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Chapter 22. Disruptive, Impulse-Control, and Conduct Disorders

Bonnie Taylor, Ph.D.; Meredith Weiss, M.D.; Casara Ferretti, M.S.; Gregory Berlin, B.S.; Eric Hollander, M.D.
DOI: 10.1176/appi.books.9781585625031.042882

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Excerpt

Disruptive, impulse-control, and conduct disorders is a new diagnostic class in DSM-5 (American Psychiatric Association 2013) that combines related disorders that were previously classified within two distinct DSM-IV-TR (American Psychiatric Association 2000) categories. More specifically, and as illustrated in Figure 22–1 , DSM-IV (American Psychiatric Association 1994) included 1) oppositional defiant disorder (ODD), conduct disorder (CD), and disruptive behavior disorder not otherwise specified (DBD NOS) among the Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence, and 2) intermittent explosive disorder (IED), pyromania, and kleptomania among the Impulse-Control Disorders Not Elsewhere Classified. The common thread that runs through these disorders is an underlying construct of emotional and/or behavioral dysregulation that results in impulsive behavior, aggressiveness, and pathological rule breaking. Whereas ODD and CD were conceptualized in DSM-IV-TR as developmental disabilities defined by defiant behaviors and features of impulsivity commonly seen in attention-deficit/hyperactivity disorder (ADHD), they are classified within DSM-5 together with disorders of impulse control that typically persist into adulthood.

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DSM-5 disruptive, impulse-control, and conduct disorders: comparison with DSM-IV classification.ADHD = attention-deficit/hyperactivity disorder; CD = conduct disorder; IED = intermittent explosive disorder; ODD = oppositional defiant disorder.
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Disruptive, impulse-control, and conduct disorders and related disorders of emotional and/or behavioral dysregulation
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Pharmacotherapy for intermittent explosive disorder
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Prevalence of kleptomania in clinical samples

References

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. Washington, DC, American Psychiatric Association, 1994
 
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000
 
American Psychiatric Association: DSM-5 Development: Recent Updates to Proposed Revisions for DSM-5. Available at: www.dsm5.org/Pages/RecentUpdates. aspx. Accessed September 27, 2012.
 
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. Arlington, VA, American Psychiatric Association, 2013
 
Angold A, Costello EJ, Erkanli A: Comorbidity. J Child Psychol Psychiatry 40:57–87, 1999
[PubMed]
 
Barlow J, Stewart-Brown S: Behavior problems and group-based parent education programs. J Dev Behav Pediatr 21:356–370, 2000
[PubMed]
 
Bassarath L: Conduct disorder: a biopsychosocial review. Can J Psychiatry 46:609–616, 2001
[PubMed]
 
Bauer LO, Hesselbrock VM: Brain maturation and subtypes of conduct disorder: interactive effects on P300 amplitude and topography in male adolescents. J Am Acad Child Adolesc Psychiatry 42:106–115, 2003
[PubMed]
 
Ben-Shachar S, Lanpher B, German JR, et al: Microdeletion 15q13.3: a locus with incomplete penetrance for autism, mental retardation, and psychiatric disorders. J Med Genet 46:382–388, 2009
[PubMed]
 
Bosshart H, Capek S: An unusual case of random fire-setting behavior associated with lacunar stroke. Forensic Sci Int 209:e8–e10, 2011
[PubMed]
 
Buitelaar JK, van der Gaag RJ, Cohen-Kettenis P, et al: A randomized controlled trial of risperidone in the treatment of aggression in hospitalized adolescents with subaverage cognitive abilities. J Clin Psychiatry 62:239–248, 2001
[PubMed]
 
Burke JD, Loeber R, Birmaher B: Oppositional defiant disorder and conduct disorder: a review of the past 10 years, part II. J Am Acad Child Adolesc 41:1275–1293, 2002
[PubMed]
 
Coccaro EF: A family history study of intermittent explosive disorder. J Psychiatr Res 44:1101–1105, 2010
[PubMed]
 
Coccaro EF, Schmidt CA, Samuels JF, et al: Lifetime and 1-month prevalence rates of intermittent explosive disorder in a community sample. J Clin Psychiatry 65:820–824, 2004
[PubMed]
 
Coccaro EF, McCloskey MS, Fitzgerald DA, et al: Amygdala and orbitofrontal reactivity to social threat in individuals with impulsive aggression. Biol Psychiatry 62:168–178, 2007
[PubMed]
 
Coccaro EF, Lee RJ, Kavoussi RJ: A double-blind, randomized, placebo-controlled trial of fluoxetine in patients with intermittent explosive disorder. J Clin Psychiatry 70:653–662, 2009
[PubMed]
 
