The 4 Differences Between Conduct Disorder And Oppositional Defiant Disorder
In childhood and adolescence we can find two disorders that lead to notable social and academic maladjustment and these are conduct disorder and oppositional defiant disorder which, if not treated in a timely and adequate manner, especially conduct disorder, They could evolve during adulthood into antisocial behaviors.
Among the differences between conduct disorder and oppositional defiant disorder we can find the following: different comorbidity with other disorders, different severity of behaviors, different prevalence, different diagnostic criteria or different specifiers.
In this article We will talk about the differences between conduct disorder and oppositional defiant disorder but first we should see the diagnostic criteria for both disorders, since they allow us to roughly understand these existing differences, according to the DSM-5 criteria.
Conduct disorder in the Diagnostic and Statistical Manual of Mental Disorders DSM-5 was previously known as “conduct disorder” (DSM-IV-TR), and the main diagnostic criteria for these disorders are what we are going to expose. next.
Criterion A of oppositional disorder speaks of the existence of a persistent and repetitive pattern of behaviors through which the basic rights of others are violated and/or the fundamental social norms specific to their age; Furthermore, this should be evident through 3 or even more criteria, including some of the ones we are going to discuss below during the last 12 months or at least 1 criterion during the last 6 months.
1. Aggression to animals and/or people
Within this first category of criteria we can find 7 of them related to aggression towards animals and also people and the main ones are these:
2. Destruction of property
In this second category we can find 2 other criteria related to the destruction of property being the following:
Within this third category related to theft or fraud we can find 3 criteria that involve the misappropriation of objects:
4. Serious rule violations
In this category there are 3 criteria:
He usually plays hooky at school and/or high school.
He has run away from home during the night at least twice.
Quite often he spends the nights away from home without the permission of his parents or guardians.
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What is oppositional defiant disorder?
Within the DSM-5 we can also find oppositional defiant disorder classified, characterized by the criteria that we are going to discuss below. Criterion A refers to a pattern of irritability, anger and/or arguing, defiant and/or vindictive activity that appears for 6 months or even longer, also manifesting itself through the fulfillment of 4 or even more symptoms, classified within 3 categories.
1. Irritability/anger
Within this first category we can find 3 criteria:
Loses his cool often.
Gets irritated easily.
He often appears angry and/or resentful.
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2. Defiant attitude/arguments
In this category 4 criteria are grouped, which are the following:
He accuses other people of his own mistakes quite frequently.
Deliberately bothers other people quite often,
Often actively challenges authority figures (parents, teachers, etc.).
Argue with authority figures often.
3. Vengeful
In this third category, we can only find the following criteria: has become vindictive and/or spiteful at least 2 times over the last 6 months.
Main differences between conduct disorder and oppositional defiant disorder
After having verified the diagnostic criteria of both disorders, we can now get an idea of the differences that could exist between them; However, it is appropriate that we comment in greater detail on what those most notable differences would be.
Below we are going to explain the main differences between conduct disorder and oppositional defiant disorder, something that serves to establish the differential diagnosis between both disorders (although this task can only be carried out by mental health professionals).
The first difference between conduct disorder and oppositional defiant disorder is related to the different comorbidities that exist with each of these disorders.
Oppositional defiant disorder has greater comorbidity with ADHD (the existence of oppositional defiant disorder being much greater in people with ADHD than in the general population), anxiety disorders, major depressive disorder and conduct disorder, since these disorders can occur comorbidly.
On the other hand, although one of its greatest comorbidities develops with ADHD, anxiety disorders and major depressive disorder, it also has comorbidity with learning disorders, bipolar disorder and substance use disorder.
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2. Severity of the behaviors
Another of the main differences between conduct disorder and oppositional defiant disorder that should be highlighted is the severity of the behaviors that occur in both, perhaps being The most notable difference that exists between both alterations.
In conduct disorder, the behaviors are more serious since they can harm other people and/or animals in an aggressive manner, and other criminal acts may even be carried out such as fraudulence, destruction of property and violation of rules. serious.
Instead, In oppositional defiant disorder, the behaviors are not as aggressive or harmful, since they are mainly based on anger or irritability, arguments or a defiant attitude and/or having been vindictive or spiteful; They are also serious enough to be taken into account but are not normally as harmful as those that occur in a behavioral disorder.
3. Course and prevalence
There are also some differences between conduct disorder and oppositional defiant disorder in terms of the course of each disorder and its prevalence. Starting by Conduct disorder, whose prevalence is around an average of 4% in minors, is a more common disorder in men ; Furthermore, this prevalence increases with age, being highest during adolescence, although it is a disorder that can become apparent during the preschool stage. On the other hand, it is strange that conduct disorder begins after 16 years of age.
On the other hand, oppositional defiant disorder has a prevalence of approximately 3.3% in minors, being a disorder that usually occurs in a greater proportion in males, although in adolescence there are no significant differences with respect to the percentage of cases that occur. occurs in women. Regarding the symptoms of this disorder, it is worth mentioning that they usually appear gradually during the preschool years and rarely begin to manifest after adolescence.
Another difference between both disorders is that The first symptoms of oppositional defiant disorder could go unnoticed for several years while those with conduct disorder usually begin to attract attention earlier.
4. Specifiers
Among the main differences between conduct disorder and oppositional defiant disorder, it is also worth highlighting the different specifiers that we can count within the DSM-5 manual for both disorders.
In the case of oppositional defiant disorder we only found one specifier related to the current severity of the disorder depending on whether the symptoms appear only within one environment (e.g., only at home) or if, on the contrary, they develop in two or even three or more environments.
On the other hand, in conduct disorder several specifiers can be applied, in addition to that which is related to the current severity of the disorder. One of these specifiers refers to the onset of the disorder (childhood, adolescent or unspecified), while the most notable of the specifiers refers to 4 factors that could be associated with this disorder, these being the following:
With deficient or superficial affection.
He is unconcerned about his performance.
Appears lacking empathy or insensitive.
It shows a lack of remorse or guilt.
Shows limited prosocial emotions.
As we can see, the specifiers of both disorders can serve to give us an idea of the greater severity that the symptoms of the conduct disorder normally have.
