Review of DSM5 Mental Disorders for NCMHCE Study

1. Oppositional defiant disorder

2. Intermittent explosive disorder
3. Conduct disorder
4. Pyromania
5. Kleptomania
6. Other specified/unspecified disruptive, impulse control and conduct
disorder
Assessments
Achenbach System of Empirically Based Assessment ASEBA
Conner's Revised 3 Rating Scale
Brown Attention-Deficit Scale
Woodcock-Johnson III
Wechsler Intelligence Scale for Children IV (WISC-IV)
Level 1 Cross-Cutting-rated Symptom Measure 6-17
Treatment
1. Medications 2. Therapy
Lithium/antipsychotics CBT
Parent training
Parent-child Interaction Therapy
Behavior Modification Therapy
Emotion Regulation & Social Skills
Training
Group therapy
Family therapy
Engagement of teachers and other
involved adults
Risk factors for ODD, Conduct
Disorder
Having a parent with a mood or
substance abuse disorder
Being abused or neglected
Harsh or inconsistent discipline
Lack of supervision
Poor relationship with one or both
parents
Family instability such as multiple
moves, changing schools frequently
Parents with a history of ADHD,
or conduct problems
Financial problems in the family
Peer rejection
Exposure to violence
Frequent changes in daycare
providers
Parents who have a troubled
marriage or are divorced
Poverty
Disruptive Mood Oppositional Defiant Intermittent Explosive
Dysregulation Difficult behavior for 6 3 times yearly
2-3 times weekly months Verbal aggression
For 12 or more Verbal rages Assaults
months Argumentative Outbursts causing
Ages 6-10, until age 18 Aggressive damage
Persistently irritable More severe Ages 6-adult
or angry Remorseful
Verbal and/or physical
rages
Diagnosis
Recurrent behavioral outbursts showing a failure to control aggressive
impulses
Not premeditated
Age 6 or older
1. Verbal aggression
2 times weekly for 3 months
2. Behavioral outbursts causing damage and/or physical assault against
animals or people
3 times within 1 year
S4. Treatment
1. Medications
2. Therapy
CBT
Group therapy
Diagnosis Leads to:
Difficult behavior for 6 months Frequent temper tantrums
Negativity Argumentativeness with adults
Defiance Refusal to comply with adult requests or
Disobedience rules
Hostility directed toward Deliberate annoyance of other people
authority figures Blaming others for misbehavior
Being touchy and easily annoyed
Anger and resentment
Spiteful or vindictive behavior
Aggressiveness toward peers

Comorbid
ADHD 50% of time
S1. Find Out More
Detailed history of presenting
problem, symptoms
Detailed developmental history
Medical history
Affective functioning
Cognitive functioning
Trauma history
Destructiveness and self
destructiveness
Family and social history
Abuse of substances
Exposure to pornography
Academic performance on tests
Psychological testing
S2. Assess & Refer
Consult with both parents and
other involved adults
Psychological testing
Tests
Achenbach System of Empirically
Based Assessment ASEBA
Conner's Revised 3 Rating Scale
Brown Attention-Deficit Scale
Woodcock-Johnson III
Wechsler Intelligence Scale for
Children IV (WISC-IV)
Level 1 Cross-Cutting-rated
Symptom Measure 6-17
S4. Treatment
Long-term, multi-modal
Family therapy
Engagement of teachers and other involved adults
Parent training
Parent-child Interaction Therapy
Supportive therapy
Training in problem solving
CBT
Behavior Modification Therapy
Emotion Regulation & Social Skills Training
S5.Monitoring S6. Termination
Change in behavioral functioning Follow-up family visit
at home and school
Diagnosis
Repetitive and persistent pattern
of behavior
1. Requires 3 of the following in the
past 12 months, with at least 1 in
the past 6 months
Aggression to people and
animals
Intimidates others often
Initiates physical fights often
Used a dangerous weapon
Physically cruel to people or
animals
Stolen while confronting a victim
Forced sex on someone
Destruction of property
Arson
Deceitfulness or theft
Broken into someones place
Deceives and manipulates others
Serious violations of rules
Run away from home 2 times
Beginning before age 13 years
2. Onset before age 13
Diagnosis II
Comorbidity
ADHD
Generalized Anxiety Disorder
Major Depressive Disorder

Rule Out
Antisocial Personality Disorder:
Over age 18, and more severe
S1. Find Out More
Detailed history of presenting
problem, symptoms
Detailed developmental history
Medical history
Affective functioning
Cognitive functioning
Trauma history
Destructiveness and self
destructiveness
Family and social history
Abuse of substances
Exposure to pornography
Academic performance on tests
Psychological testing
S2. Assess & Refer
Consult with both parents and
other involved adults
Psychological testing
Tests
Achenbach System of Empirically
Based Assessment ASEBA
Conner's Revised 3 Rating Scale
Brown Attention-Deficit Scale
Woodcock-Johnson III
Wechsler Intelligence Scale for
Children IV (WISC-IV)
Level 1 Cross-Cutting-rated
Symptom Measure 6-17
S4. Treatment
Therapy
School-based therapies
Behavioral therapy
Parental skills training
Medications
Lithium/antipsychotics
Diagnosis
Recurrent failure to resist impulses to steal objects that are not needed for
personal use or for their monetary value
Increasing sense of tension immediately before committing the theft
Pleasure, gratification or relief at the time of committing the theft
Stealing is not committed to express anger and is not in response to
delusion/hallucination
Not explained better by CD, manic episode, or Antisocial Personality
Disorder
S4. Treatment
CBT
Behavior therapy
Diagnosis Rule Out
1. Deliberate and purposeful fire setting on Conduct Disorder
more than one occasion Manic Episode
Tension or affective arousal before the act Antisocial Personality
Fascination with, interest in, curiosity about Disorder
or attraction to fire
2. Motive does not include:
Monetary gain
To conceal a crime
Ideology
Express anger
Response to delusion/hallucination
Impaired judgement