Deckel AW, Hesselbrock V, Bauer L: Antisocial personality disorder, childhood delinquency, and frontal brain functioning: EEG and neuropsychological findings. J Clin Psychol 52:639–650, 1996
[PubMed]
 
Dell’Osso B, Altamura AC, Allen A, et al: Epidemiologic and clinical updates on impulse control disorders: a critical review. Eur Arch Psychiatry Clin Neurosci 256:464–475, 2006
[PubMed]
 
Farmer EMZ, Compton SN, Burns JB, et al: Review of the evidence base for treatment of childhood psychopathology: externalizing disorders. J Consult Clin Psychol 70:1267–1302, 2002
[PubMed]
 
Frick PJ, Moffitt TE: A proposal to the DSM-5 childhood disorders and the ADHD and Disruptive Behavior Disorders Work Groups to include a specifier to the diagnosis of conduct disorder based on the presence of callous-unemotional traits. Washington, DC, American Psychiatric Association, 2010. Available at: www.dsm5.org/Proposed%20Revision%20Attachments/Proposal%20for%20Callous%20and%20Unemotional%20Specifier%20of%20Conduct%20Disorder. pdf. Accessed March 9, 2013.
 
Goldman MJ: Kleptomania: making sense of the nonsensical. Am J Psychiatry 148:986–996, 1991
[PubMed]
 
Grant JE: Co-occurrence of personality disorders in persons with kleptomania: a preliminary investigation. J Am Acad Psychiatry Law 32:395–398, 2004
[PubMed]
 
Grant JE: SPECT imaging and treatment of pyromania. J Clin Psychiatry 67:998, 2006a
[PubMed]
 
Grant JE: Understanding and treating kleptomania: new models and new treatments. Isr J Psychiatry Relat Sci 43:81–87, 2006b
[PubMed]
 
Grant JE, Kim SW: An open-label study of naltrexone in the treatment of kleptomania. J Clin Psychiatry 63:349–356, 2002a
[PubMed]
 
Grant JE, Kim SW: Clinical characteristics and associated psychopathology of 22 patients with kleptomania. Compr Psychiatry 43:378–384, 2002b
[PubMed]
 
Grant JE, Kim SW: Comorbidity of impulse control disorders in pathological gamblers. Acta Psychiatr Scand 108:203–207, 2003
[PubMed]
 
Grant JE, Kim SW: Clinical characteristics and psychiatric comorbidity of pyromania. J Clin Psychiatry 68:1717–1722, 2007
[PubMed]
 
Grant JE, Potenza MN: Impulse control disorders: clinical characteristics and pharmacological management. Ann Clin Psychiatry 16:27–34, 2004
[PubMed]
 
Grant JE, Levine L, Kim SW: Impulse control disorders in adult psychiatric inpatients. Am J Psychiatry 162:2184–2188, 2005
[PubMed]
 
Grant JE, Correia S, Brennan-Krohn T: White matter integrity in kleptomania: a pilot study. Psychiatry Res 147:233–237, 2006
[PubMed]
 
Grant JE, Williams KA, Potenza MN: Impulse-control disorders in adolescent psychiatric inpatients: co-occurring disorders and sex differences. J Clin Psychiatry 68:1584–1592, 2007
[PubMed]
 
Grant JE, Kim SW, Odlaug BL: A double-blind, placebo-controlled study of the opiate antagonist, naltrexone, in the treatment of kleptomania. Biol Psychiatry 65:600–606, 2009
[PubMed]
 
Hoertel N, Le Strat Y, Schuster JP, et al: Gender differences in firesetting: results from the national epidemiologic survey on alcohol and related conditions (NESARC). Psychiatry Res 190:352–358, 2011
[PubMed]
 
Hollander E (ed): Obsessive-Compulsive Related Disorders. Washington, DC, American Psychiatric Press, 1993
 
Hollander E, Tracy KA, Swann AC, et al: Divalproex in the treatment of impulsive aggression: efficacy in Cluster B personality disorders. Neuropsychopharmacology 28:1186–1197, 2003
[PubMed]
 
Hollander E, Swann AC, Coccaro EF, et al: Impact of trait impulsivity and state aggression on divalproex versus placebo response in borderline personality disorder. Am J Psychiatry 162:621–624, 2005
[PubMed]
 
Hollander E, Berlin HA, Stein DJ: Impulse-control disorders not elsewhere classified, in The American Psychiatric Publishing Textbook of Psychiatry, 5th Edition. Edited by Hales RE, Yudofsky SC, Gabbard GO. Washington, DC, American Psychiatric Publishing, 2008, pp 777–820
 
Hudson JI, Pope HG, Jonas JM, et al: Phenomenologic relationship of eating disorders to major affective disorder. Psychiatry Res 9:345–354, 1983
[PubMed]
 
