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Coexisting Conditions: ADHD and Disruptive Behavior Disorders

by Caraline McDonnell, BA

Not every kid that has ADHD will have a coexisting disorder, but we do know that kids with ADHD are at higher risk for coexisting mental health problems than their peers. Some of the most common coexisting conditions are other Disruptive Behavior Disorders; such as, Oppositional Defiant Disorder and Conduct Disorder.

What is a Disruptive Behavior Disorder?

Oppositional Defiant Disorder (ODD) is generally identified by a consistent pattern of defiant and hostile behavior towards authority figures, mostly adults that they know well like caregivers or teachers. This pattern will cause difficulties in daily life at home, in school, or with peers.

Some of these behaviors may include:

  • Often losing their temper
  • Refusing to comply with the requests or rules of teacher and parents
  • Often feeling angry or having a desire to hurt others that have caused them problems
  • Annoying others on purpose
  • Blaming others for their own misbehavior.

The frequency of these behaviors are higher for kids with ODD than their peers. ODD is most often diagnosed prior to 8 years old, but it is also known to occur in adolescents.

It's important to note that a diagnosis of ODD does not mean that they will be permanently defiant or at risk of behavior difficulties for the rest of their lives. ODD is often a temporary diagnosis that kids can grow out of if it is addressed early and with evidence-based treatment.

Conduct Disorder (CD) is defined by a consistent behavioral pattern of aggression, and serious violations of rules, laws, and social norms such as stealing, lying, physical fighting, bullying, destroying property, sneaking out when told not to, and harming other people or animals. Conduct disorder is a more severe version of ODD, where the child or teen is intentionally harming others. If left unaddressed, the behaviors associated with Conduct Disorder make it more likely that the individual will get into trouble with the law and face serious consequences.

What Causes Disruptive Behavior Disorders?

The exact causes of Disruptive Behavior Disorders are unknown, but we know that they are more likely to occur when children are exposed to certain risk factors. However, sometimes children with DBDs are just smart and like to test and push against limits. Children with DBDs often demonstrate skills like challenging authority, thinking about things from a different perspective, and thinking critically that can be really great traits for teenagers or adults, but that make parenting and/or teaching a younger child very challenging and sometimes stressful.

Some common risk factors associated with children who have disruptive behavior disorders including having biological parents with mental health disorders such as substance abuse issues, ADHD, mood disorders, and schizophrenia. Research has also found that children who experience an inconsistent or unstable environment at home may be more likely to have disruptive behavior disorders. This includes children who grow up in a house with differing approaches and philosophies to parenting, children who are separated from their parents, who are physically, emotionally, or sexually abused, who experience poverty, or who witness domestic violence or substance abuse. There is also a greater risk for children who were born prematurely, or who have suffered neurological damage.

ADHD as Related to Anxiety and Depression

Kids with ADHD are more likely to experience symptoms of both anxiety and depressive disorders. Many of the experiences that children have because of their ADHD, like difficulty meeting expectations at school, having a hard time maintaining peer relationships, and getting in trouble with both caregivers and teachers, make it more likely that they will develop a lower self-esteem and symptoms of anxiety and depression

For example, a kid with ADHD might become anxious about school and homework assignments because it is a huge challenge to succeed, and they feel sad or worthless if they continue to fail in school. Additionally, a child with ADHD might have a hard time connecting with their peers, and after repeated unsuccessful attempts or continued exclusion by peers, they might develop anxious feelings around their ability to socialize.

What Can I Do About It?

Consulting with a mental health professional and getting a thorough evaluation will be your first step towards identifying any appropriate diagnoses for your child, and the most effective treatments to address them. Stay tuned for our next blog to learn about the most effective treatments for both ADHD and other disruptive behavior disorders.

Want to learn more?

Centers for Disease Control and Prevention. (2023a, September 27). Other concerns and conditions with ADHD. Centers for Disease Control and Prevention.
Centers for Disease Control and Prevention. (2023b, September 27). Treatment of ADHD. Centers for Disease Control and Prevention.
Centers for Disease Control and Prevention. (2023c, September 27). What is ADHD?. Centers for Disease Control and Prevention.
Disruptive behavior disorders. (DBD): Symptoms, Diagnosis and Treatment. (n.d.).
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