Common Childhood Behavioral Problems

Oppositional Defiant Disorder

Oppositional defiant disorder (ODD) refers to a specific pattern of behavioral symptoms that are exhibited by a child or teen for a period of at least six months. Characterized by a combination of negative behaviors that are often directed at authority figures, conduct associated with the disorder may include angry or irritable moods, argumentative and defiant behavior, as well as acting in a spiteful or vindictive manner.

Although it can be normal to display some oppositional behaviors at certain stages of child development, in individuals with ODD the conduct goes beyond what is considered acceptable for a particular age group. Signs of ODD are often apparent in early childhood, but may appear before early adolescence. ODD often impacts social and academic functioning. In addition, many children with the disorder may also be affected by other mental health conditions including, ADHD, mood disorders, anxiety, conduct disorder, or learning disabilities.

While the excessive behaviors associated with ODD are typically present at home, they may or may not be as evident in outside settings. The severity of the disorder depends on the number of settings in which the behavior is seen to occur. For some children with ODD, the number of settings may expand over time.

It is estimated that 2%-16% of children have ODD. While the exact cause of the disorder remains a mystery, it is believed that certain biological, genetic and environmental factors can contribute to its development. Treatment for ODD can involve multiple types of psychotherapeutic approaches for both the child and family members. Medications may also be employed in cases of co-existing conditions.

Bipolar Disorder

Bipolar disorder is a chronic mental health condition that is characterized by extreme shifts in mood, energy levels, activity, and thought processes. Although, it is normal for a person to occasionally experience a mood swing, someone who has bipolar disorder experiences extreme episodes of highs and lows, respectively known as mania and depression. According to the National Institute of Mental Health, bipolar disorder affects approximately 5.7 million adults in the United States every year.

While the average age of onset for bipolar disorder is the mid-twenties, the condition may also start in childhood or not become manifest until middle age. A person with bipolar disorder may also suffer from other mental health disorders as well as substance abuse. Having a bipolar disorder also puts one at a higher risk for certain physical ailments and illnesses.

With bipolar disorder, a person will go through distinct periods of mania or depression or have mixed episodes where both extremes are experienced simultaneously or in rapid sequence. For someone with bipolar disorder, severe episodes of mania or depression can precipitate psychotic symptoms including hallucinations and delusions.

There are four types of bipolar disorders. Each is characterized by a particular combination of periods of mania or hypomania (less severe manic periods) and depression:

• Bipolar I Disorder-Involves a manic episode, which has been preceded or followed by a hypomanic or major depressive episode
• Bipolar II Disorder-Involves a pattern of depressive and hypomanic episodes
• Cyclothymic Disorder-Periods of hypomanic symptom and depressive symptoms last for at least two years (1 year in children & adolescents). The pattern and level of symptoms distinguish this bipolar disorder from falling into another category.
• Other Types- Refers to bipolar symptoms that do not fall into the other categories as well as one that may be precipitated by alcohol, drugs or illness.

While there is no single reason for developing bipolar disorder, there are many factors that may increase one’s risk for the illness. Family history and heredity play a significant role, as more than two-thirds of individuals who are diagnosed as bipolar have at least one close relative with the illness or who suffer from depression. Other genetic factors and well as differences in brain structure and function are also linked to the disorder.

Bipolar disorder is a lifelong illness. However, with treatment the symptoms can be managed and leading a fulfilling and productive life is possible. Treatment may include psychotherapy, medication, or a combination of both.

Adjustment Disorder

An adjustment disorder can happen at any age but is quite common in children and adolescents. A child or adolescent with an adjustment disorder experiences an excessive, unhealthy, and maladaptive reaction to a stressful event or life change beginning within three months of the precipitating event.

Children and adolescents may develop an adjustment disorder in response to a variety of upsetting or disruptive life events such as a family move, the loss of a family member or beloved pet, divorce, serious illness or the birth of a sibling. Adjustment disorders occur in all cultures and with equal frequency in girls and boys.

An adjustment disorder can cause significant impairment to normal daily activities and function. The symptoms that a child or adolescent will experience can vary and depend on a number of factors. An adjustment disorder may occur with a depressed mood, anxiety, conduct disturbances, or a combination of these symptoms. Since the symptoms of an adjustment disorder can overlap with other medical or psychiatric conditions, the diagnosis can be challenging. Early recognition and intervention can help a child work on coping skills and to improve their abilities to process emotions. Treatment for the disorder may include  psychotherapy, family therapy, peer group therapy, and medication.


Impulse Control Disorder

An impulse control disorder is a mental health problem that involves an inability or failure to control an impulse that results in harm to oneself or others. Typically motivated by cravings or feelings of arousal, an individual with an impulse control disorder will experience release and derive pleasure from having engaged in a destructive behavior or act. Furthermore, despite being aware of the negative consequences, someone with an impulse control disorder cannot stop himself or herself from repeatedly engaging in harmful behavior.

Commonly diagnosed in childhood or adolescence, an impulse control disorder can cause impairment to normal daily function as well as familial and social interactions.

Impulse control disorders seen in children and adolescents may include:

● Kleptomania
● Compulsive Sexual Behaviors
● Pyromania
● Intermittent Explosive Disorder
● Trichotillomania

In some cases, other mental health disorders can be comorbid with an impulse control disorder. While no specific reason for the emergence of an impulse control disorder has been identified, it is believed that a combination of genetic, environmental and biochemical factors can contribute to an individual’s risk of developing one.

Early diagnosis and intervention offers the best prognosis. Without the appropriate care, the
consequences of an impulse control disorder can become more severe. Treatment for children and adolescents with an impulse control disorder is aimed at giving them the skills to control their impulses and more effectively manage their emotions.

Acting Out 

Acting out occurs when a child exhibits persistent out-of-control and unrestrained behavior as a means of gaining relief from tension or anxiety. Conduct associated with acting out is more emotional, aggressive, disruptive and potentially destructive than simple misbehavior.

A child may act out in response to an upsetting ongoing situation, as a means of getting attention from adults and to impress peers, or due to other untreated mental health disorders, unrecognized sensory issues as well as undiagnosed learning disabilities. Acting out behaviors can include temper tantrums, frequent arguments, self-harm, abusive actions toward people or animals, stealing or vandalizing property, promiscuity, substance abuse and other antisocial behaviors. 

A child who acts out may require professional help if the behavior persists and is having lasting negative effects on his or her quality of life and impairing daily function as well as social and familial interactions. Any behavior considered unsafe, self-injurious or damaging to others requires prompt evaluation and care.

Treatment for acting out behaviors depends upon the child’s age, the extent and severity of the behavior as well as the presence of comorbid disorders. With proper therapeutic intervention and treatment many children and adolescents can develop the tools to better understand their emotions and behavior and more effectively manage them.