This page is dedicated to organizing various examples of standardized exam questions whose answer is conduct disturbance disorder. While this may seem a odd practice, it is useful to see multiple examples of how conduct disturbance disorder will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
Question # 1
A 11 year old boy is brought in by his parents for a well child visit. His parents explain that he is very disruptive, and has a high energy level. He has been held back one time in the first grade. He sleeps about 7 hours every night. He has always been a “handful” and very difficulty to discipline, and he is constantly arguing about everything. For the past 2 years he will often refuse to go to school, so his mother has had to drive him there and literally walk him to his classroom. A few times, he has left school in the middle of the day. Two month ago he killed the family cat when he was playing with it. Although he said it was an accident, the child did not appear to have any remorse for the death of the beloved family pet. His older sister is currently in a juvenile facility. Patient is at the 6oth percentile for both height and weight. His vital sings are unremarkable. Physical exam reveals several ecchymoses over his extremities. Mental status exam reveals that while he is initially insolent, he also worries about at night something may happen to his family. What is the most likely diagnosis?
Question # 2
A 16 year old boy is brought to the clinic by his mother because “he is out of control”. His mother explains that he has always been difficult to manage, and does not respond to any disciplinary actions that she has taken. During the past few years, his behavior has significantly worsened, to the point that he has been arrested two timed int he past month. He is currently on probation, but his mother is concerned that he will get arrested again if he continues to behave this way. His mother explains that she has found him drunk in his room on a few occasions. In the clinic the patient is difficult to engage in conversation. He says he is often irritable and has a “short fuse”. He’s clothes smell of cigarettes. Physical exam shows several tattoos over the chest and arms, with also a few body piercings. Mental status exam shows an irritable mood and limited eye contact. What is the most likely diagnosis?
Question # 3
A 13 year old boy is brought to the clinic because of his severe issues with inappropriate behavior. His mother is upset that he has poor grades, and because he has been suspended from school for setting fires in the locker rooms, and stealing another students music playing device. She explains that the boy’s behavior has always been erratic, but over the past year his behavior “has gone to the next level”. The boy explains that the fires were “an accident” although he also admits to being upset about the coach kicking him off the wrestling team. When asked about stealing the music playing device, he scoffs and says “the kid deserved to have it stolen, he just left it out in the open for me to take it”. The patient has a history of theft and getting into physical fights since the 5th grade. He has no other notable past medical history. His family history is remarkable for bipolar disorder and alcohol dependence. When the patient’s mother is asked to leave the room, the patient admits to smoking cigarettes, but denies alcohol or illicit drug usage. What is the most likely diagnosis?