A 12-Year-Old Boy Is Brought to the Office Due to Behavioral

A 12-year-old boy is brought to the office due to behavioral problems.  His parents are upset about his poor grades and recent school suspension for setting fires in the locker room and stealing another student's cell phone.  They say that the boy has always been impulsive, had a lot of energy, and become angry and argumentative easily, but over the past year his aggressive behavior "has gotten out of control."  The patient says that the fires were an "accident," although he admits to being angry at the coach for kicking him off the basketball team.  Regarding the theft, he jokingly says, "People deserve to have their phones stolen when they are stupid enough to leave them in plain sight."  The patient has a history of getting into trouble for talking back to teachers, skipping class, and getting into fights since the fourth grade.  He has no medical history.  There is a family history of bipolar disorder and alcohol dependence.  The patient smokes cigarettes occasionally but denies illicit drug or alcohol use.  Which of the following is the most likely diagnosis in this patient?

A) Antisocial personality disorder
B) Attention-deficit hyperactivity disorder
C) Conduct disorder
D) Intermittent explosive disorder
E) Oppositional defiant disorder
F) Pyromania

Correct Answer:

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