Oppositional Defiant and Intermittent Explosive Disorder

Oppositional Defiant Disorder

• Includes a pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness
• Angry/irritable mood involves losing temper, being touchy or easily annoyed, and being angry and resentful
• Argumentative/defiant behavior includes arguing with authority, defying or refusing compliance, deliberately annoying others, and blaming others
• Vindictiveness is defined as being spiteful or vindictive at least twice within the past 6 months
• Diagnosis requires 4 symptoms lasting at least 6 months, and it should not be applied to siblings
• Behavioral disturbance must be associated with distress
• Behaviors should not occur exclusively during psychotic, substance use, depressive, or bipolar disorders; the criteria also should not be met for disruptive mood dysregulation disorder

Intermittent Explosive Disorder

• Involves recurrent behavioral outbursts that represent a failure to control aggressive impulses
• Includes verbal aggression or physical aggression toward property, animals, or other individuals, occurring twice weekly for 3 months without damage or injury
• Alternatively, includes 3 instances of behavioral damage, destruction, or physical injury within a 12-month period
• The magnitude of aggressiveness is grossly out of proportion to the provocation
• Recurrent aggressive outbursts are not premeditated but are impulsive and/or anger-based
• Acts are not committed to achieve a tangible objective
• The individual must be at least 6 years old
• This is not a part of an adjustment

Conduct disorder

• A repetitive and persistent behavior pattern violates others' basic rights or age-appropriate societal norms/rules
• Requires presence of 3 criteria in the past 12 months, with at least 1 criterion in the past 6 months
• Aggression to People and Animals: bullying, threatening, or intimidating others, initiating physical fights, using weapons causing serious harm, physical cruelty to people/animals, stealing while confronting a victim, forcing sexual activity
• Destruction of Property: engaging in fire setting to cause damage, deliberately destroying others' property
• Deceitfulness or Theft: breaking into buildings or cars, lying to obtain goods or favors, stealing items of nontrivial value without confronting a victim
• Serious Violations of Rules: staying out at night against parental rules (beginning before age 13), running away from home overnight at least twice or once without returning for a long period, truancy (beginning before age 13)
• Functional impairment must be present
• The individual must be under 18 to be diagnosed

Pyromania

• Involves deliberate and purposeful fire-setting on more than one occasion
• Characterized by tension or affective arousal before the act
• Fascination with, interest in, curiosity about, or attraction to fire and its situational contexts are present
• Pleasure, gratification, or relief experienced when setting fires or witnessing/participating in their aftermath
• Fire-setting is not for monetary gain, a sociopolitical statement, concealing criminal activity, expressing anger/vengeance, improving living circumstances, or due to impaired judgment
• The fire setting is not better explained by conduct disorder, a manic episode, or antisocial personality disorder

Kleptomania

• Recurrent failure to resist impulses to steal objects not needed for personal use or monetary value
• Experience of an increasing sense of tension immediately before committing the theft
• Pleasure, gratification, or relief at the time of committing the theft
• Stealing is not committed to express anger or vengeance, or in response to a delusion/hallucination
• Stealing is not better explained by conduct disorder, a manic episode, or antisocial personality disorder