Disruptive Behavior Disorders: Causes, Impact and Treatment

You have seen children throwing tantrums, while this is normal, if these tantrums are persistent and cause disruption in activities of other people that can be a problem. Disruptive behavior disorders are a group of mental health conditions which are characterized by patterns of persistent uncooperative, hostile, and disobedient behaviors. These individuals have difficulty in controlling their impulses and modulating their aggressive conducts. This causes a threat to other’s safety and societal rules. These disorders are typically diagnosed in childhood or adolescence and can profoundly impact individuals, families, and communities. The disorders under disruptive behavior disorders include impulse control disorder, intermittent explosive disorder, oppositional defiant disorder, and conduct disorder. DBD can also include conditions like pyromania and kleptomania. Now let us look at these conditions in some detail:

Oppositional Defiant Disorder:

Oppositional defiant disorder or ODD is one of the most common behavior disorders found in children. It is characterized by persistent hostile and disobedient behaviors towards authority figures. The most common symptoms seen in individuals with ODD include frequent temper tantrums, arguments with adults, refusing to comply with rules and requests, and spitefulness. This does not include physical aggression towards animals or other people. These behaviors cause disruption in school and other social settings and affect relationships with others. They are most likely to experience conflict towards adults and authority figures.

Also Read: Behavioural Disorders in Children

Intermittent Explosive Disorder:

Intermittent explosive disorder or IED is a disorder characterized by recurrent episodes of impulsive aggression, including verbal and physical assaults which are disproportionate to the event or the incident that triggered them. The observed behavior may include physical aggression towards others or animals, destruction of property or verbal assaults. It is to be kept in mind that these behaviors are impulsive in nature rather than planned, also they remain for a brief period approximately 30 minutes. These individuals often experience feelings of remorse or guilt following the episodes.

Conduct Disorder:

Conduct disorder is a more severe kind of behavioral disorder. This includes behaviors that violate the rights of others. Common symptoms observed in individuals with conduct disorder are aggression towards people and animals, destruction of property, deceitfulness or theft and serious violations of rules leading to legal consequences. Hence it is associated with increased risk of legal problems, substance abuse, and antisocial personality disorder in adults.

Kleptomania and pyromania are two uncommon disorders linked to conduct disorder. The disorder known as kleptomania is characterized by impulsive, irresistible, and involuntary theft of non-personally useful items. The kleptomaniacs hide, return, give away, or hoard the stolen goods because they do not need them. When they steal, they may feel immense pleasure and satisfaction, but afterwards they may feel regret and guilt.

Pyromania is a disorder characterized by recurrent urges and intense desires to start deliberate fires. Compared to kids who do this once out of curiosity, this is different. People who have pyromania are enthralled with fire and its applications. They feel compelled to participate in risky fire situations. This is an uncommon ailment that may co-exist with other mental illness.

Also Read: Childhood Fears and, Their Relation to Mental Health Disorders

Prevalence And Impact Of DBD

Disruptive behavior disorders are relatively common in children and adolescents, and the incidence varies depending on various factors such as age, gender, cultural background, etc. DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), prevalence of ODD in children and adolescents. was estimated at 3-5%, while the prevalence of CD was 1-3%. ODD is more common in children from low-income households and in boys than in girls. Many, but not all, children diagnosed with ODD later develop conduct disorders. Approximately 70% of people with oppositional defiant disorder have symptoms that disappear by age 18.3 In addition, approximately 67% of children diagnosed with oppositional defiant disorder no longer meet diagnostic criteria after three years of follow-up. (Rana Elmaghraby, SEPTEMBER 2021). Conduct Disorder is a more serious disorder than ODD.

It is associated with substance abuse, dropping out of high school, and criminal behavior. Approximately 40% of people diagnosed with conduct disorder later meet diagnostic criteria for antisocial personality disorder. It tends to happen more often in men. (Rana Elmaghraby, SEPTEMBER 2021). For intermittent explosive disorders, the person must be over 6 years of age or at a similar developmental level. However, the disease is usually first noticed in late childhood or adolescence.

Intermittent explosive disorder has a one-year prevalence of 2.7% and a lifetime prevalence of 7%. (Rana Elmaghraby, SEPTEMBER 2021). These disorders have significant short term and long-term consequences for individuals and society. Children and adolescents with disruptive behavior disorders are at a higher risk for developing comorbid mental health conditions such as depression, anxiety and substance use disorders. Furthermore, the antisocial behaviors associated with CD can lead to involvement in criminal activities and legal problems in adulthood, perpetuating a cycle of dysfunction and societal harm.

Also Read: Awareness And Useful Solutions To Psychological Disorders

Causes And Risk Factors:

A combination of genetic, biological, environmental, and psychosocial factors is believed to influence the development of disruptive behavior disorders. Although the etiology of the disorder lacks precise results, one can consider some risk factors.

1) Genetic And Biological Factors:

Children who have parents suffering from any mental illness like mood disorders, anxiety disorders and substance use disorder are more likely to develop DBD. Family and twin studies suggest a genetic predisposition to DBD, with heritability ranging from 40 to 60%. Brain abnormalities or dysfunction can also contribute to this disorder. Research suggests that children with DBD have abnormalities in the frontal lobe which is responsible for executive functioning and impulse control.

2) Environmental Factors:

Individuals with DBD also have a history of abuse, trauma, or neglect. Children and adolescents who lived in poverty, witnessed domestic violence, had lack of parental supervision, had parents with marriage troubles, and also were physically, sexually and emotionally abuse are at a higher risk of developing disruptive behavior disorders.

3) Psychosocial Factors:

Peer influences play a significant role in the development of DBD, as children and adolescents may model their behavior after deviant peers or seek validation through antisocial behavior. Poor academic performance, low self esteem and lack of social support also contribute to functional impairments. Also, children diagnosed with ADHD are at higher risk for DBD.

4) Assessment And Diagnosis:

The diagnosis of disruptive behavior disorders typically involves a comprehensive evaluation by a qualified mental health professional. The assessment includes a clinical interview where the clinician gathers holistic information about the individual’s presenting symptoms, developmental history, family dynamics, academic performance, and social functioning. They may then use some standardized tests and questionnaires to assess the different domains of functioning like attention, emotional regulation, and social skills.

Also Read: Violence in Manipur Is Causing Mental Health Disorders among Children

Treatment Approaches

Treatment for disruptive behavior disorders typically involves a multimodal approach that addresses individual’s unique needs and circumstances. Some of them are psychotherapy, medicines, family therapy etc.

Psychotherapy includes CBT and PMT. Therapists use cognitive-behavioral treatment (CBT) to help individuals develop coping skills, improve problem-solving abilities, and learn alternative ways of thinking. Parent management therapy focusses on teaching parents effective discipline strategies and communication skills. Psychiatrists or other physicians can prescribe medications to target specific symptoms. The matter usually involves the use of mood stabilizers and stimulants. In conjunction, psychotherapy and medication together provide overall care for the individual.

Family Dynamics in DBD

Family therapy aims to address interpersonal dynamics, communication patterns and family conflicts that contribute to or maintain disruptive patterns. By involving family members in the therapeutic process, therapists can help improve family functioning and strengthen supportive relationships within the family unit.

Disruptive behavior disorders represent a significant public health concern, with implications for individuals, family, and communities. This disorder can be challenging for the individual and his family, but timely interventions can improve the symptoms and improve the quality of life. But for this it is important to keep in check with the early signs of the disorder as DBD grown into adulthood can have severe effects on the adult and the society.