Paediatricsmiddle twist
An 8-year-old boy is brought in by his mother, who describes fourteen months of daily arguing with adults, deliberate refusal to follow instructions, blaming his sister for things he has done, and being touchy and resentful. His teacher reports the same pattern in class. He has never stolen, damaged property, been physically aggressive or hurt an animal, and he has never truanted. Between episodes his mood is cheerful. He sits through his homework, finishes what he starts and is not restless. Which one of the following best fits this pattern of behaviour?