Most of us have witnessed a toddler throwing a temper tantrum. For parents, toddler-hood entails endless screaming and crying. Toddlers behave in this way because they are experiencing emotions, but they do not have the tools to express them the way older children and adults do. As we age, we are supposed to outgrow these behaviors. We express our anger with words instead of fists pounding on the ground, we have the ability to explain why we are sad or frustrated. When a child fails to outgrow these behaviors, when they repeatedly lash out, are defiant and incapable of controlling their tempers, it can impair performance in school and cause serious family turmoil.
It’s easy to jump to the conclusion that a child who’s pushing or hitting or throwing tantrums is angry, defiant or hostile. But in many cases disruptive, even explosive behavior stems from anxiety or frustration that may not be apparent to parents or teachers. This “emotional dysregulation,” as clinicians refer to it, can reflect a number of underlying issues within broader umbrella of disruptive behavior disorders (DBDs). A major difference between DBDs and other mental health conditions is that with DBDs, the distress is focused outwards instead of inward. The dysregulated behavior is directed towards other people and property. This outward manifestation allows these disorders to be easily identified, however, the precise cause remains unknown. Risk factors include a family member with ADHD/Oppositional Defiant Disorder (ODD), depression or an anxiety disorder and environmental factors like stress in the home from divorce, separation, abuse, parental criminality or series of conflicts within the family. The disorders are also more likely to occur along with other conditions such as ADHD.
Disruptive behavior, impulse control, and conduct disorders refer to a group of disorders that include oppositional defiant disorder, conduct disorder, intermittent explosive disorder, kleptomania, and pyromania. An estimated 6 percent of children are affected by oppositional defiant disorder or conduct disorders, and each year an estimated 2.7 percent of children and adults in the U.S. are affected by intermittent explosive disorder. Conduct disorders tend to begin in childhood or adolescence and are more common in males than females. Kleptomania and pyromania are rare, affecting 1 percent or fewer of people in the U.S.
Disruptive behavior disorders are made up of two subtypes: Oppositional Defiant Disorder (ODD) and Conduct Disorder. ODD is the less severe of the two, and is more understood than Conduct Disorder. Both are the more common of all the DBDs. Children with ODD display a persistent pattern of angry outbursts, arguments and disobedience. While this behavior is usually directed at authority figures, like parents and teachers, siblings, classmates and other children can also turn into its target. Conduct disorder is a highly complex condition, and its causes aren’t fully understood. It can involve cruelty to animals and people, other violent behaviors and criminal activity.
Treatment is available for DBDs, most often in the form of therapy. Cognitive behavioral therapy is the most common for treating DBDs, although group therapy and family therapy has also proven quite successful especially in children. Medication may be given to treat symptoms of ODD. Parents and caregivers of children are often taught ways to cope with and manage their child’s disorder. It is important for anyone suffering from any of these disorders to get help because DBDs greatly affect quality of life. Left untreated, these disorders can cause major problems in all aspects of life, often leading to substance abuse disorders.
DeMaso, D. R., MD. (2011). Disruptive Behavior Disorders | Boston Children’s Hospital. Retrieved February 20, 2019, from http://www.childrenshospital.org/conditions-and-treatments/conditions/d/disruptive-behavior-disorders
Ehmke, R. (n.d.). What Is Oppositional Defiant Disorder? Retrieved February 12, 2019, from https://childmind.org/article/what-is-odd-oppositional-defiant-disorder/
Nicklaus Childrens Hospital. (n.d.). Disruptive Behavior Disorders. Retrieved February 12, 2019, from https://www.nicklauschildrens.org/conditions/disorders/disruptive-behavior-disorders
Parekh, R., M.D., M.P.H. (2018, January). What Are Disruptive, Impulse-Control and Conduct Disorders? Retrieved February 12, 2019, from https://www.psychiatry.org/patients-families/disruptive-impulse-control-and-conduct-disorders/what-are-disruptive-impulse-control-and-conduct-disorders