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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 Parents with a history of ADHD,
Having a parent with a mood or or conduct problems
substance abuse disorder Financial problems in the family
Being abused or neglected Peer rejection
Harsh or inconsistent discipline Exposure to violence
Lack of supervision Frequent changes in daycare
Poor relationship with one or both providers
parents Parents who have a troubled
Family instability such as multiple marriage or are divorced
moves, changing schools frequently 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 S2. Assess & Refer
Detailed history of presenting Consult with both parents and
problem, symptoms other involved adults
Detailed developmental history Psychological testing
Medical history Tests
Affective functioning Achenbach System of Empirically
Cognitive functioning Based Assessment ASEBA
Trauma history Conner's Revised 3 Rating Scale
Destructiveness and self Brown Attention-Deficit Scale
destructiveness Woodcock-Johnson III
Family and social history Wechsler Intelligence Scale for
Abuse of substances
Children IV (WISC-IV)
Exposure to pornography Level 1 Cross-Cutting-rated
Academic performance on tests
Symptom Measure 6-17
Psychological testing
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 Forced sex on someone
Repetitive and persistent pattern Destruction of property
of behavior Arson
1. Requires 3 of the following in the Deceitfulness or theft
past 12 months, with at least 1 in Broken into someones place
the past 6 months Deceives and manipulates others
Aggression to people and Serious violations of rules
animals Run away from home 2 times
Intimidates others often Beginning before age 13 years
Initiates physical fights often 2. Onset before age 13
Used a dangerous weapon
Physically cruel to people or
animals
Stolen while confronting a victim
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 S2. Assess & Refer
Detailed history of presenting Consult with both parents and
problem, symptoms other involved adults
Detailed developmental history Psychological testing
Medical history Tests
Affective functioning Achenbach System of Empirically
Cognitive functioning Based Assessment ASEBA
Trauma history Conner's Revised 3 Rating Scale
Destructiveness and self Brown Attention-Deficit Scale
destructiveness Woodcock-Johnson III
Family and social history Wechsler Intelligence Scale for
Abuse of substances
Children IV (WISC-IV)
Exposure to pornography Level 1 Cross-Cutting-rated
Academic performance on tests
Symptom Measure 6-17
Psychological testing
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