Based on the case study below, please indicate a possible diagnosis for Kyle along with any specifiers. Are there any differentials you might consider? Additionally, note what you would suggest as far as treatment for Kyle (i.e. type of therapy, various interventions that might be helpful, etc). Who would be involved in his treatment? What additional resources might you suggest to him or his family?

Kyle is a 12-year-old boy who reluctantly agreed to admission to a psychiatric unit after getting arrested for breaking into a grocery store. His mother said she was "exhausted", adding that it was hard to raise a boy who "doesn't know the rules".

History: As a young child, Kyle was unusually aggressive, bullying other children and taking their things. When confronted by his mother, stepfather, or teacher, he tended to curse, punch, and show no concern for possible punishment. Kyle was previously diagnosed with ADHD due to being disruptive, impulsive, and "fidgety". He began seeing a psychiatrist in fourth grade for weekly psychotherapy and medication. He was sporadic with both his medication and therapy and often said his psychiatrist was "stupid". Kyle's early history was normal. He reached his milestones on time, there was no history of abuse, and he had no known medical problems or substance use nor did he participate in gang activity. He had not previously been caught with weapons, had not set fires, and had not been seen as particularly cruel to other children or animals. He had been regularly truant from school but had neither run away nor stayed away from home until late at night.

Recent behaviors: The year prior to admission, he was caught stealing from school lockers, disciplined after "mugging" a classmate for his wallet, and suspended after multiple physical fights with classmates. He was arrested twice for these behaviors. Others would say he is charming to strangers but people quickly caught on to him being a "con artist". He was consistently unremorseful, externalizing blame, and uninterested in the feelings of others. He was disorganized, inattentive, and uninterested in instruction, and constantly lost possessions. He usually did not do his homework and when he did, his performance was erratic. When confronted about his poor performance he would reply with "what are you going to do, shoot me?".

Family: Kyle lives with his mother, stepfather, and two younger half-siblings. his stepfather was unemployed and his mother worked part-time. His biological father was in prison for drug possession. Both biological grandfathers had a history of alcohol dependence.