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The disruptive, impulse-control, and conduct disorders diagnostic class in DSM-5 (American Psychiatric Association 2013) groups together related disorders that share the underlying constructs of impulsive behavior, aggressiveness, and pathological rule breaking. Utilizing a spectrum approach to characterize related disorders with overlapping symptom presentations, one can easily conceptualize many disorders and conditions that are defined by impulsivity, aggression, and rule-breaking behaviors (Table 23–1). These disorders are found across formal DSM-5 categories, as well as among “other specified” and “unspecified” conditions, and include attention-deficit/hyperactivity disorder (ADHD), antisocial and borderline personality disorders, substance and alcohol use disorders, binge-eating disorder and bulimia nervosa, bipolar and related disorders, paraphilic disorders, excoriation (skin-picking) disorder, and Internet gaming disorder, as well as neurocognitive disorders characterized by disinhibited behaviors. Clinicians should be aware that individuals with impulsive/aggressive behaviors might indeed present with one or more of these related conditions or comorbid disorders that may contribute to their pattern of impulsive/aggressive behavior.
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