Rosh Psychiatry Board Practice Exam

Which of the following additional behaviors is most consistent with a child demonstrating chronic anger and defiance?

1. Depressed mood

2. Distractibility

3. Vindictiveness

4. Violence

The correct answer is: Vindictiveness

A child exhibiting chronic anger and defiance often displays a range of behaviors that reflect feelings of frustration, resentment, and a desire for control. Vindictiveness, as an additional behavior, aligns closely with these feelings. It indicates a propensity to retaliate or seek revenge when the child feels wronged or disrespected, further emphasizing their struggles with anger regulation and defiance toward authority figures. This behavior can manifest as intentionally hurtful actions or remarks directed at peers or caregivers, reinforcing relational conflicts and contributing to a cycle of negative interactions. It also suggests an underlying emotional disturbance where the child feels justified in their aggressive responses, reflecting a problematic coping mechanism for processing their emotions. In contrast, while depressed mood may be present in some children with behavioral issues, it does not directly relate to the chronic anger and defiance being described. Distractibility can indicate attentional problems rather than defiant behavior, and although violence could be a concern, it is a more extreme manifestation that may not be consistently observed among all children with chronic anger and defiance. Thus, vindictiveness stands out as the most fitting behavior associated with the pattern described.