Kazdin AE, Bass D, Siegel T: Cognitive problem-solving skills training and parent management training in the treatment of antisocial behavior in children. J Consult Clin Psychol 60:733–747, 1992
[PubMed]1401389
 
Kessler RC, Coccaro EF, Fava M, et al: The prevalence and correlates of DSM-IV intermittent explosive disorder in the National Comorbidity Survey Replication. Arch Gen Psychiatry 63:669–678, 2006
[PubMed]
 
Kolko DJ: Efficacy of cognitive-behavioral treatment and fire safety education for children who set fires: initial and follow-up outcomes. J Child Psychol Psychiatry 42:359–369, 2001
[PubMed]
 
Kolko DJ, Herschell AD, Scharf DM: Education and treatment for boys who set fires: specificity, moderators, and predictors of recidivism. Journal of Emotional and Behavioral Disorders 14:227–239, 2006
 
Koran LM, Aboujaoude E, Gamel N: Escitalopram treatment of kleptomania: an open-label trial followed by double-blind discontinuation. J Clin Psychiatry 68:422–427, 2007
[PubMed]
 
Kruesi MJP, Casanova MF, Mannheim G, et al: Reduced temporal lobe volume in early onset conduct disorder. Psychiatry Res 132:1–11, 2004
[PubMed]
 
Labree W, Nijman H, van Marle H, et al: Backgrounds and characteristics of arsonists. Int J Law Psychiatry 33:149–153, 2010
[PubMed]
 
Lahey BB, Van Hulle CA, Keenan K, et al: Temperament and parenting during the first year of life predict future child conduct problems.J Abnorm Child Psychol 36:1139–1158, 2008
[PubMed]
 
Lahey BB, Van Hulle CA, Singh AL, et al: Higher-order genetic and environmental structure of prevalent forms of child and adolescent psychopathology. Arch Gen Psychiatry 68:181–189, 2011
[PubMed]
 
Lambie I, Randell I: Creating a firestorm: a review of children who deliberately light fires. Clin Psychol Rev 31:307–327, 2011
[PubMed]
 
Lejoyeux M, Feuche N, Loi S, et al: Study of impulse-control disorders among alcohol-dependent patients. J Clin Psychiatry 60:302–305, 1999
[PubMed]
 
Lejoyeux M, Arbaretaz M, McLoughlin M, et al: Impulse control disorders and depression. J Nerv Ment Dis 190:310–314, 2002
[PubMed]
 
Lewis NDC, Yarnell H: Pathological Firesetting (Pyromania): Nervous and Mental Disease (Monograph No 82). New York, Coolidge Foundation, 1951
 
Lindberg N, Holi MM, Tani P, et al: Looking for pyromania: characteristics of a consecutive sample of Finnish male criminals with histories of recidivist fire-setting between 1973 and 1993. BMC Psychiatry 5:1–5, 2005
[PubMed]
 
Loeber R, Green SM, Lahey BB, et al: Findings on disruptive behavior disorders from the first decade of the developmental trends study. Clin Child Fam Psychol Rev 3:37–60, 2000
[PubMed]
 
MacKay S, Paglia-Boak A, Henderson J, et al: Epidemiology of firesetting in adolescents: mental health and substance use correlates. J Child Psychol Psychiatry 50:1282–1290, 2009
[PubMed]
 
Marazziti D, Presta S, Pfanner C, et al: The biological basis of kleptomania and compulsive buying. Paper presented at the American College of Neuropsychopharmacology 39th Annual Meeting. San Juan, Puerto Rico, December 2000
 
Maughan B, Rowe R, Messer J, et al: Conduct disorder and oppositional defiant disorder in a national sample: developmental epidemiology. J Child Psychol Psychiatry 45:609–621, 2004
[PubMed]
 
McCloskey MS, Noblett KL, Deffenbacher JL, et al: Cognitive-behavioral therapy for intermittent explosive disorder: a pilot randomized clinical trial. J Consult Clin Psychol 76:876–886, 2008
[PubMed]
 
McElroy SL, Pope HG Jr, Hudson JI, et al: Kleptomania: a report of 20 cases. Am J Psychiatry 148:652–657, 1991
[PubMed]
 
McKinney C, Renk K: Atypical antipsychotic medications in the management of disruptive behaviors in children: safety guidelines and recommendations. Clin Psychol Rev 31:465–471, 2011
[PubMed]
 
McLaughlin KA, Green JG, Hwang I, et al: Intermittent explosive disorder in the National Comorbidity Survey Replication Adolescent Supplement. Arch Gen Psychiatry 69:1131–1139, 2012
[PubMed]
 
Moffitt TE: Genetic and environmental influences on antisocial behaviors: evidence from behavioral-genetic research. Adv Genet 55:41–104, 2005
[PubMed]
 
