22 Conduct problems Flashcards
What was found in the Kim-Cohen et al. (2013) 26-year longitudinal study of rates at which childhood disorders preceded adult disorders?
Childhood conduct problems were the most common precursor to adult mental health problems.
What are two corollaries of the Kim-Cohen et. al (2013) finding, in their longitudinal study of population of a small town until 26 years old, that conduct disorder are the most common precursor to adult mental health problems?
- Best time to prevent antisocial behaviour is in childhood.
- Childhood conduct problems are a mental health issue.
What are the 3 externalising disorders in DSM-5?
Attention-deficit/hyperactivity disorder
Oppositional defiant disorder
Conduct disorder
What are the 8 symptoms of the A criterion of Oppositional Defiant Disorder?
A. A pattern of negativistic, hostile and defiant behaviour lasting at least 6 months, during which four (or more) of the following are present:
Angry/Irritable Mood
- Often loses temper
- Is often touchy or easily annoyed by others
- Is often angry and resentful
Argumentativeness/defiant behaviour
- Often argues with adults
- Often actively defies/refuses to comply with adults’ requests/rules
- Often deliberately annoys people
- Often blames others for mistakes/behaviour
Vindictiveness
8. Is often spiteful and vindictive
What are the three dimensions of Oppositional Defiant Disorder in the DSM-5?
- Angry/irritable mood (so strong emotional element)
- Argumentativeness/defiant behaviour (can exist without 1, but unusual)
- Vindictiveness
What disorders are associated with each dimension of Oppositional Defiant Disorder?
- Angry/irritable mood dimension –uniquely associated with mood and anxiety disorders
- Argumentative/defiant dimension –uniquely associated with ADHD
- Vindictiveness dimension –uniquely associated with callousness; empathic deficits; instrumental aggression
What’s the difference between instrumental and reactive aggression?
Instrumental aggression is planned for a purpose
Reactive aggression is a reaction to something undesired –e.g. loss of control, tantrums
What are the three severity specifiers for ODD, and how is their new inclusion in DSM-5 justified?
Mild: symptoms confined to only 1 setting
Moderate: Some symptoms present in at least 2 settings
Severe: Some symptoms present in 3 or more settings
Based on evidence that the number of settings the problem is present adds predictive value independent of how often the behaviour is occurring.
How is the setting in which symptoms of ODD are present differ from the case of ADHD?
Not unusual to find kid with ODD where symptoms are just in the home. Very different from ADHD –deficits are more stable across contexts.
What are the distal and proximal risk factors for conduct problems?
Distal
- Family adversity (e.g., marital discord, unemployment)
- Parent problems (e.g. depression, attributional biases - ‘child doing this to annoy me’
Proximal
Disrupted parenting practices (e.g., coercive interactions; monitoring/supervision)
How do distal risk factors for conduct problems confer risk on proximal problems?
Distal factors, such as family adversity and attributional biases, confer risk of conduct problems through disrupted parenting practices, such as coercive interactions.
Do conduct problems exist independently of a child’s environment?
No, they are highly embedded in the social relationships of a child’s life.
What is the dominant causal model of conduct problems?
Patterson’s Coercion Theory (1982)
Describe the coercive cycle in Patterson’s Coercion Theory?
- Parent gives directive
- Child noncomplies
- Parent attacks
- Child counterattacks (positively reinforced - child gets what it wants)
- Parent withdraws (negatively reinforced - parent avoids unpleasant interaction)
In coercive interactions, what percentage of exchanges were found to be in favour of the child?
70%
Describe the steps whereby exchanges resolve in favour of the parent in coercive interactions?
... Parent resumes attack Child noncomplies Parent escalates Child escalates Parent escalates sharply (positively reinforced) Child complies
What do the child and the parent both learn from the coercive cycle?
Child learn that usually gets his way if he reacts. Negative behaviour is reinforced. Positive behaviour is rarely reinforced.
Parent learns that shouting is the only thing that works. Avoids unnecessary interactions; engages with child only when it misbehaves.
What happens in coercive cycle over time if unchecked?
The misbehaviours escalate. Family members train each other in coercion. Child becomes more skilled and therefore more difficult to discipline.