Disruptive, impulse control, and conduct disorders

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Introduction0:00–0:51

The Diagnostic and Statistical Manual of Mental Disorders - 5th edition or DSM 5 has a relatively new category called “Disruptive, Impulse Control, and Conduct Disorders” or DIC for short, which were previously organized in different sections.
This category includes a number of disorders like oppositional defiant disorder, conduct disorder, antisocial personality disorder, intermittent explosive disorder, as well as other impulse control disorders such as the compulsive desire to start fires, or pyromania, and the compulsive desire to steal things, or kleptomania.
The common thread that runs through all of these disorders is that they all involve impulsive behaviors, or a lack of self-control.
These disorders tend to begin in childhood or adolescence, and persist into adulthood. Oppositional defiant disorder, or ODD, is defined by defiant behavior that is both persistent and willful, and can be thought of in terms of emotional, behavioral, and cognitive patterns.

Oppositional defiant disorder0:51–1:50

Individuals with ODD have emotion dysregulation which can lead them to feel irritable and resentful towards 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.
Individuals with ODD might even deliberately annoy their family and friends, purposefully defying anyone who tries to control their behavior.
Cognitively, these individuals often fall into a pattern of vindictiveness and spitefulness, believing that others are to blame for their own behaviors.
In order to meet the criteria for ODD, these emotional, behavioral, and cognitive patterns must be ongoing for at least 6 months, and must interfere with family, school, and other social interactions.

Conduct disorder1:50–2:31

Conduct disorder has a lot of overlap with oppositional defiant disorder with one key additional feature - aggressive behaviour 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 ten and adolescent-onset type, which starts between age ten and age 18.
Typically the earlier the symptoms, the more severe the behavioral problems. Okay, so antisocial personality disorder—these individuals disregard moral values and societal norms, have little empathy, and poor impulse control.

Antisocial personality disorder2:31–3:46

This combination makes them willing to hurt others if it helps them, making them prone to aggressive and unlawful behavior, at times earning the label sociopath or psychopath.
In fact, individuals with this disorder tend to be overrepresented in prison populations and have higher rates of substance use.
These individuals typically fail to show remorse or guilt and rarely accept responsibility for any of the harm that they cause others.
That said, they can be superficially charming and often use that to manipulate others for their personal gain. To be diagnosed with this disorder, individuals must be over 18 years old and have a history of conduct disorder.
Interestingly, this disorder fits into two categories, and can also be found in the personality disorders section of the DSM-5.
While there is certainly a relationship between oppositional defiant disorder, conduct disorder, and antisocial personality disorder, it is important to note that not all individuals with oppositional defiant disorder will go on to develop conduct disorder, and not all individuals with conduct disorder will go on to develop antisocial personality disorder.

Intermittent explosive disorder3:46–4:26

Another disorder is intermittent explosive disorder, or IED. IED 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 six 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 result in physical injury or property damage.

Pyromania and kleptomania4:26–5:24

Pyromania and kleptomania are also categorized as DIC disorders. 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 that has to do with fires- for example, they might hang out around fire-stations, or watch videos of fires on youtube.
Individuals with kleptomania feel a strong impulse to steal things- not out of need- but out of the pleasure and relief of tension that they feel once they steal something.
In fact, these individuals often steal items that are of little value to them, or items that they could easily afford. Not surprisingly, both pyromania and kleptomania can easily land individuals in serious legal trouble.

Treatment for disruptive, impulse control and conduct disorders5:24–6:01

Treatment for disruptive, impulse control, and conduct disorders are generally focused on changing behaviors through therapy rather than pharmaceutical treatments.
In particular, cognitive-behavioral therapy has been shown to be successful. Social skills training as well as anger management are also useful in helping to decrease some of the problematic behaviors seen in DIC disorders.
Lastly, parent management training- teaching parents how to respond- can also be very effective. Thanks for watching, you can help support us by donating on patreon, or subscribing to our channel, or telling your friends about us on social media.