BIHILDIS C.

MABUNGA, MD, DPBP, FPPA

 Is characterized by a recurrent
pattern of negativistic, defiant,
disobedient, and hostile behavior
toward authority figures.
 DSM-5 DISRUPTIVE,
DSM-5
Substance- IMPULSE-CONTROL, AND
Related and CONDUCT DISORDERS
Addictive
Disorders
(emotional and/or behavioral
DSM-IV
Gambling dysregulation: impulsivity, Disorders Usually
Disorder aggression, rule breaking)
ODD CD
Fiirst Diagnosed in
Infancy, Childhood, or
IED Other Adolescence:
DSM-IV Pyromania Specified Attention-Deficit and
Impulse- Kleptomani Unspecified Disruptive Behavior
Control a Disorder

Disorders Not
Elsewhere
ADHD
Classified
Trichotillomania
DSM-5
Neurodevelo

DSM-5 pmental
Disorders
Obsessive-
Compulsive and
Related
Disorders
OPPOSITIONAL DEFIANT DISORDER

Oppositional defiant disorder (ODD) is broadly defined

as a persistent pattern of defiance and hostility against
authority figures (e.g., parents and teachers).
A diagnosis of ODD is more common among young
children (i.e., ages 3–7 years) manifesting clinically
severe levels of disruptive behavior than is conduct
disorder (CD).
Considerable evidence suggests that ODD often
precedes the development of CD in children (e.g., Burke
et al. 2010); thus, many researchers consider ODD and
CD to be age-related manifestations of a common
syndrome, with CD representing a more severe
developmental progression of disruptive behavior
(Loeber et al. 2009)
CRITERIA FOR OPPOSITIONAL DEFIANT
DISORDER

includes at least four symptoms from any of these

categories — angry and irritable mood;
argumentative and defiant behavior; or
vindictiveness Occurs with at least one individual
who is not a sibling Causes significant problems at
work, school or home Occurs on its own, rather than
as part of the course of another mental health
problem, such as a substance use disorder,
depression or bipolar disorder Lasts at least six
months
❖ Angry and irritable mood:
▪ Often loses temper
• Is often touchy or easily annoyed by others
• Is often angry and resentful
❖ Argumentative and defiant behavior:
• Often argues with adults or people in authority
• Often actively defies or refuses to comply with
adults' requests or rules
• Often deliberately annoys people
• Often blames others for his or her mistakes or
misbehavior
❖ Vindictiveness:
Is often spiteful or vindictive
▪ Has shown spiteful or vindictive behavior at least twice in
the past six months
❖ These behaviors must be displayed more often than is
typical for your child's peers. For children younger than 5
years, the behavior must occur on most days for a period of
at least six months. For individuals 5 years or older, the
behavior must occur at least once a week for at least six
months.
❖ ODD can vary in severity:

Mild. Symptoms occur only in one setting, such as only at

home, school, work or with peers.
Moderate. Some symptoms occur in at least two settings.
Severe. Some symptoms occur in three or more settings.
For some children, symptoms may first be seen only at home,
but with time extend to other settings, such as school and
with friends.
 is a disorder characterized by
recurrent episodes of inability to
control aggressive impulses,
reflected by verbal and / or
physical aggression.
 CRITERIA FOR INTERMITTENT
EXPLOSIVE DISORDER

Recurrent outbursts that demonstrate an inability to control impulses,

including either of the following:
Verbal aggression (tantrums, verbal arguments or fights) or physical
aggression that occurs twice in a week-long period for at least three months
and does not lead to destruction of property or physical injury (Criterion A1)
Three outbursts that involve injury or destruction within a year-long period
(Criterion A2)
Aggressive behavior is grossly disproportionate to the magnitude of the
psychosocial stressors (Criterion B)
The outbursts are not premeditated and serve no premeditated purpose
(Criterion C)
The outbursts cause distress or impairment of functioning, or lead to
financial or legal consequences (Criterion D)
The individual must be at least six years old (Criterion E)
The recurrent outbursts cannot be explained by another mental
disorder and are not the result of another medical disorder or substance
use (Criterion F)
ICD-10 DIAGNOSTIC CRITERIA FOR HABIT AND
IMPULSE DISORDER

