© 2014 Laureate Education, Inc. Page 1 of 2 Disruptive Behaviors In the DSM-IV, attention deficit and disruptive behaviors were grouped as a category within the classifications of disorders usually first diagnosed in infancy, childhood, and adolescence. Though it is true that these disorders are generally first diagnosed during these stages, the classifications of these disorders has been reconceptualized to reflect their similarities in manifestation, as well as considerations for the impact on social functioning. ADHD, for example, is grouped in the DSM-5 with neurodevelopmental disorders; research has supported a strong biological basis for this disorder as well as for others found in this classification (see “Exceptionalities” in Week 11 of this course). However, because the expression of ADHD often includes behaviors that can be disruptive to the child’s social environment, it will be included with the topics for this week. Other disorders addressed this week are those now included in a new chapter of the DSM-5: disruptive, impulse-control, and conduct disorders. This new grouping of diagnoses reflects a recognition of the similarities of these diagnoses—all of these are associated with an intrusion upon the rights, property, or physical safety of others. In addition, individuals with these disorders generally act against societal expectations and norms and show a significant inability to control behavioral or emotional impulses. Disruptive, Impulse-Control, and Conduct Disorders This new DSM-5 chapter includes oppositional defiant disorder, intermittent explosive disorder, conduct disorder, antisocial personality disorder (also listed in the personality disorders chapter), pyromania, kleptomania, other specified disruptive, impulse-control, and conduct disorders, and unspecified disruptive, impulse-control, and conduct disorders. Two of these diagnoses are new to the DSM-5: other specified disruptive, impulse- control, and conduct disorders, and unspecified disruptive, impulse-control, and conduct disorders. These take the place of disruptive behavior disorder NOS in the DSM-IV, which has been removed. Both of these diagnoses represent significant clinical distress or impairment based on criteria for disruptive, impulse-control, and conduct disorders, but do not meet full criteria for a specific diagnosis in this class. Clinicians should use other specified disruptive, impulse-control, and conduct disorders and add the specific reason for the more general diagnosis (e.g., falling short of duration or frequency criteria). The latter diagnosis—unspecified disruptive, impulse-control, and conduct disorders—is used when clinicians cannot (or choose not to) identify reasons for the inability to make a more specific diagnosis, yet clearly observe multiple criteria from the disruptive, impulse-control, and conduct disorder classification. The following is a summary of key change.

1. © 2014 Laureate Education, Inc. Page 1 of 2
Disruptive Behaviors
In the DSM-IV, attention deficit and disruptive behaviors were
grouped as a category
within the classifications of disorders usually first diagnosed in
infancy, childhood, and
adolescence.
Though it is true that these disorders are generally first
diagnosed during these stages,
the classifications of these disorders has been reconceptualized
to reflect their
similarities in manifestation, as well as considerations for the
impact on social
functioning. ADHD, for example, is grouped in the DSM-5 with
neurodevelopmental
disorders; research has supported a strong biological basis for
this disorder as well as
for others found in this classification (see “Exceptionalities” in
Week 11 of this course).
However, because the expression of ADHD often includes
behaviors that can be
disruptive to the child’s social environment, it will be included
with the topics for this
week.
Other disorders addressed this week are those now included in a
new chapter of the
DSM-5: disruptive, impulse-control, and conduct disorders.

2. This new grouping of
diagnoses reflects a recognition of the similarities of these
diagnoses—all of these are
associated with an intrusion upon the rights, property, or
physical safety of others. In
addition, individuals with these disorders generally act against
societal expectations
and norms and show a significant inability to control behavioral
or emotional impulses.
Disruptive, Impulse-Control, and Conduct Disorders
This new DSM-5 chapter includes oppositional defiant disorder,
intermittent explosive
disorder, conduct disorder, antisocial personality disorder (also
listed in the personality
disorders chapter), pyromania, kleptomania, other specified
disruptive, impulse-control,
and conduct disorders, and unspecified disruptive, impulse-
control, and conduct
disorders.
Two of these diagnoses are new to the DSM-5: other specified
disruptive, impulse-
control, and conduct disorders, and unspecified disruptive,
impulse-control, and conduct
disorders. These take the place of disruptive behavior disorder
NOS in the DSM-IV,
which has been removed. Both of these diagnoses represent
significant clinical
distress or impairment based on criteria for disruptive, impulse-
control, and conduct
disorders, but do not meet full criteria for a specific diagnosis

3. in this class. Clinicians
should use other specified disruptive, impulse-control, and
conduct disorders and add
the specific reason for the more general diagnosis (e.g., falling
short of duration or
frequency criteria). The latter diagnosis—unspecified
disruptive, impulse-control, and
conduct disorders—is used when clinicians cannot (or choose
not to) identify reasons
for the inability to make a more specific diagnosis, yet clearly
observe multiple criteria
from the disruptive, impulse-control, and conduct disorder
classification.
The following is a summary of key changes to diagnostic
criteria for this group of
disorders.
Oppositional Defiant Disorder
© 2014 Laureate Education, Inc. Page 2 of 2
Criterion A has been revised in several ways. First, the
symptoms have been grouped
into categories relating to mood, behavior, and malicious intent.
Second, the duration,
persistence, and frequency requirements have been more clearly
described, with
considerations made for differences related to age,
developmental level, gender, and
culture. Lastly, a severity rating associated with pervasiveness

4. has been included in
the specifiers for this disorder.
Intermittent Explosive Disorder
The criteria for this diagnosis have been considerably revised in
the DSM-5. Criterion A
has been expanded with more specific detail added, including
the inclusion of verbal
aggression and nondestructive aggressive behavior. Language
has also been added
regarding intensity and frequency of the outbursts that are key
components of this
diagnosis. In addition, the minimum age for this diagnosis is
now 6 years old; this
change helps to distinguish the diagnostic criteria from normal
temper and behavioral
variations in very young children.
Conduct Disorder
The DSM-5 criteria for a conduct disorder diagnosis is similar
to that found in the DSM-
IV. However, an important addition has been made: The DSM-5
includes a specifier for
observed limitations in socially appropriate emotional response.
This may be
exemplified by deficits in empathy, remorse, or guilt. This may
also be reflected in a
general lack of concern over impact of behaviors and decreased
expressive affect.
Neurodevelopmental Disorders

5. This group of disorders is covered more thoroughly in Week 11
of this course.
However, one of the disorders from this group frequently has a
disruptive component
to it and is, therefore, included in this week.
Attention-Deficit/Hyperactivity Disorder (ADHD)
Though the basic diagnostic criteria for ADHD is very similar
in the DSM-5, there are a
number of key differences from the DSM-IV, including stage-
related examples to aid in
diagnosis in childhood, adolescence, and adulthood. One of the
key changes has been
to raise the identification of symptomology from before age 7 to
before age 12 and to
use a single diagnosis with specifiers rather than several related
diagnoses in a group.
Specifiers replace prior subtypes, identifying the predominant
presenting
symptomology. Specifiers are also now used to reflect severity
of impairment of
functioning.
Reference:
• American Psychiatric Association. (2013). Highlights of
changes from DSM-IV-
TR to DSM-5. Retrieved from
http://www.dsm5.org/Documents/changes%20from%20dsm-iv-
tr%20to%20dsm-5.pdf