Let's break down each disorder and cover the main details you requested from the DSM-5. Keep in mind that the DSM-5 is a copyrighted publication, and the information provided here is a summary. If you need comprehensive details or the exact diagnostic criteria, you should consult the DSM-5 directly.
1. ADHD (Attention-Deficit/Hyperactivity Disorder)
Diagnostic Criteria: ADHD is characterized by persistent patterns of inattention and/or
hyperactivity-impulsivity that interferes with functioning or development.
- Inattention: Six or more symptoms for children up to age 16; five for adolescents 17 and older and adults.
A. A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, as characterized by (1) and/or (2):
Inattention: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities:
Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities.
Often has difficulty sustaining attention in tasks or play activities.
Often does not seem to listen when spoken to directly.
Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace.
Often has difficulty organizing tasks and activities.
Often avoids or is reluctant to engage in tasks that require sustained mental effort.
Often loses things necessary for tasks or activities.
Is often easily distracted by extraneous stimuli.
Is often forgetful in daily activities.
- Hyperactivity-Impulsivity: Six or more symptoms for children up to age 16; five for adolescents 17 and older and adults.
Hyperactivity and Impulsivity: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities:
Often fidgets with or taps hands or feet or squirms in seat.
Often leaves seat in situations where remaining seated is expected.
Often runs about or climbs in situations where it is inappropriate.
Often unable to play or engage in leisure activities quietly.
Is often "on the go," acting as if "driven by a motor."
Often talks excessively.
Often blurts out an answer before a question has been completed.
Often has difficulty waiting for his or her turn.
Often interrupts or intrudes on others (e.g., butts into conversations, games, or activities; may start using other people's things without asking or receiving permission).
B. Several inattentive or hyperactivity-impulsivity symptoms were present before age 12 years.
C. Several inattentive or hyperactivity-impulsivity symptoms are present in two or more settings (e.g., at home, school, or work; with friends or relatives; in other activities).
D. There is clear evidence that the symptoms interfere with or reduce the quality of social, academic, or occupational functioning.
E. The symptoms are not better explained by another mental disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication, or withdrawal).
Subtypes:
ADHD, Combined Presentation: If both Criterion A1 (inattention) and Criterion A2 (hyperactivity-impulsivity) are met for the past 6 months.
ADHD, Predominantly Inattentive Presentation: If Criterion A1 (inattention) is met but Criterion A2 (hyperactivity-impulsivity) is not met for the past six months.
ADHD, Predominantly Hyperactive-Impulsive Presentation: If Criterion A2 (hyperactivity-impulsivity) is met and Criterion A1 (inattention) is not met for the past six months.
This summary is based on the criteria as described in the DSM-5. It's important to consult the DSM-5 or a licensed mental health professional for a complete understanding and accurate diagnosis.
- Associated Features: Poor academic performance, low self-esteem, difficulty maintaining relationships.
- Prevalence: Approximately 5% of children and 2.5% of adults.
- Development and Course: Often identified in school-aged children, persists into adulthood in many cases.
- Risk and Prognostic Factors: Family history of ADHD, substance abuse during pregnancy, premature birth, and low birth weight.
Neurological or Psychological? Both. ADHD is often described as a neurodevelopmental disorder because it involves alterations in brain structure and function. Various neuroimaging studies have shown differences in the brains of individuals with ADHD compared to those without. However, ADHD also involves behavioral symptoms, and its diagnosis and treatment often involve psychological assessments and interventions.
2. ODD (Oppositional Defiant Disorder)
- Diagnostic Criteria: Pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months.
A. A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months as evidenced by at least four symptoms from any of the categories and exhibited during interaction with someone who is not a sibling.
Angry/Irritable Mood:
Loses temper frequently.
Touchy or easily annoyed.
Often angry and resentful.
Argumentative/Defiant Behavior:
Argues with authority figures/adults.
Actively defies requests.
Deliberately annoys others.
Blames others for mistakes or misbehavior.
Vindictiveness:
Has been spiteful or vindictive at least twice within the past six months.
