The revised Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, has a new chapter called “Disruptive, Impulse-Control, and Conduct Disorders.”
This chapter brings together, with refinements, disorders characterized by problems with self-control.
The new pages contain criteria for oppositional defiant disorder (ODD), conduct disorder, and intermittent explosive disorder, which were in the eliminated DSM-IV section titled “Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence.”
The DSM-5 chapter also includes disorders such as kleptomania and pyromania. All these self-control related diagnoses are marked by externalizing behaviors, or acting-out toward others or the environment.
DSM-5 Oppositional Defiant Disorder Changes
Oppositional defiant disorder is characterized by repeated angry, defiant, disobedient behavior with authority figures.
- Unlike previously, an individual can now have both conduct disorder and ODD. It was originally thought that a person might graduate from ODD to conduct disorder but could not have both.
- Symptoms such as aggressive behaviors must now be demonstrated more than one time per week to be considered abnormal.
- The criteria now have a severity rating indicating a behavior’s degree of pervasiveness across different settings. This rating will reflect whether an individual, for example, displays defiant behavior with one parent only or with all adults.
DSM-5 Intermittent Explosive Disorder Changes
Intermittent explosive disorder is characterized by an extreme expression of anger or rage that is out of proportion to the individual’s situation.
- The types of aggressive outbursts now to be considered are: physical aggression (as in the DSM-IV), verbal aggression, and nondestructive/non-injurious physical aggression.
- Frequency of behavior criteria is more detailed.
- Criteria now indicate that aggressive outbursts are impulsive and/or angry in nature and must result in marked distress, cause significant problems in work/school or interpersonal functioning, or be the cause of financial or legal problems.
- An individual must be at least 6 years old to receive this diagnosis.
DSM-5 Conduct Disorder Refinement
Conduct disorder is characterized by actions that violate other individual's rights or societal norms. The criteria for conduct disorder have not changed except for an added specifier for children who are lacking in “pro-social behaviors” (social skills).
The new specifier replaces the DSM-IV stigmatizing descriptive phrase of “callous and unemotional.” Research indicates that people with conduct disorder who do not have adequate pro-social behaviors are frequently diagnosed with a severe form of the disorder requiring different treatment considerations.
Source: Psychiatric News
