Question

Read the case and answer the questions that follow.

Malay, a student of class IX, was referred to a mental health clinic with complaints of stealing money, excessive lying, setting fire to household items, teasing young girls of the locality, and passing lewd remarks and making obscene gestures. The onset was about three years ago and has increased over the past eight months. Of late, he has started using alcohol and spending more time outdoors with friends of similar interests. School reports suggested the gradual development of inappropriate behaviours such as openly defying rules in school, playing truant, instigating fellow students to pass silly remarks in class, and disrespectful attitude towards elders ultimately resulting in frequent school absenteeism, mixing with local goons, and excessive aggression. Further investigation revealed that the family history is disturbed, the relationship with the father was extremely hostile and there were frequent conflicts among the family members. Birth and developmental milestones are normal.

Identify the disorder Malay is exhibiting. Distinguish it from Attention Deficit/Hyperactivity Disorder (ADHD).

Answer 1

Conduct Disorder: The terms conduct disorder and antisocial behaviour refer to age-inappropriate actions and attitudes that violate family expectations, societal norms, and the personal or property rights of others. The behaviours typical of conduct disorder include aggressive actions that cause or threaten harm to people or animals, nonaggressive conduct that causes property damage, major deceitfulness or theft, and serious rule violations.

ADHD: It is a Neurodevelopmental disorder. The two main features of ADHD are inattention and hyperactivity-impulsivity. Children who are inattentive find it difficult to sustain mental effort during work or play. They have a hard time keeping their minds on any one thing or following instructions. Common complaints are that the child does not listen, cannot concentrate, does not follow instructions, is disorganised, easily distracted, forgetful, does not finish assignments, and is quick to lose interest in boring activities. Children who are impulsive seem unable to control their immediate reactions or to think before they act. They find it difficult to wait or take turns and have difficulty resisting immediate temptations or delaying gratification. Minor mishaps such as knocking things over are common whereas more serious accidents and injuries can also occur. Hyperactivity also takes many forms. Children with ADHD are in constant motion. Sitting still through a lesson is impossible for them. The child may fidget, squirm, climb and run around the room aimlessly. Parents and teachers describe them as ‘driven by a motor’, always on the go, and talking incessantly.