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A personality development disorder is an inflexible and pervasive pattern of inner experience and behavior in children and adolescents, that markedly deviates from the expectations of the individual's culture. Personality development disorder is not recognized as a mental disorder in any of the medical manuals, such as the ICD-10 or the DSM-IV, neither is it part of the proposed revision of this manual, the DSM-5. DSM-IV allows the diagnosis of personality disorders in children and adolescents only as an exception.
This diagnosis is currently proposed by a few authors in Germany. The term personality "development" disorder is used to emphasize the changes in personality development which might still take place and the open outcome during development. Personality development disorder is considered to be a childhood risk factor or early stage of a later personality disorder in adulthood.
Adults usually show personality patterns over a long duration of time. Children and adolescents however still show marked changes in personality development. Some of these children and adolescents have a hard time developing their personalities in an ordinary way. DSM-IV states, for example, that children and adolescents are at higher risk to develop an antisocial personality disorder if they showed signs of conduct disorder and attention deficit disorder before the age of 10. This led Adam & Breithaupt-Peters (2010) to the idea that these children and adolescents need to be looked at more carefully. The therapy which these children and adolescents need might be more intense and maybe even different from looking at the disorders traditionally. The concept of personality development disorders also focuses on the severity of the disorder and the poor prognosis. An early diagnosis might help to get the right treatment at an early stage and thus might help to prevent a personality disorder outcome in adulthood.
According to Adam und Breithaupt-Peters personality development disorders are defined as complex disorders
- which show similarity to a certain type of personality disorder in adulthood
- which persist over a long period of time (more than a year) and show a tendency towards being chronic
- which have a severe negative impact on more than one important area of functioning or social life
- which show resistance to traditional educational and therapeutic treatment methods
- which result in a reduced insight into or ignorance of the own problem behavior. The family usually suffers more than the child or adolescent and has a hard time dealing with the diminished introspection.
- which make positive interactions between the children/adolescents and other people merely impossible. Instead social collisions are part of everyday life.
- which threaten the social integration of the young person into a social life and might result in an emotional disability.
Typical deficiencies may include problems identifying, processing, describing, and working with one's own feelings, often marked by a lack of understanding of the feelings of others; difficulty distinguishing between feelings and the bodily sensations of emotional arousal; confusion of physical sensations often associated with emotions; few dreams or fantasies due to restricted imagination; and concrete, realistic, logical thinking, often to the exclusion of emotional responses to problems. Those who have alexithymia also report very logical and realistic dreams, such as going to the store or eating a meal. Clinical experience suggests it is the structural features of dreams more than the ability to recall them that best characterizes alexithymia.
Some alexithymic individuals may appear to contradict the above-mentioned characteristics because they can experience chronic dysphoria or manifest outbursts of crying or rage. However, questioning usually reveals that they are quite incapable of describing their feelings or appear confused by questions inquiring about specifics of feelings.
According to Henry Krystal, individuals suffering from alexithymia think in an operative way and may appear to be superadjusted to reality. In psychotherapy, however, a cognitive disturbance becomes apparent as patients tend to recount trivial, chronologically ordered actions, reactions, and events of daily life with monotonous detail. In general, these individuals lack imagination, intuition, empathy, and drive-fulfillment fantasy, especially in relation to objects. Instead, they seem oriented toward things and even treat themselves as robots. These problems seriously limit their responsiveness to psychoanalytic psychotherapy; psychosomatic illness or substance abuse is frequently exacerbated should these individuals enter psychotherapy.
A common misconception about alexithymia is that affected individuals are totally unable to express emotions verbally and that they may even fail to acknowledge that they experience emotions. Even before coining the term, Sifneos (1967) noted patients often mentioned things like anxiety or depression. The distinguishing factor was their inability to elaborate beyond a few limited adjectives such as "happy" or "unhappy" when describing these feelings. The core issue is that people with alexithymia have poorly differentiated emotions limiting their ability to distinguish and describe them to others. This contributes to the sense of emotional detachment from themselves and difficulty connecting with others, making alexithymia negatively associated with life satisfaction even when depression and other confounding factors are controlled for.
