At The Neuropsychology Service, we have been keeping a database of the referred clients (mostly children and adolescents). We are keeping track of 149 measures, mostly testing data, but also descriptors (2) of the referral questions and also up to two diagnoses from the Diagnostic and Statistical Manual of the Mental Disorders – Fifth Edition (DSM-5).
For this article, we selected 173 cases where the “conduct problems” rating was at the 90th percentile or higher in the Behavior Assessment System for Children (either the second edition or the third edition). Very often, children and adolescents with this profile would carry the diagnosis of Conduct Disorder. We were interested in other outcome diagnoses that applied to this group. The primary DSM-5 diagnoses are listed below along with the associated percentages:
- Dysphoric Mood Dysregulation Disorder 24%
(includes Bipolar Disorder and Cyclothymic D/O)
- Anxiety Disorder (Generalized Anxiety D/O, Anxiety D/O, NOS) 30%
- Depression 14.5%
- Learning Disorder 7.5%
- Other (e.g., PTSD, Tourette’s, Autism) 14%
- Conduct Disorder 10%
The data suggests that mood regulation problems (Dysphoric Mood Dysregulation Disorder and depression) and anxiety regulation problems can result in behaviors that are labeled “conduct problems.” The implication is that conduct problems in children and adolescents often need to be carefully evaluated in order to determine if there are underlying mood and anxiety regulation difficulties that contribute to this presentation. This has implications for medication management, mental health support and school interventions.
This data cannot be considered a scientific sample. It represents cases referred to a clinical neuropsychological practice on the North Shore and the diagnostic framework used here. The data is also subject to the biases of the schools, medical professionals, therapists and parents who refer people to The Neuropsychology Service.