Explanation:

In the DSM-5 and DSM-5-TR, externalizing behavioral difficulties in students include 3 main conditions: oppositional defiant disorder (ODD), intermittent explosive disorder (IED), conduct disorder (CD) . Attention deficit disorder with or without hyperactivity (AD/HD) is one of the neurodevelopmental disorders and for this reason, this syndrome will only be the subject of a single presentation by the professor. Furthermore, these diagnoses are often comorbid (associated) with anxiety and mood disorders, as well as substance use and learning disorders (Mass, Desbiens, & Lanaris, 2020).

After completing this module, you should be able to:

To describe and define oppositional defiant disorder (ODD), conduct disorder (TC), intermittent explosive disorder (IED). To recognize these three disorders in students who attend regular classes. To have a better understanding of the developmental trajectories of these disorders.

Oppositional defiant disorder

Oppositional defiant disorder (ODD) was officially introduced into the DSM-IV in 1994. According to the DSM-5 and DSM-5-TR, the first manifestations of ODD usually appear during preschool age but rarely after the onset of adolescence. Furthermore, we will remember that opposition is a normal phase of early childhood. Up to 2-3 years old, the child opposes our requests to assert himself. This phase fades when the parent, recognizing the child's individuality, allows him to do several things that he did not know how to do before. It allows him to make choices, to make decisions that are within his reach to help him develop his autonomy. After 4 years, if this opposition continues, we must intervene more firmly. ODD is a psychiatric diagnosis that merits consultation because, in the absence of targeted intervention, this disorder could develop into delinquency. In general, ODD disappears around the age of 12, precisely as adolescence arrives. Table 1 ODD shows the diagnostic criteria for ODD according to the DSM-5 and DSM-5-TR. Here is a video clip on the TOP.

Intermittent Explosive Disorder (IED)

Intermittent explosive disorder is characterized by several episodes of explosive behavior, out of proportion to the triggers that may have provoked this reaction and reflect a failure to control aggressive impulses. TEI occurs in 4% to 7% of the population and is associated with disruption of functioning, social (work), academic (school) and relationships with others. Although TEI is classified among impulse control and conduct disorders, and the emphasis is placed on the failure to control aggressiveness, some authors question the origin of this problem and would attribute more to manifestations of TEI to the failure of emotion regulation. Table 2 TEI shows the diagnostic criteria for TEI according to DSM-5 and DSM-5-TR. Here is a clip on the TEI

Conduct disorder (CD)

The behaviors characteristic of CD usually occur in varied contexts: at school, at home or outside. Symptoms vary as the student grows, physical strength increases, cognitive abilities and sexual maturity develop. The diagnostic criteria give the impression that this condition constitutes a homogeneous group, but the clinic actually reveals that it is a rather heterogeneous group. Some have more physical aggression, poor relationships with peers, others may have deviant behavior (fraud, rape, lying, etc.) but maintain good relationships with peers, others are characterized by limited prosocial emotions. When CD appears before puberty, often after having presented symptoms of ODD during early childhood, the disorder generally turns out to be more chronic and persists during adulthood (criminal behavior, drug addiction, professional instability, poor social adjustment). ) and which persist even through generations; there are usually more boys than girls there. When it begins during adolescence, TC most often resolves at the end of adolescence and the boy/girl ratio is more balanced.

According to the DSM-5 and DSM-5-TR, young people with TBI have an increased risk of later developing a mood disorder, an anxiety disorder, post-traumatic stress disorder, an impulse control disorder, a psychotic disorder, a somatic symptom disorder or even a substance use disorder. A large number of factors may contribute from the severity of the clinical presentation of TBI to its prognosis. Poor family supervision (too lax or too rigid), parental rejection, the presence of psychopathology or delinquent behavior among parents increase the risks. Personal factors such as the presence of an intelligence quotient below average (especially with regard to verbal IQ) and the nature of neuropsychological deficits or learning disorders, if any, complicate the presentation of CD. . Table 3 TC shows the diagnostic criteria for TC according to the DSM-5 and DSM-5-TR. Here is a clip on the TC.

https://youtu.be/f7AVZOrCFEI?si=Lf3andRgdAp761dX

Whether they are behavioral problems or disorders, their presence in the school environment undeniably contributes to undermining the educational climate. Teachers as well as students are affected by their consequences (reduction in learning time, relational difficulties between students, between teachers and students, etc.). The existence of these difficulties should lead the various stakeholders in educational environments to question the causes of their appearance. Indeed, they may follow situations of adversity that a student may have faced on a personal, family, or academic level. In this regard, externalized behavioral difficulties must also be seen from the angle of their adaptive function, their role in maintaining a relative balance of the young person with his environment. In short, externalized behavioral difficulties can play the role of a symptom which reflects perhaps more significant difficulties experienced on other levels. It is therefore important to remain attentive and present with these students who demonstrate through their disruptive behavior that they need help and support.

Questions:

Now that you are more familiar with ODD, TEI and TC, which of these three disorders do you think is the most demanding for teachers? In other words, is it more difficult to manage a class with a student with an ODD, a TEI or a TC?