Alexithymia is considered to be a personality trait that places affected individuals at risk for other medical and psychiatric disorders while reducing the likelihood that these individuals will respond to conventional treatments for the other conditions. Alexithymia is not classified as a mental disorder in the fourth edition of the "Diagnostic and Statistical Manual of Mental Disorders". It is a dimensional personality trait that varies in severity from person to person. A person's alexithymia score can be measured with questionnaires such as the Toronto Alexithymia Scale (TAS-20), the Bermond-Vorst Alexithymia Questionnaire (BVAQ), the Online Alexithymia Questionnaire (OAQ-G2) or the Observer Alexithymia Scale (OAS). It is distinct from the psychiatric personality disorders, such as antisocial personality disorder or borderline personality disorder, with which it shares some characteristics, and is likewise distinct from the abnormal conditions of sociopathy or psychopathy.
Alexithymia is defined by:
1. difficulty identifying feelings and distinguishing between feelings and the bodily sensations of emotional arousal
2. difficulty describing feelings to other people
3. constricted imaginal processes, as evidenced by a scarcity of fantasies
4. a stimulus-bound, externally oriented cognitive style.
In studies of the general population the degree of alexithymia was found to be influenced by age, but not by gender; the rates of alexithymia in healthy controls have been found at: 8.3%; 4.7%; 8.9%; and 7%. Thus, several studies have reported that the prevalence rate of alexithymia is less than 10%. A less common finding suggests that there may be a higher prevalence of alexithymia amongst males than females, which may be accounted for by difficulties some males have with "describing feelings", but not by difficulties in "identifying feelings" in which males and females show similar abilities.
Psychologist R. Michael Bagby and psychiatrist Graeme J. Taylor have argued that the alexithymia construct is strongly related (negatively) to the concepts of psychological mindedness and emotional intelligence and there is "strong empirical support for alexithymia being a stable personality trait rather than just a consequence of psychological distress". Other opinions differ and can show evidence that it may be state-dependent.
Bagby and Taylor also suggest that there may be two kinds of alexithymia, "primary alexithymia" which is an enduring psychological trait that does not alter over time, and "secondary alexithymia" which is state-dependent and disappears after the evoking stressful situation has changed. These two manifestations of alexithymia are otherwise called "trait" or "state" alexithymia.
Avoidant individuals often choose jobs of isolation so that they do not have to interact with the public regularly, due to their anxiety and fear of embarrassing themselves in front of others. Some with this disorder may fantasize about idealized, accepting, and affectionate relationships, due to their desire to belong. Individuals with the disorder tend to describe themselves as uneasy, anxious, lonely, unwanted and isolated from others. They often feel themselves unworthy of the relationships they desire, so they shame themselves from ever attempting to begin them.
People with avoidant personality disorder are preoccupied with their own shortcomings and form relationships with others only if they believe they will not be rejected. Loss and social rejection are so painful that these individuals will choose to be alone rather than risk trying to connect with others (see rejection sensitivity). They often view themselves with contempt, while showing an increased inability to identify traits within themselves that are generally considered as positive within their societies.
- Hypersensitivity to rejection and criticism
- Self-imposed social isolation
- Extreme shyness or anxiety in social situations, though the person feels a strong desire for close relationships
- Avoids physical contact because it has been associated with an unpleasant or painful stimulus
- Feelings of inadequacy
- Drastically reduced or absent self-esteem
- Self-loathing, autophobia or self-harm
- Mistrust of others or oneself; exhibits heightened self-doubt
- Emotional distancing related to intimacy
- Highly self-conscious
- Self-critical about their problems relating to others
- Heightened attachment-related anxiety, which may include a fear of abandonment
- Problems in occupational functioning
- Lonely self-perception, although others may find the relationship with them meaningful
- Feeling inferior to others
- Substance abuse and/or dependence
- In some extreme cases, agoraphobia
- Uses fantasy as a form of escapism to interrupt painful thoughts
Borderline personality disorder may be characterized by the following signs and symptoms:
- Markedly disturbed sense of identity
- Frantic efforts to avoid real or imagined abandonment and extreme reactions to such
- Splitting ("black-and-white" thinking)
- Impulsivity and impulsive or dangerous behaviours
- Intense or uncontrollable emotional reactions that often seem disproportionate to the event or situation
- Unstable and chaotic interpersonal relationships
- Self-damaging behavior
- Distorted self-image
- Dissociation
- Frequently accompanied by depression, anxiety, anger, substance abuse, or rage
The most distinguishing symptoms of BPD are marked sensitivity to rejection or criticism, and intense fear of possible abandonment. Overall, the features of BPD include unusually intense sensitivity in relationships with others, difficulty regulating emotions, and impulsivity. Other symptoms may include feeling unsure of one's personal identity, morals, and values; having paranoid thoughts when feeling stressed; dissociation and depersonalization; and, in moderate to severe cases, stress-induced breaks with reality or psychotic episodes.
