chapter 11: disruptive, impulse-control, and conduct disorders

Question 1

define conduct disorder

Answer 1

repetitive behavior pattern of violating basic human rights of others or major age appropriate societal norms
- aggression towards people and animals
- destruction of property
- deceitfulness or theft
- serious violations of rules
using begins in childhood and adolescents
- 12% life prevalence in males and 7% in females
2-5% (5-12 yrs old), 5-9% (13-18 yrs old)
- african mercian children more likely to be diagnosed with conduct disorder
- worse lifetime behavior issues (antisocial, difficult to stay employed, family relationship) when behavior onset is earlier in age
- american american males under 11, are 11x more likely to have comorbid psychosis and 7x more likely to have depression when from low-income compared to high-income children with same disorder

Question 2

oppositional defiant disorder

Answer 2

behavior is angry/ irritable, argumentative/defiant, and vindictive
- symptoms usually begin during toddler/preschool years
- children can later on be diagnosed with conductive disorder, substance use disorder, mood and anxiety disorder
- boys 3x more likely than girls to be diagnosed with conduct and oppositional defiant
- males 10-15x more likely to have lifetime antisocial behavior (but now thinking girls just show it differently through emotions and verbal)

Question 3

bio factors for conduct and oppositional defiant disorder

Answer 3

• parental history of antisocial behavior
• gene monoamine oxidase that encodes enzyme to metabolize serotonin, dopamine, and norepinephrine.
• deficit in brain system responsible for planning and controlling behavior and processing reward and punishment (prefrontal cortex, and anterior cingulate)
• less amygdala activity to emotional stimuli
• problem with executive functioning and visual working memory to recognize various emotions in others
• exposure to neurotoxins and drugs prenatally
• increased serotonin may be correlated with aggression and impulsive behavior
• children with may experience lower physiological responses to stress (there heart rate stays low, etc) so they are willing to push more boundaries because they are not as frightened)
• or if paired with anxiety, will have an excessive physiological response to stress

Question 4

social factors associated with conduct disorder

Answer 4

• lower SES and urban areas
• thought bio based difficult temperament that interacts with parents and their environment to produce behavioral problems
• physical abuse or neglect
• malnutrition can interfere with brain development, protein deficiency is linked with antisocial behavior
• can help by surrounding themselves with those who do not have conduct problems

Question 5

cognitive factors of conductive disorder

Answer 5

• based behavior on their own assumptions instead of reading the social situation, think anything besides aggression in useless or unattractive

Question 6

neurophys problems seen in children with conduct disorder

Answer 6

irritable, impulsive, awkward, overreactive, inattentive, slow to learn

Question 7

psychological and social therapy for conduct disorder

Answer 7

• CBT to help interpersonal interactions, and self-talk to learn other ways to handle situations instead of violence
• they first need to understand what situations trigger their aggressive and impulsive behaviors
• problem-solving
• have to consider cultural element too with parenting because kids are likely to relapse if parents have poor skills, history of alcoholism/ drug abuse or other psychopathology

Question 8

drug therapies

Answer 8

comorbid with ADHD so stimulants can be helpful
- atypical antipsychotics

Question 9

antisocial personality disorder - most socially destructive personality disorder

Answer 9

disregard and violation of rights of others (usually since age 15) and have impulse control, deceitfulness, irritability, reckless, irresponsible, lack of remorse, etc.
- they have complete acts like murder and feel no remorse or pain from suffering they have cause
- cannot handle a daily routine or marriage due to the structure and responsibility
- in prison: 50-80% of males and 20% of females diagnosed with ASPD

Question 10

stats of antisocial disorder

Answer 10

• lifetime prevalence of 1-4% with males 3-5x more likely to be diagnosed than females
• 80% of those with this diagnosis will abuse drugs and alcohol
• conduct disorder thought of as precursor

Question 11

contributors to antisocial personality disorder

Answer 11

38-69% heritability
- serotonin abnormality
- socioeconomically deprived
- lower verbal skills and executive functioning
- less grey matter in prefrontal cortex in males
-fearlessness
- seek stimulation and can be found in unhealthy ways

Question 12

treatment for antisocial disorder

Answer 12

at the moment its often the most excluded disorder from mental health services
- no meds currently approved, could try drugs to help comorbid symptoms

Question 13

intermittent explosive disorder

Answer 13

• over age 6 relatively frequent impulsive acts of aggression that are verbal or physical, grossly out of proportion, and are not dont to gain some advantage
• thought 3.5-7% of population could be diagnosed with
  -lower activity in orbitofrontal cortex (OFC) and hyperactivity in amygdala
• runs in families but is unclear if this is due to genetic, environmental, or parental

Question 14

treatment for intermittent explosive disorder

Answer 14

CBT: identify triggers and teach to look at situations in ways that do not provoke aggression
- individual and group sessions are thought to be effective
-meds: serotonin, norepinephrine re-uptake inhibitors