Disruptive behavior disorders

Disruptive behavior disorders, comprising Oppositional Defiant Disorder and Conduct Disorder are characterized by behaviors that violate the rights of others and/or bring the individual into significant conflict with societal norms or authority figures. These disorders emerge early in childhood, are highly prevalent, and are associated with profound disability and societal burden. Given the heterogeneity in presentation and outcomes of youth with disruptive behavior disorders, attempts have been made to identify more homogenous subgroups to deliver tailored treatment. Notably, children displaying callous-unemotional traits (e.g., lack of empathy, remorse/guilt) represent a distinct subtype of disruptive behavior disorders, specified as “with limited prosocial emotions” in diagnostic classification systems, presenting with particularly severe, aggressive, and chronic disruptive behavior. To identify this and other important moderators and predictors of clinical outcomes, it is imperative that assessment of disruptive behavior disorders is both comprehensive and grounded in the most contemporary understanding of their development. Assessment findings should directly inform selection and implementation of evidence-based treatment that is personalized to the child's and family's individual needs. Additional clinical considerations and recommendations for clinical practice with children with disruptive behavior disorders are discussed.