Abnormal Psychology

654 CHAPTER 14

Oppositional behavior is common among toddlers and adolescents; a clinician

must be careful not to make the diagnosis of oppositional defi ant disorder unless

the disruptive behaviors occur signifi cantly more often or with more intensity than

is expected for the individual’s age group. Critically, normal oppositional behavior

does not impair functioning.

Moreover, symptoms of other disorders may be mistaken for symptoms of

oppositional defiant disorder. For instance, a young patient who is psychotic

may become angry and defi ant, or a depressed individual may become irritable.

When disruptive behaviors arise only in the context of a psychotic or mood dis-

order, oppositional defi ant disorder is not the appropriate diagnosis. As another

14.2 • Typical Paths Related to Disruptive Behavior Disorders Several diagnostic paths

are possible for individuals who exhibit signifi cantly disruptive behaviors. Oppositional defi ant

disorder and conduct disorder can arise either in childhood or in adolescence. Once symptoms reach

a level that meets the diagnostic criteria for either disorder, symptoms may (1) remain relatively stable

(and hence do not progress to a different part of the diagram), (2) resolve so that the diagnosis no

longer applies, or (3) shift, so that a different diagnosis is more appropriate. Although a patient’s

symptoms can shift from oppositional defi ant disorder to conduct disorder, this is not typical.

Nevertheless, most research on oppositional defi ant disorder has studied the small subset of people

who go on to develop conduct disorder.

Figure 14.2

14 2 i l h l d i i h i i d

g4

Callous and

unemotional traits

Oppositional defiant

disorder

Conduct disorder,

childhood-onset

type

Increasingly serious

symptoms

No callous and

unemotional traits

Antisocial

personality disorder

in adulthood

Psychopathy or

antisocial

personality disorder

in adulthood

Symptoms

resolve

Symptoms

resolve

Symptoms

resolve

Disruptive behaviors

that meet the

diagnostic criteria

for a disorder

Conduct disorder,

adolescent-onset

type