The likely course and outcome of mental disorders varies and is dependent on numerous factors related to the disorder itself, the individual as a whole, and the social environment. Some disorders are transient, while others may be more chronic in nature.
Even those disorders often considered the most serious and intractable have varied courses i.e. schizophrenia, psychotic disorders, and personality disorders. Long-term international studies of schizophrenia have found that over a half of individuals recover in terms of symptoms, and around a fifth to a third in terms of symptoms and functioning, with some requiring no medication. At the same time, many have serious difficulties and support needs for many years, although "late" recovery is still possible. The World Health Organization concluded that the long-term studies' findings converged with others in "relieving patients, carers and clinicians of the chronicity paradigm which dominated thinking throughout much of the 20th century."
Around half of people initially diagnosed with bipolar disorder achieve syndromal recovery (no longer meeting criteria for the diagnosis) within six weeks, and nearly all achieve it within two years, with nearly half regaining their prior occupational and residential status in that period. However, nearly half go on to experience a new episode of mania or major depression within the next two years. Functioning has been found to vary, being poor during periods of major depression or mania but otherwise fair to good, and possibly superior during periods of hypomania in Bipolar II.
One of the symptoms of conduct disorder is a lower level of fear. Research performed on the impact of toddlers exposed to fear and distress shows that negative emotionality (fear) predicts toddlers' empathy-related response to distress. The findings support that if a caregiver is able to respond to infant cues, the toddler has a better ability to respond to fear and distress. If a child does not learn how to handle fear or distress the child will be more likely to lash out at other children. If the caregiver is able to provide therapeutic intervention teaching children at risk better empathy skills, the child will have a lower incident level of conduct disorder.
There are no specific criteria for "externalizing behavior" or "externalizing disorders." Thus, there is no clear classification of what constitutes an externalizing disorder in the DSM-5. Attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD), antisocial personality disorder(ASPD), pyromania, kleptomania, intermittent explosive disorder (IED), and substance-related disorders are frequently referred to as externalizing disorders. Disruptive mood dysregulation disorder has also been posited as an externalizing disorder, but little research has examined and validated it to date given its recent addition to the DSM-5, and thus, it is not included further herein.
Externalizing disorders often involve emotion dysregulation problems and impulsivity that are manifested as antisocial behavior and aggression in opposition to authority, societal norms, and often violate the rights of others. Some examples of externalizing disorder symptoms include, often losing one's temper, excessive verbal aggression, physical aggression to people and animals, destruction of property, theft, and deliberate fire setting. As with all DSM-5 mental disorders, an individual must have functional impairment in at least one domain (e.g., academic, occupational, social relationships, or family functioning) in order to meet diagnostic criteria for an externalizing disorder. Moreover, an individual's symptoms should be atypical for their cultural and environmental context and physical medical conditions should be ruled out before an externalizing disorder diagnosis is considered. Diagnoses must be made by qualified mental health professionals. DSM-5 classifications of externalizing disorders are listed herein, however, can also be used to classify externalizing disorders. More specific criteria and examples of symptoms for various externalizing disorders can be found in the DSM-5.
As it has already been mentioned, the organic personality disorder is included in a wide group of personality and behavioural disorders. This mental health disorder can be caused by disease, brain damages or dysfunctions in specific brain areas in frontal lobe. The most common reason for this profound change in personality is the traumatic brain injury (TBI). Children, whose brain areas have injured or damaged, may present Attention Deficit Hyperactivity Disorder (ADHD), oppositional defiant disorder (ODD) and organic personality disorder. Moreover, this disorder is characterised as "frontal lobe syndrome". This characteristic name shows that the organic personality disorder can usually be caused by lesions in three brain areas of frontal lobe. Specifically, the symptoms of organic personality disorder can also be caused by traumatic brain injuries in orbitofrontal cortex, anterior cingulate cortex and dorsolateral prefrontal cortex. It is worth to be mentioned that organic personality disorder may also be caused by lesions in other circumscribed brain areas.
