MENTAL health is for everyone, regardless of age, gender, class, race and color. This is one of the Philippine Mental Health Association (PMHA)’s slogan.

No one is immune to mental health problems. Children also suffer from mental disorders. Mental illness is a disease of the brain. It is not a choice. It is like any other disease. But it can be managed.

Some common mental disorders in children are anxiety disorders, pervasive development disorders, affective (mood) disorders, eating disorders and disruptive behavior disorders.

Last week, I shared about depression, a type of mood disorder, in children. Today, I will talk about disruptive behavior disorders.

According to webmd.com, children with disruptive behavior disorders tend to defy rules and often disturbing in structured environments, such as in school.

Children with troublesome behaviors (aside from defying authority), usually skip school, steal, cheat or damage property. They may also have aggressive behavior and persistent disobedience. They may also be persistently defiant and argumentative. There is a pattern of anger and irritability.

There are two types of disruptive behavior disorders -Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD).

Oppositional Defiant Disorder is defined as a pattern of disobedient and hostile behavior towards authority figures. (Quach, 2014)

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, lists criteria for ODD. This manual is used by mental health professionals as a guide. However, only a psychiatrist can diagnose a mental disorder.

The DSM-5 criteria for diagnosis of ODD show a pattern of beahavior that:

*includes at least four symptoms from any of these categories – angry and irritable mood; argumentative and defiant behavior; or vindictiveness

*occurs with at least one individual who is not a sibling

*causes significant problems at work, school or home

*occurs on its own, rather than as part of the course of another mental health problem, such as substance use disorder, depression or bipolar disorder

*lasts at least SIX months

DSM-5 criteria for diagnosis of ODD indicate both emotional and behavioral symptoms

Angry and irritable mood:

*often loses temper

*is often touchy or easily annoyed by others

*is often angry and resentful

Argumentative and defiant behavior:

*often argues with adults or people in authority

*often actively defies or refuses to comply with adults’ requests or rules

*often deliberately annoys people

*often blames others for his or her mistakes or misbehavior

Vindictiveness

*is often spiteful or vindictive

*has shown spiteful or vindictive behavior at least twice in the past six months

For some children, symptoms may first be seen only at home, but will extend in time to other settings, such as the school and even with friends.

Conduct Disorder is a disorder in which the child violates rules, destroys properties, lies, cheats, steals or being cruel to animals and aggressive to other people. (Quach, 2014)

CD is a serious behavioral and emotional disorder that can occur in children and teenagers. According to webmd.com, these are some behavioral symptoms

Aggressive behavior

Threaten or cause physical harm – e.g. fighting, bullying, being cruel to others or animals, using weapons and forcing another person into a sexual activity

Destructive behavior

Involves intentional destruction of property – e.g. deliberately fire-setting (arson) and harming another person’s property (vandalism)

Deceitful behavior

Involves repeated lying, shoplifting or breaking into homes or cars in order to steal

Violation or rules

Involves going against accepted rules of society or engaging in behavior that is not appropriate for the child’s age – e.g. running away, skipping school, playing pranks or being sexually active at a very young age

Children with conduct disorder tend to be irritable, have a low self-esteem and may throw frequent temper tantrums. Some may be abusing drugs and alcohol. They may not see how they have hurt others and they may have little guilt or remorse feelings about hurting another.

Causes of these disorders are unknown but could be a combination of genetics/biological, environmental, social or psychological.

Most of the time the child who has the tendency to behave like the above named symptoms won’t see it as a problem. However, if symptoms continue to persist and becomes uncontrollable, it is recommended to consult with a psychiatrist.

Psychiatrists volunteer their time in PMHA once a week. Call PMHA at 433-8868 for inquiries.