Introduction to Disruptive, Impulse Control, and Conduct Disorders
Disruptive, impulse-control, and conduct disorders involve much more constant behaviors than typical, temporary episodes of most children and adolescents. These disorders can cause individuals to behave violently toward others or property. They may have problems in managing their emotions and behavior, and may violate rules or laws. One significant difference between the disorders and many other mental health conditions is that with conduct disorders, a person's distress is focused outward and directly affects other people. While with most other mental health conditions, a person's distress is generally directed inward toward themselves.
Types of Disruptive, Impulse Control, and Conduct Disorders
Disruptive, impulse-control, and conduct disorders refer to a group of disorders, including oppositional defiant disorder (ODD), intermittent explosive disorder (IED), conduct disorder (CD), antisocial personality disorder (ASPD or APD), pyromania, and kleptomania. About 6% of children are affected by oppositional defiant disorder or conduct disorder while an estimated 2.7% of children and adults in the U.S. are affected by intermittent explosive disorder, and 1% or fewer people by kleptomania and pyromania.
Causes of Disruptive, Impulse Control, and Conduct Disorders
A combination of factors, including genetic vulnerability, biology, and environmental adversity interact to cause disruptive, impulse control, and conduct disorders.
There is a genetic risk for conduct disorder, although no specific gene marker has been identified. The disorder is more common in children who have a sibling with conduct disorder or a parent with antisocial personality disorder, substance abuse, mood disorder, schizophrenia, or attention deficit hyperactivity disorder (ADHD).
There is a lack of reactivity of the autonomic nervous system in children with conduct disorder. This non-responsiveness is similar to adults with antisocial personality disorder.
Poor family functioning, poor parenting, a family history of substance abuse or psychiatric problems are all associated with the development of disruptive, impulse control, and conduct disorders.
Management of Disruptive, Impulse Control, and Conduct Disorders
Due to the multifaceted nature of conduct problems, particularly related comorbidities, treatment usually includes medication, teaching parenting skills, family therapy, and consultation with the school. Stimulant medicine is effective in controlling the specific symptoms of inattention, impulsivity, and hyperactivity. Then, anticonvulsants are the second group of medications to be used in nonspecific aggression. Moreover, lithium and methylphenidate have been shown to reduce aggressiveness in several studies but the effectiveness of lithium could not be replicated.
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