In the American Psychiatric Association's DSM-5, schizotypal personality disorder is defined as a "pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of contexts."
At least five of the following symptoms must be present: ideas of reference, strange beliefs or magical thinking, abnormal perceptual experiences, strange thinking and speech, paranoia, inappropriate or constricted affect, strange behavior or appearance, lack of close friends, and excessive social anxiety that does not abate and stems from paranoia rather than negative judgments about self. These symptoms must not occur only during the course of a disorder with similar symptoms (such as schizophrenia or autism spectrum disorder).
The ICD-10 includes a diagnostic guideline for the wide group of personality and behavioural disorders. However, every disorder has its own diagnostic criteria. In case of the organic personality disorder, patient has to show at least three of the following diagnostic criteria over a six or more months period. organic personality disorder is associated with a large variety of symptoms, such as deficits in cognitive function, dysfunctional behaviours, psychosis, neurosis, emotional changes, alterations in expression function and irritability. Patients with organic personality disorder can present emotional lability that means their emotional expressions are unstable and fluctuating. In addition, patients show reduction in ability of perseverance with their goals and they express disinhibited behaviours, which are characterised by inappropriate sexual and antisocial actions. For instance, patients can show dissocial behaviours, like stealing. Moreover, according to diagnostic guideline of ICD-10, patients can suffer from cognitive disturbances and they present signs of suspiciousness and paranoid ideas. Additionally, patients may present alteration in process of language production that means there are changes in language rate and flow. Furthermore, patients may show changes in their sexual preference and hyposexuality symptoms.
Another common feature of personality of patients with organic personality disorder is their dysfunctional and maladaptive behaviour that causes serious problems in these patients, because they face problems with pursuit and achievement of their goals. It is worth to be mentioned that patients with organic personality disorder express a feeling of unreasonable satisfaction and euphoria. Also, the patients show aggressive behaviours sometimes and these serious dysfunctions in their behaviour can have effects on their life and their relationships with other people. Specifically patients show intense signs of anger and aggression because of their inability to handle their impulses. The type of this aggression is called "impulsive aggression". Furthermore, it is worth to be mentioned that the pattern of organic personality disorder presents some similarities with pattern of temporal lobe epilepsy (TLE). Specifically patients who suffer from this chronic disorder type of epilepsy, express aggressive behaviours, likewise it happens to patients with organic personality disorder. Another similar symptom between Temporal lobe epilepsy and organic personality disorder is the epileptic seizure. The symptom of epileptic seizure has influence on patients' personality that means it causes behavioural alterations". The Temporal lobe epilepsy (TLE) is associated with the hyperexcitability of the medial temporal lobe (MTL) of patients. Finally, patients with organic personality disorder may present similar symptoms with patients, who suffer from the Huntington's disease as well. The symptoms of apathy and irritability are common between these two groups of patients.
People with HPD are usually high-functioning, both socially and professionally. They usually have good social skills, despite tending to use them to manipulate others into making them the center of attention. HPD may also affect a person's social and/or romantic relationships, as well as their ability to cope with losses or failures. They may seek treatment for clinical depression when romantic (or other close personal) relationships end.
Individuals with HPD often fail to see their own personal situation realistically, instead dramatizing and exaggerating their difficulties. They may go through frequent job changes, as they become easily bored and may prefer withdrawing from frustration (instead of facing it). Because they tend to crave novelty and excitement, they may place themselves in risky situations. All of these factors may lead to greater risk of developing clinical depression.
Additional characteristics may include:
- Exhibitionist behavior
- Constant seeking of reassurance or approval
- Excessive sensitivity to criticism or disapproval
- Pride of own personality and unwillingness to change, viewing any change as a threat
- Inappropriately seductive appearance or behavior of a sexual nature
- Using somatic symptoms (of physical illness) to garner attention
- A need to be the center of attention
- Low tolerance for frustration or delayed gratification
- Rapidly shifting emotional states that may appear superficial or exaggerated to others
- Tendency to believe that relationships are more intimate than they actually are
- Making rash decisions
- Blaming personal failures or disappointments on others
- Being easily influenced by others, especially those who treat them approvingly
- Being overly dramatic and emotional
Some people with histrionic traits or personality disorder change their seduction technique into a more maternal or paternal style as they age.
