Disruptive, impulse control, and conduct disorders

The Diagnostic and Statistical Manual of Mental Disorders, the 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 into 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 like 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 is that they all involve impulsive behaviors, or a lack of self-control. These disorders tend to start in childhood or adolescence, and persist into adulthood.

Oppositional defiant disorder, or ODD, is defined by defiant behavior that’s both persistent and willful, and can be thought of in terms of emotional, behavioral, and cognitive patterns. People with ODD have emotional 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. People with ODD might even deliberately annoy their family or friends, purposefully defying anyone who tries to control their behavior. Cognitively, these people 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 disorder has a lot of overlap with oppositional defiant disorder with one key additional feature - aggressive behavior towards people and animals. For example, people 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 start 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.