Function! Function! Function!
Imagine a continuum, where one end represents emotional sensitivity, and the other end is callous unemotional. Supersensers are closer to the emotional sensitivity side, while conduct disorder children are closer to the callous unemotional side. The two types are radically different, yet, behaviorally they may look very much alike (screaming, yelling, cursing, breaking things, punching, kicking, etc.).
To understand the difference, we need to imagine another continuum – dysregulated dysregulation on the one end and regulated dysregulation on the other end. Dysregulated dysregulation occurs in a state of emotional intoxication, where a reaction usually functions to decrease emotional arousal. Supersensers have dysregulated dysregulation. Regulated dysregulation occurs in a state of emotional sobriety, where a reaction functions to achieve an instrumental gain. Callous unemotional children usually have regulated dysregulation. People who are callous unemotional do not easily get emotionally intoxicated. This is simple biology, as limbic system (area in the brain that produces emotions) is larger than average in emotionally sensitive people and smaller than average in callous unemotional people.
Thus, emotionally sensitive children have reactive aggression. They do not have strong enough emotion regulation muscles to withstand the impact of their emotional tsunamis. Frequently after an outburst, such children are remorseful and upset about their behavior. Children with conduct disorder, on the other hand, present with proactive or predatory aggression. The main function of their outbursts is usually instrumental – to achieve a desired outcome, as opposed to cope with an extreme emotional arousal. Proactive means occurring with a prior plan in mind. Predatory means using others as objects to achieve a personal gain. Usually after an outburst, such children do not express remorse.
Oppositional Defiant Disorder is just a list of maladaptive behavioral responses. This list can describe reactive as well as proactive responding. The list itself is not useful without understanding the function of a response.