PATHOLOGICAL GAMBLING
PATHOLOGICAL FIRE SETTING (PYROMANIA)
PATHOLOGICAL STEALING (KLEPTOMANIA)
TRICHOTILLOMANIA
OTHER HABIT & IMPULSE DISORDER
HABIT & IMPULSE DISORDER, UNSPECIFIED
 is an urge to gamble
continuously despite
harmful negative
consequences or a desire
to stop
 CRITERIA FOR PATHOLOGICAL
GAMBLING

Persistent and recurrent problematic gambling behavior leading to clinically

significant impairment or distress, as indicated by the individual exhibiting
four (or more) of the following in a 12-month period:
Needs to gamble with increasing amounts of money in order to achieve the
desired excitement.
Is restless or irritable when attempting to cut down or stop gambling.
Has made repeated unsuccessful efforts to control, cut back, or stop
gambling.
Is often preoccupied with gambling (e.g., having persistent thoughts of
reliving past gambling experiences, handicapping or planning the next
venture, thinking of ways to get money with which to gamble).
Often gambles when feeling distressed (e.g., helpless, guilty, anxious,
depressed).
After losing money gambling, often returns another day to get even
(“chasing” one’s losses).
Lies to conceal the extent of involvement with gambling.
Has jeopardized or lost a significant relationship, job, or educational or career
opportunity because of gambling.
Relies on others to provide money to relieve desperate financial situations
caused by gambling.
 The gambling behavior is not better explained by a manic
episode.
Specify if:
Episodic: Meeting diagnostic criteria at more than one time
point, with symptoms subsiding between periods of gambling
disorder for at least several months.
Persistent: Experiencing continuous symptoms, to meet
diagnostic criteria for multiple years.
Specify if:
In early remission: After full criteria for gambling disorder were
previously met, none of the criteria for gambling disorder have
been met for at least 3 months but for less than 12 months.
In sustained remission: After full criteria for gambling disorder
were previously met, none of the criteria for gambling disorder
have been met during a period of 12 months or longer.
Specify current severity:
Mild: 4–5 criteria met.
Moderate: 6–7 criteria met.
Severe: 8–9 criteria met.
 is an impulse control
disorder in which
individuals repeatedly fail
to resist impulses to
deliberately start fires, in
order to relieve tension
or for instant
gratification.
 CRITERIA FOR PYROMANIA

A. Deliberate and purposeful fire setting on more than one

occasion.
B. Tension or affective arousal before the act.
C. Fascination with, interest in, curiosity about, or attraction to fire
and its situational contexts (e.g., paraphernalia, uses,
consequences).
D. Pleasure, gratification, or relief when setting fires, or when
witnessing or participating in their aftermath.
E. The fire setting is not done for monetary gain, as an expression
of sociopolitical ideology, to conceal criminal activity, to express
anger or vengeance, to improve one's living circumstances, in
response to a delusion or a hallucination, or as a result of impaired
judgment (e.g., in Dementia, Mental
Retardation, Substance Intoxication).
F. The fire setting is not better accounted for by Conduct Disorder,
a Manic Episode, or Antisocial Personality Disorder.
is the inability to refrain
from the urge for
stealing items and is
usually done for reasons
other than personal use
or financial gain
 CRITERIA FOR KLEPTOMANIA

A. Recurrent failure to resist impulses to steal objects that are

not needed for personal use or for their monetary value.
B. Increasing sense of tension immediately before committing
the theft.
C. Pleasure, gratification, or relief at the time of committing the
theft.
D. The stealing is not committed to express anger or vengeance
and is not in response to a delusion or a hallucination.
E. The stealing is not better accounted for by Conduct Disorder,
a Manic Episode, or Antisocial Personality Disorder.
is a condition where a
person feels compelled
to pull their hair out.
CRITERIA FOR TRICHOTILLOMANIA

Recurrent pulling out of one's hair resulting in

noticeable hair loss.
B. An increasing sense of tension immediately before
pulling out the hair or when attempting to resist the
behavior.
C. Pleasure, gratification, or relief when pulling out the
hair.
D. The disturbance is not better accounted for by
another mental disorder and is not due to a general
medical condition (e.g., a dermatological condition).
E. The disturbance causes clinically significant distress
or impairment in social, occupational, or other important
areas of functioning.