Moffitt TE, Caspi A, Rutter M, et al: Sex Differences in Antisocial Behaviour: Conduct Disorder, Delinquency and Violence in the Dunedin Longitudinal Study. Cambridge, UK, Cambridge University Press, 2001
 
New AS, Hazlett EA, Buchsbaum MS, et al: Blunted prefrontal cortical 18fluoro-deoxy-glucose positron emission tomography response to meta-chlorophenylpiperazine in impulsive aggression. Arch Gen Psychiatry 59:621–629, 2002
[PubMed]
 
Nock MK, Kazdin AE, Hiripi E, et al: Lifetime prevalence, correlates, and persistence of oppositional defiant disorder: results from the national comorbidity survey replication. J Child Psychol Psychiatry 48:703–713, 2007
[PubMed]
 
Odlaug BL, Grant JE: Impulse-control disorders in a college sample: results from the self-administered Minnesota Impulse Disorders Interview (MIDI). Prim Care Companion J Clin Psychiatry 12, 2010
[PubMed]
 
Pappadopulos E, Woolston S, Chait B, et al: Pharmacotherapy of aggression in children and adolescents: efficacy and effect size. J Am Acad Child Adolesc Psychiatry 15:27–39, 2006
[PubMed]
 
Perez-Rodriguez MM, Hazlett EA, Rich EL, et al: Striatal activity in borderline personality disorder with comorbid intermittent explosive disorder: sex differences. J Psychiatr Res 46:797–804, 2012
[PubMed]
 
Phan KL, Lee R, Coccaro EF: Personality predictors of antiaggressive response to fluoxetine: inverse association with neuroticism and harm avoidance. Int Clin Psychopharmacol 26:278–283, 2011
[PubMed]
 
Potenza MN, Hollander E: Pathological gambling and impulse-control disorders, in Neuropsychopharmacology: The 5th Generation of Progress. Edited by Coyle JT, Nemeroff C, Charney D. Baltimore, MD, Lippincott Williams & Wilkins, 2002, pp 1725–1741
 
Presta S, Marazziti D, Dell’Osso L, et al: Kleptomania: clinical features and comorbidity in an Italian sample. Compr Psychiatry 43:7–12, 2002
[PubMed]
 
Robins LN, Ratcliff KS: Risk factors in the continuation of childhood antisocial behavior into adulthood. Int J Ment Health 7:96–111, 1979
 
Rowe R, Maughan B, Worthman CM, et al: Testosterone, antisocial behavior, and social dominance in boys: pubertal development and biosocial interaction. Biol Psychiatry 55:546–552, 2004
[PubMed]
 
Rowe R, Costello EJ, Angold A, et al: Developmental pathways in oppositional defiant disorder and conduct disorder. J Abnorm Psychol 119:726–773, 2010
[PubMed]
 
Specker SM, Carison GA, Christenson GA, et al: Impulse control disorders and attention deficit disorder in pathological gamblers. Ann Clin Psychiatry 7:175–179, 1995
[PubMed]
 
Speltz ML, McClellan J, Deklyen M, et al: Preschool boys with oppositional defiant disorder: clinical presentation and diagnostic change. J Am Acad Child Adolesc Psychiatry 38:838–845, 1999
[PubMed]
 
Stanford MS, Helfritz LE, Conklin SM, et al: A comparison of anticonvulsants in the treatment of impulsive aggression. Exp Clin Psychopharmacol 13:72–77, 2005
[PubMed]
 
Sterzer P, Stadler C, Krebs A, et al: Abnormal neural responses to emotional visual stimuli in adolescents with conduct disorder. Biol Psychiatry 57:7–15, 2005
[PubMed]
 
Stringaris A, Goodman R: Longitudinal outcome of youth oppositionality: irritable, headstrong, and hurtful behaviors have distinctive predictions. J Am Acad Child Adolesc Psychiatry 48:404–412, 2009
[PubMed]
 
Taylor J, Iacono WG, McGue M: Evidence for a genetic etiology of early onset delinquency. J Abnorm Psychol 109:634–643, 2000
[PubMed]
 
Teichner G, Golden CJ: The relationship of neuropsychological impairment to conduct disorder in adolescence: a conceptual review. Aggression and Violent Behavior 5:509–528, 2000
 
Tyler N, Gannon TA: Explanations of firesetting in mentally disordered offenders: a review of the literature. Psychiatry 75:150–166, 2012
[PubMed]
 
Vaughn MG, Fu Q, DeLisi M, et al: Prevalence and correlates of fire-setting in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Compr Psychiatry 51:217–233, 2010
[PubMed]
 
Virkkunen M, Eggert M, Rawlings R, et al: A prospective follow-up study of alcoholic violent offenders and fire setters. Arch Gen Psychiatry 53:523–529, 1996
[PubMed]
 
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