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ADHD and the Disruptive Behavior Disorders

  • Chapter
The Medical Basis of Psychiatry

Abstract

Although it has now been reclassified as a Neurodevelopmental Disorder, Attention Deficit/Hyperactivity Disorder (ADHD) frequently overlaps with the Disruptive, Impulse Control, and Conduct Disorders such as Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD), forming a heterogeneous group of childhood onset behavioral disorders that have traditionally been lumped together as Disruptive Behavior Disorders (DBD). These frequently comorbid disorders cause significant disturbance and distress within the child’s environment, usually school and/or family, as well as causing severe developmental and psychosocial dysfunction for the individual. ADHD is characterized by symptoms of inattention, impulsivity and hyperactivity, ODD by hostility, anger, argumentativeness, defiance, and CD by aggression, deceitfulness, and violation of rights of others. The DBDs play an enormous social role because they represent a high risk for developmental trajectories that harbor psychosocial, economic, psychiatric, and criminal morbidity across the lifespan and have significant socioeconomic and health impact on a national level (1). The DBDs may share comorbidities and some etiologic and pathophysiologic characteristics, however, their clinical manifestations, developmental trajectories, and biologic substrates are distinct.

The explosion of neurobiological literature about the Disruptive Behavior Disorders, most specifically on ADHD, reflects the complex, fluid, and often-contradictory manifestations of brain-behavior relationships. This complexity is enhanced further by the accumulating research demonstrating significant differences in manifestations according to age, cognitive status, gender, comorbidities, psychosocial context, and treatment response. There is an enormous degree of individual variation shaped by the transaction of biological and environmental factors, which again has major implications for prevention and diagnostic and therapeutic interventions. For practical purposes, the current discussion will focus on each condition separately.

This is a revision of a previous edition of this chapter authored by Drs. A. Baumgaertel, L. Blaskey, and S.X. Antia.

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  1. Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of Minnesota School of Medicine, Minneapolis, MN, USA

    Elena B. Metcalf M.D. (Fellow)

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  1. University of Minnesota School of Medicine, Minneapolis, Minnesota, USA

    S. Hossein Fatemi

  2. University of New Mexico School of Medicine Pasadena, University of Minnesota School of Medicine, California, California, USA

    Paula J. Clayton

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Metcalf, E.B. (2016). ADHD and the Disruptive Behavior Disorders. In: Fatemi, S., Clayton, P. (eds) The Medical Basis of Psychiatry. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2528-5_18

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