Theodore Millon proposes two subtypes of schizotypal. Any individual with schizotypal personality disorder may exhibit either one of the following somewhat different subtypes "("Note that Millon believes it is rare for a personality with one pure variant, but rather a mixture of one major variant with one or more secondary variants):"
A mental disorder, also called a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitting, or occur as a single episode. Many disorders have been described, with signs and symptoms that vary widely between specific disorders. Such disorders may be diagnosed by a mental health professional.
The causes of mental disorders are often unclear. Theories may incorporate findings from a range of fields. Mental disorders are usually defined by a combination of how a person behaves, feels, perceives, or thinks. This may be associated with particular regions or functions of the brain, often in a social context. A mental disorder is one aspect of mental health. Cultural and religious beliefs, as well as social norms, should be taken into account when making a diagnosis.
Services are based in psychiatric hospitals or in the community, and assessments are carried out by psychiatrists, psychologists, and clinical social workers, using various methods but often relying on observation and questioning. Treatments are provided by various mental health professionals. Psychotherapy and psychiatric medication are two major treatment options. Other treatments include social interventions, peer support, and self-help. In a minority of cases there might be involuntary detention or treatment. Prevention programs have been shown to reduce depression.
Common mental disorders include depression, which affects about 400 million, dementia which affects about 35 million, and schizophrenia, which affects about 21 million people globally. Stigma and discrimination can add to the suffering and disability associated with mental disorders, leading to various social movements attempting to increase understanding and challenge social exclusion.
Some debates have pervaded the field of psychology since its genesis. Perhaps one of the most salient ones deals with the nature of personality. Personality psychology studies one's distinctive style of cognition, behavior, and affect. However, this concept elicits discord among psychologists as some have insisted that it does not exist, while others struggle with issues of measurement.
A mnemonic that can be used to remember the characteristics of histrionic personality disorder is shortened as "PRAISE ME":
- Provocative (or seductive) behavior
- Relationships are considered more intimate than they actually are
- Attention-seeking
- Influenced easily by others or circumstances
- Speech (style) wants to impress; lacks detail
- Emotional lability; shallowness
- Make-up; physical appearance is used to draw attention to self
- Exaggerated emotions; theatrical
People with BPD may be misdiagnosed for a variety of reasons. One reason for misdiagnosis is BPD has symptoms that coexist (comorbidity) with other disorders such as depression, PTSD, and bipolar disorder.
Personality disorders (PD) are a class of mental disorders characterized by enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating markedly from those accepted by the individual's culture. These patterns develop early, are inflexible, and are associated with significant distress or disability. The definitions may vary somewhat, according to source. Official criteria for diagnosing personality disorders are listed in the "Diagnostic and Statistical Manual of Mental Disorders" (DSM) and the of the "International Classification of Diseases" (ICD). The DSM-5 lists personality disorders in the same way as other mental disorders, rather than on a separate 'axis', as previously.
Personality, defined psychologically, is the set of enduring behavioral and mental traits that distinguish between individual humans. Hence, personality disorders are defined by experiences and behaviors that differ from societal norms and expectations. Those diagnosed with a personality disorder may experience difficulties in cognition, emotiveness, interpersonal functioning, or impulse control. In general, personality disorders are diagnosed in 40–60% of psychiatric patients, making them the most frequent of psychiatric diagnoses.
Personality disorders are characterized by an enduring collection of behavioral patterns often associated with considerable personal, social, and occupational disruption. Personality disorders are also inflexible and pervasive across many situations, largely due to the fact that such behavior may be ego-syntonic (i.e. the patterns are consistent with the ego integrity of the individual) and are therefore perceived to be appropriate by that individual. This behavior can result in maladaptive coping skills and may lead to personal problems that induce extreme anxiety, distress, or depression. These behaviour patterns are typically recognized in adolescence, the beginning of adulthood or sometimes even childhood and often have a pervasive negative impact on the quality of life.
Many issues occur with classifying a personality disorder. Because the theory and diagnosis of personality disorders occur within prevailing cultural expectations, their validity is contested by some experts on the basis of inevitable subjectivity. They argue that the theory and diagnosis of personality disorders are based strictly on social, or even sociopolitical and economic considerations.
