Deck 13: Disruptive, Impulse-Control, and Conduct Disorders

Question 1

Mr. and Mrs. Mallner are confused about their son's behavior and contacted the social worker to see if he needs "further tests or something to find out if there's something seriously wrong with our son." Fifteen year-old Rick is described with a history of episodic and violent behavior that is out of proportion to the situation. It is during these "episodes" that he will become extremely angry to the point of destroying things or punching holes in the wall or doors). There seems to be no precipitant and "after about half an hour he's back to his old self," adds Mr. Mallner. What is the most likely diagnosis to consider for Rick?

A)Oppositional defiant disorder
B)Conduct disorder
C)Intermittent explosive disorder
D)Disruptive mood dysregulation disorder

Answer 1

C

Question 2

When it is clear that a disruptive, impulse-control, and conduct disorder ought to be diagnosed, but the practitioner does not have enough information about the child's difficulties, the following diagnosis is assigned with the understanding that as more information becomes available, a more specific diagnosis can be made. It is:

A)Other specified disruptive, impulse-control, and conduct disorder
B)Unspecified disruptive, impulse-control, and conduct disorder
C)Pervasive developmental disorder
D)None of the above

Answer 2

A

Question 3

Frankie earned the reputation of being the "terrorist of the 4 year olds" at his daycare center. He has been expelled from 2 other daycare centers and is on notice with the current one. If Frankie's behavior does not improve, he will not be invited back. Frankie punches or bites other children so he spends a lot of time in the timeout corner. On the playground, he pushes the other children off the swings for no apparent reason. Frankie squeezes the class pet rabbit and when he thinks no one is looking swings it by the tail despite being told how much this hurts the animal. According to his mother, "Frankie has been hard to manage even when he was an infant." Frankie's diagnosis is:

A)Oppositional defiant disorder, mild
B)Unspecified disruptive, impulse-control, and conduct disorder
C)Conduct disorder, childhood-onset
D)Intermittent explosive disorder

Answer 3

C

Question 4

Intermittent explosive disorder should not be diagnosed when the individual's aggressive outbursts are judged to result from the physiological effects of another diagnosable medial condition.

Question 5

Which one of the following categories are not a part of the criterion describing the pattern of behavior in which the rights of others or societal norms or rules) are violated in conduct disorder?

A)Aggression to people or animals
B)Destruction of property
C)Angry/irritable mood
D)Deceitfulness or theft

Question 6

Allen Semmes is a 3 year-old youngster who was described as an "angel" but lately he has had severe temper tantrums that happen on a weekly basis for the past 6 weeks. According to his mother, "They often follow a change in his routine, not having an afternoon nap, or if he's hungry. On rare occasions Allen will get so worked up that he'll grab something and throw it on the floor. Funny, but his teachers love him at preschool. I don't want to reach any premature conclusions but if there's anything his father and I can do to nip this in the bud, we're all in." Which of the following best describes Allen?

A)Oppositional defiant disorder, mild
B)Intermittent explosive disorder
C)Conduct disorder
D)Does not meet criteria for a disorder

Question 7

The aggression seen in oppositional defiant disorder is typified by temper tantrums and verbal arguments with authority figures in contrast to the impulsive aggressive outbursts in intermittent explosive disorder which are in response to a broader array of provocation - and including physical assault.

Question 8

The social worker remembered thinking, "Wow! That kid sure is a handful. I'm surprised he was not referred sooner." Mark Pryor is an 11 year-old boy who is described by his parents as being stubborn and defiant since early childhood. "Sometimes that child can be so spiteful," adds his father. His mother comments, "If I ask Mark to brush his teeth and he's watching TV, he'll turn around and call me all sorts of names. I know my son doesn't mean it… at least I hope so, but it sure hurts. His brothers walk on eggs when he's in one of his moods, which lately seems to be all the time. Oddly enough he does pretty good in school but I notice he doesn't have that many friends these days." What is the most like diagnosis to consider?

A)Attention-deficit hyperactivity disorder
B)Disruptive behavior disorder
C)Oppositional defiant disorder
D)Conduct disorder

Question 9

Betty Martin contacted her 13 year-old daughter's teachers asking how she is doing in school. Lately, her daughter, Isabella, who up to this point had been characterized as the "ideal child," has now become defiant, oppositional, and vindictive. Mrs. Martin adds, "The father and I have been separated for years but now Isabella threatens to leave and move into his apartment over the least little thing. After all we've been through, that really hurts. When I challenge Isabella's behavior, it becomes all my fault. On top of all that, Isabella takes no responsibility for her behavior. Needless to add, things are miserable here at home. I've also noticed her friends are keeping their distance, too." Given Mrs. Martin's account, what diagnosis could be ruled out?

