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?
a) Oppositional defiant disorder
b) Conduct disorder
c) Disruptive mood dysregulation disorder
d) Attention/deficit hyperactivity disorder
b)
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