The Diagnostic and Statistical Manual of Mental Disorders revision IV (DSM-IV) describes passive–aggressive personality disorder as a "pervasive pattern of negativistic attitudes and passive resistance to demands for adequate performance in social and occupational situations."
Passive-aggressive behavior is the obligatory symptom of the passive–aggressive personality disorder. Persons with passive–aggressive personality disorder are characterized by procrastination, covert obstructionism, inefficiency and stubbornness.
The diagnosis of PTSD was originally developed for adults who had suffered from a single event trauma, such as rape, or a traumatic experience during a war. However, the situation for many children is quite different. Children can suffer chronic trauma such as maltreatment, family violence, and a disruption in attachment to their primary caregiver. In many cases, it is the child's caregiver who caused the trauma. The diagnosis of PTSD does not take into account how the developmental stages of children may affect their symptoms and how trauma can affect a child’s development.
The term developmental trauma disorder (DTD) has also been suggested. This developmental form of trauma places children at risk for developing psychiatric and medical disorders. Bessel van der Kolk explains DTD as numerous encounters with interpersonal trauma such as physical assault, sexual assault, violence or death. It can also be characterized by subjective events like betrayal, defeat or shame.
Repeated traumatization during childhood leads to symptoms that differ from those described for PTSD. Cook and others describe symptoms and behavioural characteristics in seven domains:
- "Attachment" – "problems with relationship boundaries, lack of trust, social isolation, difficulty perceiving and responding to others' emotional states"
- "Biology" – "sensory-motor developmental dysfunction, sensory-integration difficulties, somatization, and increased medical problems"
- "Affect or emotional regulation" – "poor affect regulation, difficulty identifying and expressing emotions and internal states, and difficulties communicating needs, wants, and wishes"
- "Dissociation" – "amnesia, depersonalization, discrete states of consciousness with discrete memories, affect, and functioning, and impaired memory for state-based events"
- "Behavioural control" – "problems with impulse control, aggression, pathological self-soothing, and sleep problems"
- "Cognition" – "difficulty regulating attention, problems with a variety of 'executive functions' such as planning, judgement, initiation, use of materials, and self-monitoring, difficulty processing new information, difficulty focusing and completing tasks, poor object constancy, problems with 'cause-effect' thinking, and language developmental problems such as a gap between receptive and expressive communication abilities."
- "Self-concept" – "fragmented and disconnected autobiographical narrative, disturbed body image, low self-esteem, excessive shame, and negative internal working models of self".
Ganser syndrome was once considered a separate factitious disorder. It is a disorder of extreme stress or an organic condition. The patient suffers from approximation or giving absurd answers to simple questions. The syndrome is sometimes diagnosed as merely malingering—however, it is more often defined as a factitious disorder. This has been seen in prisoners following solitary confinement, and the symptoms are consistent in different prisons, though the patients do not know one another.
Symptoms include a clouding of consciousness, somatic conversion symptoms, confusion, stress, loss of personal identity, echolalia, and echopraxia. Individuals also give approximate answers to simple questions such as, "How many legs on a cat?" "Three"; "What's the day after Wednesday?" "Friday"; and so on. The disorder is extraordinarily rare with fewer than 100 recorded cases. While individuals of all backgrounds have been reported with the disorder, there is a higher inclination towards males (75% or more). The average age of those with Ganser syndrome is 32, though it stretches from ages 15–62 years old.
Factitious disorder should be distinguished from somatic symptom disorder (formerly called somatization disorder), in which the patient is truly experiencing the symptoms and has no intention to deceive.
In conversion disorder (previously called hysteria), a neurological deficit appears with no organic cause. The patient, again, is truly experiencing the symptoms and signs and has no intention to deceive.
The differential also includes body dysmorphic disorder and pain disorder.
Conduct disorder (CD) is a mental disorder diagnosed in childhood or adolescence that presents itself through a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate norms are violated. These behaviors are often referred to as "antisocial behaviors." It is often seen as the precursor to antisocial personality disorder, which is per definition not diagnosed until the individual is 18 years old.
Conduct disorder is estimated to affect 51.1 million people globally as of 2013.