he parents of a child report that the child steals small items, shows little or no remorse when caught, and frequently bullies younger children at school. Which of the following is the most likely diagnosis?

1. A

   Oppositional defiant disorder (ODD)

2. B

   Attention-deficit/hyperactivity disorder (ADHD)

3. C

   Conduct disorder

4. D

   Conversion disorder

Appeared in: AIIMS M.Sc. Nsg Entrance exam-2026

Explanation

• The correct diagnosis is Conduct Disorder because the child's behaviors—stealing, bullying, and lack of remorse—are hallmark features.
• Conduct Disorder is characterized by a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms are violated.
• The key symptoms presented in the scenario fall into the categories of aggression towards others (bullying) and deceitfulness or theft (stealing).
• The lack of remorse is a crucial specifier for Conduct Disorder, known as 'with limited prosocial emotions,' indicating a more severe form of the disorder.

Why Other Options Were Wrong

• Option A: Oppositional Defiant Disorder (ODD) involves a pattern of angry/irritable mood and defiant behavior primarily toward authority figures. It does not typically include the severe violation of others' rights like stealing and bullying.
• Option B: Attention-Deficit/Hyperactivity Disorder (ADHD) is defined by symptoms of inattention and/or hyperactivity-impulsivity. While impulsivity can lead to poor decisions, a persistent pattern of calculated bullying and theft with no remorse is not a core feature of ADHD.
• Option D: Conversion Disorder (Functional Neurological Symptom Disorder) is a psychiatric condition where a person has physical symptoms, such as paralysis or blindness, that cannot be explained by a medical condition. It is completely unrelated to behavioral problems.

Related Visual

• Visual 1: Infographic: A comparative chart showing the overlapping and distinct symptoms of ODD, Conduct Disorder, and ADHD to help visualize the key differences.
• Visual 2: Flowchart: A diagram illustrating the potential progression from ODD in early childhood to Conduct Disorder in adolescence, and the increased risk for Antisocial Personality Disorder in adulthood.

Clinical Relevance

• Nursing practice connection: Use the key finding related to Differential diagnosis of childhood behavioral disorders based on presenting symptoms to guide bedside assessment, documentation, and the next nursing action.
• Early identification of Conduct Disorder is critical for nurses, as it allows for timely intervention which can alter the long-term prognosis.
• Nurses play a key role in educating parents about behavioral management techniques, the importance of consistency, and connecting the family with mental health resources like therapy and counseling.
• Without treatment, individuals with Conduct Disorder are at high risk for legal trouble, substance abuse, and developing Antisocial Personality Disorder in adulthood. Nursing assessment should include screening for these risk factors.

How to Approach the Question

• First, carefully read the clinical vignette and identify the key behaviors presented: 1) stealing, 2) lack of remorse, and 3) bullying.
• Next, analyze these behaviors. Stealing and bullying are actions that violate the rights of others. Lack of remorse points to a deficit in empathy.
• Review the diagnostic criteria for each option. Match the identified behaviors to the disorder that best encompasses them.
• ODD is about defiance to authority, not severe violation of rights. ADHD is about inattention/impulsivity, not a pattern of aggression and theft. Conversion disorder involves physical symptoms.
• Conclude that the combination of aggression (bullying), theft, and lack of remorse are the classic triad for Conduct Disorder.

Concept Tested & Keywords

• Concept Tested: Differential diagnosis of childhood behavioral disorders based on presenting symptoms.
• Stem keywords: child, steals, little or no remorse, bullies
• Lead-in keywords: most likely diagnosis
• Clinical cues: The combination of stealing, bullying, and lack of remorse points towards a specific diagnosis that involves violation of others' rights.

Question ID

Q4qY7JIgWzOEaw2RA-fe_L

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