Adolescent Behavioural Disorder and Mental Health

“…behavioral disorders are among the leading causes of illness and disability among adolescents.” (1)

As a parent, you’ve probably become accustomed to the odd temper tantrum or displays of defiant behavior from your child from time to time. But if this sort of “bad” behavior seems to be the norm, or appears to be more frequent and severe than in their peers, it may be as a result of an underlying behavioral disorder.

What are behavioral disorders?

Behavioral disorders are a pattern of disruptive and harmful behaviors which last for more than six months. These disorders are usually diagnosed in early childhood, and if left untreated from early on, may negatively impact a child’s ability to build and maintain relationships in the long term. (2,3)

If you’re concerned about a potential disorder, being fully informed is key. Here are some of the most common behavioral disorders affecting adolescents and young adults.

Attention deficit hyperactivity disorder (ADHD)

ADHD is characterized by a difficulty to focus, hyperactivity, and impulsivity. Depending on the symptoms, a child can be diagnosed with one of the following subtypes: inattentive, hyperactive-impulsive, or combined type. ADHD can be diagnosed from six-years-old, as the symptoms usually start to appear around school-going age. Symptoms include: (3)

• Impulsivity.?They tend to interrupt others and find it difficult to wait their turn.
• Easily distracted.?They struggle to pay attention and find it difficult to complete tasks.
• Fidgety.?They find it difficult to stay still or remain seated. This may also include tapping their hands and feet or running around when it’s not appropriate.
• Easily frustrated.?They struggle to cope with stress and may appear moody at times.

Conduct disorder

Adolescents with conduct disorder tend to show disregard for basic social rules and others’ rights. They also exhibit antisocial behaviors and struggle to show empathy. This can have a significant impact on their interpersonal relationships in the long term. Conduct disorder usually develops at around the age of 16 and is more common in boys than girls.3?Adolescents with conduct disorder are often unable to interpret the behavior of others, and when they feel attacked, it causes them to display violent behavior.

Symptoms include: (3)

• Aggression.?Bullying others and starting physical fights.
• Vandalism.?Destroying private property.
• Lying.?Deceiving or tricking others.
• Rule-breaking.?Frequent truancy or running away.

Oppositional defiant disorder

While it’s normal for children to act up and throw tantrums, those with oppositional defiant disorder tend to be argumentative, disregard rules, and are hostile towards those in authority (e.g. parents and teachers). As children usually act up when they’re unhappy, it’s not always easy to distinguish between oppositional defiant disorder and stress-related behavior. However, if this type of behavior persists for six months or more, it is best to take it up with a medical professional. (3)

Symptoms include: (3)

• Throwing temper tantrums and being irritable.
• Constantly looking to argue and intentionally annoying or irritating others.
• Being stubborn and refusing to follow instructions.
• Being spiteful and vindictive.

Obsessive-compulsive disorder (OCD)

Children with OCD experience recurring, unwanted thoughts, ideas or sensations (obsessions) that drive them to do something repetitively (compulsions). While many children can have distressing thoughts or repetitive behavior, for a child with OCD the obsessive and compulsive behavior can be distressing and interfere with everyday life. (3,4,5)

Symptoms include: (3,4,5)

• Checking.?The obsessional fear of damage can cause repeated checking that, for example, the front door is locked.
• Contamination.?The obsessional fear that someone has been contaminated leading to compulsively washing hands or some other cleaning ritual.
• Symmetry and ordering.?They need to have everything lined up perfectly to avoid feelings of anxiety.
• Intrusive thoughts.?Constantly thinking the same thoughts over and over.

A developmental disability worth noting

Autism Spectrum Disorder (ASD)

Perhaps you’ve noticed that your child struggles to build and maintain friendships? Or maybe they find it difficult to interact socially with peers and adults, or to understand expected behaviors? These are common signs of ASD, a developmental disability that is caused by differences in the brain.6?Children with ASD typically start displaying symptoms under the age of three years, which can last throughout their lifetime.6?Unlike the other conditions described in this article, ASD is not a behavioral disorder, but can impact your child’s ability to interact successfully with others. Early diagnosis is critical to ensuring individuals with ASD get the support they need.

Unfortunately there is no medical test for ASD, making it difficult to diagnose. If you suspect your child is autistic, it’s imperative that you consult a medical practitioner.6

When to ask for help

If your child is exhibiting symptoms of any of the disorders mentioned above, it’s important for you to speak to a medical professional. If necessary, your doctor may refer you to a specialist such as a developmental-behavioral pediatrician, child psychologist, child psychiatrist, or a pediatric neurologist for further investigation.

This article was reviewed by Dr. Shashi Pradhan, Medical Advisor at Cigna.

?REFERENCES:

1. Adolescent mental health. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health. Accessed April 22, 2022.
2. Behavioral Disorder Symptoms, Causes and Effects. Psych Guides. https://www.psychguides.com/behavioral-disorders/. Accessed April 22, 2022.
3. Chapter V Mental and behavioral disorders (F00-F99): Obsessive-compulsive disorder (OCD). International Statistical Classification of Diseases and Re?lated Health Problems 10th Revision (ICD-10)-WHO. https://icd.who.int/browse10/2019/en#/F40-F48. Accessed April 22, 2022.
4. Common behavioral disorders in children. Medical News Today. https://www.medicalnewstoday.com/articles/behavioral-disorders-in-children. Accessed April 22, 2022.
5. Obsessive-compulsive disorder (OCD). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/symptoms-causes/syc-20354432. Updated March 2020. Accessed April 22, 2022.
6. What is Autism Spectrum Disorder? Centers for Disease Control and Prevention.?https://www.cdc.gov/ncbddd/autism/facts.html. Accessed July 4, 2022.

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