Review Question - QID 214232

A 7-year-old boy is brought to the pediatrician for bad behavior. His teachers note that the child frequently has outbursts where he screams, yells, and occasionally throws objects at others. His symptoms are usually set off by minor stimuli such as recess ending early, and he then is in a disgruntled mood for the rest of the day. Even on good days, the child is observed to be more irritable than the other children. The child's parents also note this behavior at home. The patient's vitals are unremarkable. When the physician takes away the child's toy to do a physical exam, he begins screaming and attempts to punch the physician. Which of the following is the most likely diagnosis?