A)Oppositional defiant disorder
B)Major depressive disorder
C)Substance use disorder
D)Adjustment disorder

Question 10

Sixteen year-old Bill Atkins was referred to the school social worker after his most recent suspension. According to the staff interviewed - the guidance counselor, assistant principal, teachers - Bill has a long history of defiance and aggression toward peers as shown in numerous fights in school. The social worker also interviewed Bill's parents who confirmed the youngster's defiant behavior at home. His parents added that he can be aggressive; seen in breaking doors or punching holes in the walls if he doesn't get his way. Bill's mother comments, "When backed into a corner, Bill will choose a lie rather than the truth. Lately, his father and I have noticed things missing around the house. It started with small change but now I'm afraid to leave my jewelry out." Bill's mood was consistently seen by those who were interviewed as irritable or depressed. No psychotic symptoms or sleep disturbances were reported. What would be the most likely diagnosis to consider for Bill?

A)Oppositional defiant disorder
B)Conduct disorder
C)Disruptive mood dysregulation disorder
D)Attention/deficit hyperactivity disorder

Question 11

Which of the following statements reflect the most likely risk factors seen in a child with the diagnosis of a conduct disorder:

A)Parental rejection and neglect, inconsistent child-rearing practices, harsh discipline, physical or sexual abuse, lack of supervision, early institutional living, frequent changes of caregivers, large family size, parental criminality
B)Peer rejection, association with a delinquent peer group, neighborhood exposure to violence
C)Having a parent or sibling with conduct disorder, biological parents with severe alcohol use, depressive and bipolar disorders, or schizophrenia or who have a history of conduct disorder or attention/deficit hyperactivity disorder
D)None listed

Question 12

Aggression in the context of a mood disorder is a behavior that qualifies for the criterion of aggression to people and animals for conduct disorder.

Question 13

Looking to the symptom of running away from home overnight in the context of conduct disorder, the frequency according to diagnostic criteria must occur:

A)At least once without returning home for a lengthy period
B)At least twice in response to abuse, such as physical or sexual
C)At least three times
D)At least five times
True/False:

Question 14

Children who show behavior characterized by characterized by a pattern of disobedient, hostile, and defiant behavior toward authority figures and along with the absence of a serious violation of the basic rights of others can be considered for the diagnosis of:

A)Conduct disorder
B)Oppositional defiant disorder
C)Antisocial personality disorder
D)Intermittent explosive disorder

Question 15

The diagnosis of intermittent explosive disorder can be made even if the impulsive aggressive outbursts occur in the context of an adjustment disorder.

Question 16

The likely onset for oppositional defiant disorder typically occurs in adolescence.

Question 17

Cyber bullying qualifies as aggressive behavior under the criterion of aggression to people and animal as defined for a conduct disorder.

Question 18

Forcing someone into sexual activity is a behavior that can be considered among the criterion for conduct disorder.

Question 19

Disruptive mood dysregulation disorder is characterized by a persistently negative mood state - such as irritability, anger - most of the day, nearly every day, between impulsive aggressive outbursts.

Question 20

Individuals with childhood-onset type conduct disorder are more likely to have persistent conduct disorder into adulthood.

Question 21

Use the following terms to answer:

The diagnosis of ____________ is considered for the individual who takes pleasure or feels a sense of relief when deliberately and purposefully setting fires and on more than one occasion.
Matching:

Question 22

Use the following terms to answer:

____________ applies to a person's recurrent failure to resist impulses to steal objects that are not needed for personal use or for their monetary value.

Question 23

Use the following terms to answer:

When an adolescent shoplifts something on a dare, then then the diagnosis of ____________ is most likely ruled out.

Question 24

Use the following terms to answer:

Individuals who qualify for the specifier of "with limited prosocial emotions" are more likely to have childhood onset type of ____________ disorder.

Question 25

Use the following terms to answer:

On those occasions when the practitioner determines that a person's behavior does not meet full criteria for any of the disorders in the disruptive, impulse-control and conduct disorders class and chooses not to specify the reason criteria are not met, then the ____________ designation applies.

Question 27

Use the following terms to answer:

Symptoms of significant emotional dysregulation are seen in ____________ disorder.