Dr. George Still

George Still was a physician in England. His work provided a more complete account of conceptualizing the disorder. He documented the following accounts in some of his child patients:

• Defiance: a tendency to resist; or contempt of opposition.
• Aggression: an unprovoked attack; hostile, injurious, or destructive behavior or outlook especially when caused by frustration.
• Emotionalism: having intense feelings and swings such as love, hate and despair.
• Resistance to Discipline: the act or instance of opposing discipline.
• Over-activity: an exaggerated state of being active, brisk and lively.
• Inability to Sustain Attention: unable to hold up or keep applying the mind to a specific object.
• Little Self-Control: limited ability to direct, regulate or restrain one’s self.

Dr. Still also noted that more boys than girls exhibited these behaviors and that there was a higher incidence of minor facial anomalies among these children. The conceptualization viewed these children as deficient in "volitional inhibition" that arose from "defects in moral control.” Although Dr. Still acknowledged that there was variation in moral and volitional control in the population at-large due to environmental and innate factors, he also believed that when such variations were extreme, they were due to biological factors.

For some of these children, Dr. Still suggested a possible hereditary inheritance, whereas in others he suggested that the behavioral variations were due to central nervous system insult either during the perinatal or postnatal period. Yet in another subset of children, he posited that these problems could be caused by acute brain disease or infection.