeared genuinely frightened of the “man in his head.”

Diagnosis The setting of fires can be symptomatic of conduct disorder. The six year-old, however, has no other antisocial problems and performed well at school – working well with both peers and his teacher. It is doubtful that he set fires as political statements or for insurance purposes, but evidently he derived much pleasure and excitement from fire and fire-setting. Although documenting such information in a young child is difficult, it can be inferred that there was tension before the boy set the fires. Therefore, the diagnosis is pyromania. Because he had no other signs of psychotic behavior apart from the “man in his head,” and because his reasons for setting the fires varied, an additional diagnosis of a psychotic disorder is not made. His overall diagnosis is pyromania.