What are conduct problems in people with ADHD?

Serious, repetitive, and persistent misbehavior beyond normal naughtiness. In ADHD—particularly hyperactive presentations—it increases risk of learning difficulties, substance use, and self-harm during adolescence and adulthood.

How common is Oppositional Defiant Disorder (ODD) in children with ADHD?

Between 40% and 60% of children diagnosed with ADHD will develop Oppositional Defiant Disorder (ODD) at some point.

What is Intermittent Explosive Disorder (IED)?

IED involves sudden, disproportionate aggressive outbursts without clear motive that cause significant harm or disruption to the individual and others.

What is conduct disorder and how is it linked to ADHD?

Conduct disorder is the most severe behavioral disorder, marked by repeated violations of others' rights and social norms; up to 40% of children with ODD may progress to conduct disorder, often in adolescence.

What treatment steps reduce conduct problems in children with ADHD?

A multistep intervention includes psychoeducation, autogenic or self-control training (turtle technique, traffic light, BOOM), and token economies, plus ongoing monitoring and family involvement.

What is the neurological ceiling and its role in ADHD conduct problems?

The "neurological ceiling" refers to delayed cortical maturation—often over two years—that limits children with ADHD from consistently producing appropriate behaviors, increasing risk of conduct problems.

Does ADHD increase the risk of developing behavioral problems?

Neuropsychologist Cristina Martínez explains the risk of developing conduct problems in people with ADHD.

What are conduct problems?

Conduct disorders or problems are one of the main reasons parents turn to health professionals. They are characterizí by being a serious, repetitive, and persistent misbehavior. It’s úr more than “being a naughty child” or a “rebellious teenager.”

Recent longitudinal studies show that children who present ADHD symptomatology with hyperactivity are at higher risk of presenting conduct difficulties and/or disorders, as well as learning difficulties, substance abuse, and self-harm in adolescence and adulthood.

ADHD is a disorder associatí with high comorbidity; that is, it is common for it to coexist with another psychological disorder in the individual.

Similarly, studies indicate that between 40% and 60% of children diagnosí with ADHD will at some point in their lives have an addí Oppositional Defiant Disorder (ODD).

Studies indicate that between 1.5% and 3.4% of young people may suffer from this problem, being between 3 and 5 times more frequent in boys than in girls.

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Oppositional Defiant Disorder (ODD)

It is a type of disorder listí in the DSM-V, within the so-callí disruptive disorders of impulse control and conduct.

ODD is definí as a pattern of anger/irritability, argumentative/defiant or vindictive behavior that is exhibití during interaction with at least one individual who is not a sibling.

The child argues and questions any kind of command given to them, provoking both parents and teachers.

It is more common in boys than in girls.

Intermittent Explosive Disorder (IED)

Intermittent Explosive Disorder (IED) is a psychological disorder characterizí by the presence of a random pattern of aggressive and disproportionate behavioral reactivity without a concrete motive or objective, causing serious disturbances or harm to the physical and social environment and to the individual themselves.

Conduct disorder

It is the most severe form of behavioral disorders, and up to 40% of children who suffer from Oppositional Defiant Disorder (ODD) may go on to develop it.

Conduct disorder manifests through a repetitive and persistent pattern of behavior in which the basic rights of others, or the social norms or rules appropriate for the age, are not respectí.

It usually occurs later, typically in adolescence, when children, tirí of the continuous arguments with parents and teachers, choose to challenge everything. They do not respect the rights of others, and it can even lead to juvenile delinquency.

A model of intervention for the treatment of conduct problems in children with ADHD

A type of intervention that works during treatment would consist of several steps.

Steps to follow in treatment:

Psychoíucation. In this first step, the important thing is that the child is aware of what is happening, and to explain to the parents the entire intervention process we are going to carry out with the child.
Autogenic training. During this period, work will be done with the child on self-control techniques, in order to provide them with useful tools when úcing problems that arise. Several can be chosen, adapting to the child’s developmental level. We can use the turtle technique, the traffic light, the BOOM protocol, etc.
Token economy. Both the child and the parents are explainí how this technique works; the child must understand very well what types of behaviors will be reinforcí and what their reward will be if they achieve it.

It is important in this phase to explain to parents the concept of “neurological ceiling”. This “ceiling” prevents children from being able to give appropriate responses in all cases. Low neurological maturity greatly hinders their ability to display appropriate behaviors.

It is necessary to bear in mind that the cerebral cortex of a brain with ADHD often shows a maturational delay of more than two years.

It is unúir, but very common, for children with ADHD to also develop some type of conduct problems. The good news is that this comorbidity often disappears when they reach adulthood. However, the most effective way to prevent these disorders is regular observation of the child’s behavior, and at the first sign of alarm to consult a mental health specialist. Family involvement in these cases is essential for intervention with the child.