Disorders of Childhood & Adolescence
Disorders first diagnosed in infancy, childhood, or adolescence, such as conduct disorder, oppositional defiant disorder, attention-deficit hyperactivity disorder, Rett syndrome, autism spectrum disorder, eating disorders, and intellectual disabilities, are brain-based illnesses and have many similarities to disorders diagnosed more commonly in adulthood.
OPPOSITIONAL DEFIANT DISORDER (ODD).
Oppositional defiant disorder (ODD) is an enduring pattern of angry or irritable mood and argumentative, defiant, or vindictive behavior lasting at least 6 months with at least four of the associated symptoms: Loses temper, Touchy or easily annoyed, Angry or resentful, argues with authority, actively defies, or refuses to comply with request or rules from authority figures, blames others, deliberately annoys others, & Spiteful or vindictive.
CONDUCT DISORDER.
Conduct disorder is a repetitive and persistent pattern of behavior in which the rights of others or societal norms or rules are violated. The presence of at least three of the following criteria must be present in the past 12 months, with one in the past 6 months:
Aggression toward people or animals—bullies, threatens, intimidates, initiates physical fights, uses a weapon to cause physical harm to others, physically cruel to people or animals, stealing while confronting a victim, forced sexual activity on someone
- Destruction of property—engaged in fire-setting, destroyed others’ property
- Deceit or theft—broke into house, building, or car; lies, steals items
- Serious violation of rules—stays out late before age 13, runs away from home, truant before age 13
- Child onset before age 10 or adolescent onset after age 10
DISRUPTIVE MOOD DYSREGULATION DISORDER (DMDD)
Disruptive mood dysregulation disorder (DMDD) is a childhood condition marked by extreme irritability, persistent anger, and frequent, intense temper outbursts. These symptoms go far beyond typical childhood moodiness and cause significant impairment that requires clinical care.
DMDD is diagnosed in children between the ages of 6 and 18.
The features of this disorder are:
- Chronic dysregulated mood,
- Frequent temper outbursts, and
- Severe irritability.
Risk Factors: A complex psychiatric history, including coexisting conditions such as ADD or ADHD, can increase the likelihood of developing DMDD.
Prevention and Screening: Children and adolescents should be screened for both personal and family histories of bipolar disorder, as DMDD symptoms may appear similar.
Assessment: Evaluate for co-occurring conditions, including bipolar disorder, oppositional defiant disorder (ODD), ADHD, depressive or anxiety disorders, and autism spectrum disorder.
Signs and Symptoms
DMDD symptoms typically begin before the age of 10, but the diagnosis is not given to children under 6 or adolescents over 18. A child with DMDD experiences:
- Irritable or angry mood most of the day, nearly every day
- Severe temper outbursts (verbal or behavioral) at an average of three or more times per week that are out of keeping with the situation and the child’s developmental level
- Trouble functioning due to irritability in more than one place (e.g., home, school, with peers)
To be diagnosed with DMDD, a child must have these symptoms steadily for 12 or more months.
AUTISM SPECTRUM DISORDER.
Restricted repetitive behavior: Stereotyped or repetitive motor movements, Insistence on sameness, highly restricted with fixed interests, Hyper- or hypo-sensory input.
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