Disruptive, Impulse-Control, and Conduct Disorders

Quick Links

• Conduct disorder (CD)
• Disruptive Mood Dysregulation Disorder (DMDD)
• Intermittent Explosive Disorder
• Oppositional defiant disorder (ODD)

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Disruptive Mood Dysregulation Disorder*

Characterized by:

• Irritability or anger nearly all of the time.
• Verbal and/or behavioral temper outbursts that are severe, out of proportion with the situation, are inconsistent with child’s developmental level, and occur three or more times per week.
• Symptoms present consistently for 12 or more months.
• Symptoms present at home, school, or with peers (two out of the three), and are severe in at least one of these settings.
• Symptoms noticed by others in the child’s environment.

Differential Diagnoses:

• Bipolar disorders
• Oppositional defiant disorder
• Attention-deficit/hyperactivity disorder
• Major depressive disorder
• Anxiety disorders
• Autism spectrum disorder
• Intermittent explosive disorder

DSM-5 Diagnostic Considerations:

• Typically appears before the age of 10 but diagnosis is not made in children younger than 6 or older than 18.
• The symptoms (excluding duration) for a manic or hypomanic episode have never been met.
• The child’s behaviors do not occur during a major depressive episode and can’t be better explained by a different mental disorder.
• The child’s behaviors can’t be attributed to the effects of a substance or a medical/neurological condition.
• DMDD cannot coexist with bipolar disorder, oppositional defiant disorder, or intermittent explosive disorder.

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Assessment & Screening Tools

Child-Rated

• Conners Comprehensive Behavior Rating Scale (CBRS)
• Oppositional Defiant Disorder - Severity​
• Anger (PROMIS Emotional Distress)
• Social Skills Rating System (SSRS)
• Reynolds Adolescent Adjustment Screening Inventory (RAASI)

Caregiver-Rated

• Disruptive Behavior Rating Scale (Parent and Teacher) ($)
• Conners Comprehensive Behavior Rating Scale (CBRS) (parent, teacher)
• Adjustment Scales for Children and Adolescents (ASCA)
• ​Conduct Disorder Rating Scale (parent)
  
• Anger (PROMIS Emotional Distress)
• Social Skills Rating System (SSRS)

Clinician-Rated

• Conduct Disorder - Severity

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Position Papers & Practice Parameters

• AACAP's Practice Parameter for the Assessment and Treatment of Children and Adolescents with Oppositional Defiant Disorder (2007)
• American Counseling Association's DMDD Practice Brief (ACA, 2015)

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Articles

• Treatment Options for the Cardinal Symptoms of DMDD (Tourian, et al, 2015)
• Disruptive Mood Dysregulation Disorder (Tapia and John, 2018)
• Disruptive Mood Dysregulation Disorder (DMDD): A New Diagnostic Approach to Chronic Irritability in Youth (Roy, Lopes & Klein, 2014)
• DSM-5 Disruptive Mood Dysregulation Disorder: Correlates and Predictors in Young Children (Dougherty, et al, 2014)

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Resources

For Patients/Caregivers:

• DMDD Facts For Families (AACAP)

Organizations

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*DMDD content originally curated by Kelsey Abbott, BSN, RN,  and Isabella Narvaez, RN.

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