Child Abnormal: Conduct Problems Flashcards
Conduct disorders leading to adult disorders later in life?
- longitudinal studies show early onset conduct disorder highly predictive on adult disorders later in life e.g. anxiety, antisocial pd, substance use, eating disorders
- conduct suggests something wrong with social and emotional development, focus on them to prevent mental illness
EXTERNALISING DISORDERS: DSM-5
Attention-Deficit/Hyperactivity Disorder
Oppositional defiant disorder
Conduct disorder
ODD & Conduct Disorder –> Conduct Problems
- ODD most common out of 2
OPPOSITIONAL DEFIANT DISORDER
A. A pattern of negativistic, hostile, and defiant behavior lasting at least 6
months, during which four (or more) of the following are present:
(1) often loses temper
(2) often argues with adults
(3) often actively defies/refuses to comply with adults’ requests/rules
(4) often deliberately annoys people
(5) often blames others for mistakes/misbehavior
(6) is often touchy or easily annoyed by others
(7) is often angry and resentful
(8) is often spiteful or vindictive
ODD & Heterogeneity
Symptoms grouped along 3 dimensions
(1) Angry/irritable mood –> negative affectivity, correlates highly with mood/anxiety/depression (often loses temper, touchy, easily annoyed, angry or resentful)
(2) Argumentative/defiant behaviour –> associated with ADHD (argues with adults, deliberately annoys others, blames others for their mistakes)
(3) Vindictiveness –> lowest frequency, instrumental aggression, associated with callous, unemotional traits (spiteful)
Family influences on Conduct Problems - Patterson’s (1982) coercion theory
The dominant causal model of conduct problems based of Skinnerian operant learning (reinforcer/punisher)
Mechanisms based in the moment-to-moment interactions
between parents and children form traps of escalation cycles
Parent gives directive –> child non-compliance –> parent attacks –> child is positively reinforced and counterattacks –> parent is negatively reinforced and withdraws –> child suspends attack
Parent-child interactions play out
as an Interlocking pattern of reinforcement, Coercive cycles will continue over time but reach high levels more rapidly and be pushed to higher and higher amplitudes
Family members continuously training each other in coercion
The child becomes more skilled, and therefore more difficult to discipline
Parent begins to avoid contact with child so child pulls for more contact
Both parties as victim and architect
Implications for early development - Self regulation
In order to develop self-regulation a child must first develop the capacity for compliance with external regulation (be taught self-regulation by environment)
- Coercive patterns disrupt the developmental
prerequisites for emerging self-regulation
(internal controls over behaviour / emotion / thinking)
Implications for early development
Failure to establish normative compliance in early childhood
Coercive behaviour functions as a substitute social skill
Child becomes increasingly harder to discipline and socialise
Enters school with social skills deficits
Entrained coercive exchanges generalise to teachers and peers
Deviancy training
Through the contingencies supplied by peers, antisocial
children mutually reinforce such behaviour in one another e.g. selectively attending
to deviant talk and ignore / punishing
prosocial talk.
Externalising trajectory
Family and peer relationship processes, and the emergence, amplification and transformation of maladaptation across an externalising trajectory
Origins in temper tantrums and oppositional behaviour, driven by coercive family process, as child goes to school acts in same way
Conduct Disorder
A. A repetitive and persistent pattern of behavior in which the basic rights of
others or major age-appropriate societal norms or rules are violated, as
manifested by the presence of three (or more) of the following criteria in the
past 12 months, with at least one criterion present in the past 6 months:
1. Aggression to people and animals –> often bullies, threatens, or intimidates others, often initiates physical fights, has used a weapon that can cause serious physical harm, has been physically cruel to people, has been physically cruel to animals, has stolen while confronting a victim, has forced someone into sexual activity
2. Destruction of property –> has deliberately engaged in fire setting with the intention of causing serious damage has deliberately destroyed others’ property (other than by fire setting)
3. Deceitfulness or theft –> has broken into someone else’s house, building, or car, often lies to obtain goods or favors or to avoid obligations (i.e., “cons” others), has stolen items of nontrivial value without confronting a victim (e.g., shoplifting)
4. Serious violations of rules –> often stays out at night despite parental prohibitions, beginning before age 13 years, has run away from home overnight at least twice while living in parental or parental surrogate home (or once without returning for a lengthy period), is often truant from school
CONDUCT DISORDER & HETEROGENEITY
- Conduct disorder usually late childhood into teen years mostly
- Adolescent onset type more normative, tend to grow out of it
- Females not generally delinquent/aggressive compared to males (later onset)
Onset Types
Childhood-Onset Type
- Onset of at least one criterion characteristic of conduct disorder prior to age10yrs
- Neurocognitive risk factors (e.g., executive function deficits, low verbal IQ)
- Temperamental/personality risk factors (e.g.,
impulsivity and problems in emotional regulation)
- Coercive parent-child dynamics
Adolescent-Onset Type
- Absence of any criteria characteristic of Conduct Disorder prior to age 10 years
- No such risk factors, an exaggeration of the normative process of adolescent rebellion
Heterogeneity within this high-risk, early onset group?
Specifier for ‘limited prosocial emotions’ “…at least two of the following characteristics persistently over at least 12 months…in multiple relationships and settings.”
- Lack of remorse or guilt, Callous-lack of empathy, Unconcerned about performance, Shallow or deficient affect
- Callous Unemotional traits = pschyopathic traits
Low & High CU
Low CU (hot): Emotionally dysregulated, Over reactive to emotional cues, Reactive aggression, Hostile attributional biases
High CU (cold): More severe & chronic, Proactive aggression, Reward-dominance, Under-reactive to emotional cues
Attention to eyes & fear recognition
- High CU reduced ability to detect fear stimuli, don’t look at right spot (CONCENTRATE ON MOUTH WHEN SHOULD ON EYES), don’t have awareness of emotional environment, reduced amygdala activity –> less attentional ability
- doesn’t not feel, just doesn’t pay attention to right thing?
