Rosh Psychiatry Board Practice Exam

What is the likely diagnosis for a 16-year-old boy with a history of defiant behavior and legal issues?

1. Attention-deficit hyperactivity disorder

2. Conduct disorder

3. Intermittent explosive disorder

4. Oppositional defiant disorder

The correct answer is: Conduct disorder

The diagnosis of conduct disorder is well-suited for this 16-year-old boy, particularly given his history of defiant behavior coupled with legal issues. Conduct disorder is characterized by patterns of behavior that violate the rights of others and societal norms, such as aggression towards people or animals, destruction of property, deceitfulness, or serious rule violations. In adolescents, this may manifest through delinquent activities, which can include theft, vandalism, or other legal infractions. The presence of legal issues typically signifies a more significant pattern of antisocial behavior, which aligns with the criteria for conduct disorder rather than other disorders. While oppositional defiant disorder shares some characteristics, such as defiance and argumentative behavior, it does not involve the more severe behaviors and violations of norms seen in conduct disorder. In summary, the combination of the boy's defiant behavior and legal troubles points toward conduct disorder as the most fitting diagnosis.