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Help With Disruptive, Impulse Control and Conduct Disorders

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.

See definition, symptoms, & treatment

Upcoming Events
Oct
2018
01

Council for Children with Behavior Disorders

Oct
2018
01
Behavioral and Emotional Skills Training
  • New York City
  • Mon,  Oct  01 - Wed,  Oct  31
  • 10:15 AM - 10:15 AM

Child Mind Institute

Most children go through the "terrible twos;" isn't it just a phase they will grow out of?

It certainly is a phase. Most kids at 2 are exploring their growing independence. They're noticing they have new motor skills that allow them some freedom to explore their environment, and finding they have strong preferences but little ability to regulate their emotions. One of the reasons why we have the phrase "terrible twos" is that this is commonly when a child's capability for exploring the world is clashing with the rules of the world.

Every family with a 2-year-old may experience acting out - the child doesn't want to put on his shoes, or he doesn't want to go to bed one night a week, so there's a lot of screaming. But if it's happening every morning as you go out, or the house ends up looking like a disaster area, or it happens every night for bedtime, or it takes hours to get the child to bed, and parents are pulling their hair out and no one is sleeping - that is when professional help may be necessary. More

How can I tell if my child's behavior is typical acting out or a more serious disorder?

I often tell parents about a clinical acronym we use to better understand whether a child's symptoms are consistent with a mental health diagnosis: FIDI, for "Frequency, Intensity, Duration and Impairment." When parents come into the office worrying about a child's tantrums, I ask, "How often do the tantrums happen? How intense do things get? How long do these things last and how long have they been going on? How much does it get in the way of you being able to do stuff as a family?" We have diagnostic criteria for certain behavior disorders, but those criteria don't cover every behavior that could impair a child's or family's functioning. So we have to look objectively at the frequency, intensity and duration of these behaviors, and then discuss how they're impairing the child's life and family.

Impairment is the key dividing line between "typical" and clinical, and it isn't always as sharp as we would like it to be. It may be that a child has milder behavioral issues, but they are really getting in the way for a family and causing a lot of conflict between the parents. We don't only treat problem behavior if it is the most severe it can be. We treat because a family needs help. More

Isn't most child misbehavior and defiance because parents don't discipline them enough?

Parents are not necessarily the cause of behavior problems, but they can be the solution. Behavior problems have many different causes. There are biological and genetic reasons why a child might have behavioral difficulties. Some children react more strongly to interruptions in daily rhythms - like overreactions to hunger or irritability related to too little sleep. Some children have real difficulties controlling emotions, difficulties that have been there since infancy as part of a reactive and highly sensitive temperament.

To be sure, there are parent-child interaction patterns that we know lead to a higher instance of behavior problems - usually the techniques we would call "harsh discipline." Parents who end up making threat after threat, who engage in physical discipline, or who frequently criticize their children often see more behavior problems.

But the issue we see most often is parents who believe their child's behavior problems must be the result of their actions or some mistake in discipline, like being too harsh or too permissive. The reality is it can happen to anybody, and we want to re-establish a balance between nurture and structure in effectively managing behavior. We see parents who have what seems to be flawless parenting strategies with one child in a family, and through no fault of their own, the other child has just stumbled upon ways of coping with stress or with their emotions that become impairing and disruptive over time. Parenting is just a part of what goes into a child's behavior patterns; but parent behavior is adjustable, so it's one of the most powerful tools we have. More

About the Experts

Harold Koplewicz, M.D.

Harold Koplewicz, M.D.
President
Child Mind Institute

David Anderson, Ph.D.

David Anderson, Ph.D.
Senior Director of the ADHD and Behavior Disorders Center
Child Mind Institute

Julia's Story

Julia was 8 years old when she was diagnosed with oppositional defiant disorder. Her parents had since divorced when they sought advice and potential treatment for Julia’s continued defiant and aggressive behavior two years later. The parents disagreed on the validity of Julia’s diagnosis, stemming from Julia’s strikingly different behavioral patterns in her two home environments. Her father reported frequent disruptive arguments at home that eroded the relationship and impaired family functioning. Julia’s mother and the school reported no rebellious or defiant behaviors, and limited outbursts when she was frustrated or upset.

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Editor's Choice

OCT 4, 2018

Addressing Persistent Defiance

Edutopia.org

Any student may refuse to cooperate at times, but handling students with oppositional defiant disorder requires that teachers have a plan. Up to 16 percent of all children and 40 percent of students are diagnosed with attention-deficit/hyperactivity disorder have oppositional defiant disorder (ODD), which is characterized by a pattern, in multiple settings over time, of consistent negative and hostile behavior that can include deliberately annoying or upsetting others, explosions of anger and hostility, defiance or frequent arguing with adults, and then blaming others for misbehavior.

SEPT 21, 2018

Improving Medicaiton Adherence in ADHD Lowers Risk for Oppositional Defiant Disorder

Psychiatry Advisor

Adherence with drug treatment in children with attention-deficit/hyperactivity disorder (ADHD) may be associated with lower risk for oppositional defiant disorder or conduct disorder in adulthood, according to the results of a study published in the Journal of Clinical Psychiatry.

SEPT 18, 2018

ADHD and Conduct Disorder Cause Simlar Brain Chanages

ADDitude

Emotional dysregulation is a core, and often overlooked, symptom of attention deficit disorder (ADHD or ADD). It is commonly comorbid with mood disorders including oppositional defiant disorder, anxiety, and depression. Yet no physical link between ADHD and emotional instability disorders was documented — until last month. A recent study1, conducted by the Swedish Karolinska Institute and published in Molecular Psychiatry, finds biological similarities between ADHD and conduct disorder traits.