Technical Assistance Partnership for Child and Family Mental Health

MAY2002

What are Disruptive Disorders and are they a significant problem for children and families within the System of Care programs?

Disruptive disorders are characterized by verbally abusive and/or aggressive behaviors towards others; non-compliance with appropriate directives, rules, or the law; and defiance and disobedience of legitimate authority figures-parents, teachers, and other adults.

Oppositional defiant disorder (ODD) and conduct disorder are the two diagnoses most commonly included in discussions of disruptive behaviors. They comprise almost 44% of the diagnoses given in grant communities. However, many disruptive behaviors are subsumed under other diagnostic categories such as depression and attention deficit/hyperactivity disorder (ADH). Thus, they are exhibited by far more children than indicated by the diagnostic rates of ODD or conduct disorder.

Children with a diagnosis of ODD are frequently involved in arguments and fights. They are often angry and easily annoyed. Their testing of the limits placed on them and stubbornness often cause major conflicts with adults.

Youth with a diagnosis of ODD are at high risk of escalating to Conduct Disorder. Young people with a diagnosis of Conduct Disorder, usually adolescents, are often involved with the juvenile justice system. Their behaviors will often include substance abuse, assaultive behaviors, precocious sexual involvement, and various misdemeanor and even felonious criminal activities.

There are a number of psychosocial interventions with proven effectiveness in reaching positive outcomes with these youth-especially boys. They include:

1. Two parent training programs: Living with Children, based on Patterson's and Guillions manual, and Problem Solving Skills Training by S. Spaccarelli, S. Coller and D. Penman;

2. Cognitive behavioral approaches, including: Multisystemic Therapy by Scott Hengyeler; Anger Coping Therapy by Lochman and Lochman; Assertiveness Training by Huey and Rank; Delinquency Prevention Program by Tremblay and Vitaro; Rational Emotive Therapy by Block; Videotape Modeling Parent Training by Webster-Stratton; Parent-Child Interaction Therapy by Eyberg and McNeil.

The only medication that has proven consistent effectiveness is Ritalin.

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	MAY2002 What are Disruptive Disorders and are they a significant problem for children and families within the System of Care programs? Disruptive disorders are characterized by verbally abusive and/or aggressive behaviors towards others; non-compliance with appropriate directives, rules, or the law; and defiance and disobedience of legitimate authority figures-parents, teachers, and other adults. Oppositional defiant disorder (ODD) and conduct disorder are the two diagnoses most commonly included in discussions of disruptive behaviors. They comprise almost 44% of the diagnoses given in grant communities. However, many disruptive behaviors are subsumed under other diagnostic categories such as depression and attention deficit/hyperactivity disorder (ADH). Thus, they are exhibited by far more children than indicated by the diagnostic rates of ODD or conduct disorder. Children with a diagnosis of ODD are frequently involved in arguments and fights. They are often angry and easily annoyed. Their testing of the limits placed on them and stubbornness often cause major conflicts with adults. Youth with a diagnosis of ODD are at high risk of escalating to Conduct Disorder. Young people with a diagnosis of Conduct Disorder, usually adolescents, are often involved with the juvenile justice system. Their behaviors will often include substance abuse, assaultive behaviors, precocious sexual involvement, and various misdemeanor and even felonious criminal activities. There are a number of psychosocial interventions with proven effectiveness in reaching positive outcomes with these youth-especially boys. They include: 1. Two parent training programs: Living with Children, based on Patterson's and Guillions manual, and Problem Solving Skills Training by S. Spaccarelli, S. Coller and D. Penman; 2. Cognitive behavioral approaches, including: Multisystemic Therapy by Scott Hengyeler; Anger Coping Therapy by Lochman and Lochman; Assertiveness Training by Huey and Rank; Delinquency Prevention Program by Tremblay and Vitaro; Rational Emotive Therapy by Block; Videotape Modeling Parent Training by Webster-Stratton; Parent-Child Interaction Therapy by Eyberg and McNeil. The only medication that has proven consistent effectiveness is Ritalin.

Mental Health and Systems of Care Frequently Asked Questions