(in children) In adults, this type of thing would show up as an Axis II personality disorder.
In children, particularly 4 (very young for this kind of diagnosis, ADD/
ADHD as well - and I would hold off on the meds until a second or third opinion is obtained..cheaper than treatment I'm sure...) ALSO - (I have personal experience in this - my 5 yr old girl had wild tantrums, and I was very worried,, and took her to different drs...