Child: Conduct

Question 1

What did the Kim-Cohen et al (2003) New Zealand study show regarding the link between child and adult disorders

Answer 1

The biggest predictor of adult disorders was childhood conduct disorders.

Conducts problems os one of the first signs that there is something emotionally and behaviourally wrong

Question 2

What does conduct problems entail?

Answer 2

Oppositional Defiant Disorder (ODD) and Conduct Disorder

Question 3

What are the criteria for ODD

Answer 3

A pattern of negatavistic, hostile, and defiant behaviour lasting at least 6 months

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/misbehaviour
6) is often touchy or easily annoyed by others
7) is often angry and resentful
8) is often spiteful or vindictive

Question 4

How many of the ODD criteria must be met

Answer 4

FOUR (in the last 6 months)

Question 5

What are the

Answer 5

1) Angry/irritable mood
> feels done badly by
2) Argumentative/defiant dimension
> projects blame and argues
3) Vindicitiveness

Question 6

What are the angry/irritability dimension

Answer 6

angry and poor emotional regulation

> most likely leads to mood and anxiety disorder

Question 7

Arguementative dimension

Answer 7

ADHD

Question 8

Vindictiveness dimension

Answer 8

Callousness; empathic defecits; instrumental aggression - aggression to get what you want!

> lowest frequency amongst ODD

Question 9

What is Patterson’s (1982) coercion theory?

Answer 9

Family interactions based on social learning (operant conditioning) theory.

Husband gets yelled at to take out garbage, yelling escolates…
> He is negatively reinforced (removes aversive interchange)
> Wife is positively reinforced
(high escolation results in what she wants)

Question 10

Whats is the result of the coercion model

Answer 10

The 100’s of aversive interaction on a day to day basis:
> causes traps, which train (through negative and positive reinforcement) aggressive and hostile behaviour
> gradually attention patterns trap the child - they only get attention when they are naughty
> the parent no longer pays any positive attention to the child - only attend to child when they are aggressive and non-compliant
> the child will become a master at getting what they want through heightening on the aversive interchanges
> the child does not learn how to regulate

“The adult and child are both the victim and architect of this viscous cycle.”

Question 11

What are the implications of the coercion interchange in early development?

Answer 11

> The child will then take these un-regulated behaviour into school
The environment will reinforce this behaviour as the child will socialise with other kids of the same ‘defiance’.

Question 12

What are the four dimensions of conduct disorder?

Answer 12

1. Aggression to people and animals
2. Destruction of property
3. Deceitfulness or theft
4. Serious violations of rules

Question 13

Is conduct disorder heterogenous or homogenous?

Answer 13

Herterogenous
> levels of emotionality
> level of onset
> levels of callousness

Changes treatment methods

Question 14

What are the two onset types of conduct disorder?

Answer 14

Childhood-onset type:
> less normative and less healthy
> cut off 10 years
> many more neurocognitive risk factors (eg exucutive functioning, low IQ)
> coercise parent-child dynamics
> temperamental/personality risk factors

Adolescent-onset type:
> much more normative
> no such risk factors
> an exaggeration of the normative process of adolescent rebellion

Question 15

What is the sex difference

Answer 15

There is some evidence that the normal onset age of conduct disorder is LATER for females than men

Question 16

What type of conduct disorder are we more concerned about as clinicians?

Answer 16

Early-onset type

Question 17

What are the two types of children with conduct disorder?

Answer 17

WITH limited prosocial emotions

WITHOUT limited prosocial emotions

Question 18

What are the characteristics of children with and without the limited prosocial specifier (LPS)

Answer 18

Without:
> Low callous-unemotional (CU) traits
> emotionally dysregulated
> over reactive to emotional cues
> typical of anxiety, depression or ADHD
> reactive aggression - overreacting to emotional cues
> high attributional biases

With:
> high CU traits
> more severe and chronic
> proactive aggression
> reward-dominance
> under-reactive to emotional cues - doesn't notice anybody else's state (what do I need?)

Question 19

What type of conduct disorder sufferers struggle to identify face emotions?

Answer 19

Those with limited prosocial specifiers
High callous- unemotional traits
> they rarely show activation of the emotional brain (amygdala)
> may just be paying attention to the wrong areas of the face - looking at the mouth instead of the eyes

Question 20

Heritability of high and low callous-unemotional traits

Answer 20

> Moderate genetic (0.3) and environmental influence

> High genetic 0.81 but low genetic influence

Question 21

When do conduct problems begin?

Answer 21

Early, in either childhood or adolescence

Question 22

What do conduct problems predicts?

Answer 22

A substantial risk for a range of future health problems eg depression, anxiety, personality disorders