B. The disturbance in behavior causes significant impairment in social, academic, or occupational functioning.
- Associated Features: Difficulties in school, conflict with authority figures.
- Prevalence: Around 3.3% among children and adolescents.
- Development and Course: Often precedes conduct disorder or mood disorders.
- Risk and Prognostic Factors: Harsh discipline, instability in the family, family history of mood disorders.
Neurological or Psychological? Primarily psychological. While there may be underlying neurological components, ODD is primarily characterized by behavioral symptoms. It's diagnosed and treated within the realm of mental health and behavioral interventions.
3. Conduct Disorder
A. A repetitive and persistent pattern of behavior violating the rights of others or societal norms/rules, as manifested by at least three of the following in the past 12 months, with at least one in the past 6 months:
Aggression to people and animals.
Destruction of property.
Deceitfulness or theft.
Serious violation of rules.
- Diagnostic Criteria: Persistent pattern of behavior in which the basic rights of others are violated. Examples include aggression, property destruction, deceitfulness, theft, or serious rule violations.
- Associated Features: Low self-esteem, school dropout, substance use.
- Prevalence: Around 4% among adolescents.
- Development and Course: Symptoms typically first appear during childhood or adolescence.
- Risk and Prognostic Factors: Genetic and environmental factors, traumatic events, brain damage.
Neurological or Psychological? Primarily psychological. As with ODD, conduct disorder is characterized by a pattern of behavioral symptoms. However, some research suggests there might be neurological differences in those with conduct disorder, but it's primarily diagnosed and treated as a behavioral and mental health issue.
4. Impulse Control Disorders
Impulse control disorders in the DSM-5 encompass various disorders, including Intermittent Explosive Disorder, Kleptomania, and Pyromania, among others. Each has its own diagnostic criteria. For instance, for Intermittent Explosive Disorder:
A. Recurrent outbursts representing a failure to control aggressive impulses as manifested by either:
Verbal aggression or physical aggression toward property, animals, or other individuals, occurring on average twice weekly for three months.
Three outbursts involving physical assault or property destruction within a 12-month period.
B. The magnitude of the aggressiveness is out of proportion to the provocation or any precipitating psychosocial stressors.
- Diagnostic Criteria: Varies by specific disorder, but generally involves the inability to resist an impulse or temptation to perform some act harmful to oneself or others.
- Associated Features: Regret after acting on impulses, financial or legal issues.
- Prevalence: Varies by specific disorder.
- Development and Course: Typically begins in late childhood or adolescence.
- Risk and Prognostic Factors: Biological and environmental factors, traumatic experiences.
Neurological or Psychological? Both. Impulse control disorders can be linked to specific areas of the brain involved in impulse regulation, such as the prefrontal cortex. However, like the disorders above, they are also characterized by behavioral symptoms and are diagnosed and treated primarily within the realm of mental health.
This summary provides an overview of the diagnostic criteria. For full details, including specifiers and subtypes, consult the DSM-5 directly. Always seek a licensed professional for an accurate diagnosis.
Brief Story:
Ella, a 15-year-old, is brought to the clinic by her parents. They describe her as being easily distracted in school and constantly "on the go," aligning with ADHD's Combined Presentation. Lately, Ella has been increasingly defiant, frequently losing her temper, and arguing with adults, indicative of ODD. In school, Ella has been involved in a few incidents of stealing from classmates, aligning with conduct disorder. Her parents also note that Ella has lately made impulsive online purchases with their credit card without thinking about the consequences, hinting at impulse control disorder.
This brief story encapsulates multiple disorders in one presentation, but it's crucial to remember that a comprehensive assessment is required for accurate diagnosis, and co-morbidity can complicate the diagnostic picture.
In general, while many disorders have neurological underpinnings (i.e., differences or changes in brain structure or function), they manifest as behavioral or psychological symptoms. As such, many disorders, including ADHD, ODD, conduct disorder, and impulse control disorders, are often treated with a combination of medical and psychological/behavioral interventions.
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