Sixteen year-old Bill Atkins was referred to the school social worker after his most recent suspension. According to the staff interviewed - the guidance counselor, assistant principal, teachers - Bill has a long history of defiance and aggression toward peers as shown in numerous fights in school. The social worker also interviewed Bill's parents who confirmed the youngster's defiant behavior at home. His parents added that he can be aggressive; seen in breaking doors or punching holes in the walls if he doesn't get his way. Bill's mother comments, "When backed into a corner, Bill will choose a lie rather than the truth. Lately, his father and I have noticed things missing around the house. It started with small change but now I'm afraid to leave my jewelry out." Bill's mood was consistently seen by those who were interviewed as irritable or depressed. No psychotic symptoms or sleep disturbances were reported. What would be the most likely diagnosis to consider for Bill?

Question

Quizplus · Accepted Answer

Bill's history of defiance, aggression, and antisocial behavior at school and at home strongly supports a diagnosis of conduct disorder. The fact that he lies, steals, and has shown property destruction further supports this diagnosis. While oppositional defiant disorder and disruptive mood dysregulation disorder may be considered in the differential diagnosis, Bill's behaviors go beyond simply being argumentative or moody. Attention deficit hyperactivity disorder may co-occur with conduct disorder, but it is not the primary diagnosis in this case.

Sixteen Year-Old Bill Atkins Was Referred to the School Social