Child Psych 1: Disruptive Behavior Disorders

Question 1

ADHD: how different than Schwartz’s slide?

Answer 1

Could be 5 or more for 17+ (vs. 6 or more for > 6 months otherwise)

Question 2

Treatment besides the pharm?

Answer 2

Behavioral (direct contingency management, teacher training, parent management training)

Question 3

Oppositional Defiant Disorder:

Answer 3

A. Pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months; includes 4 or more symptoms from any category, and occurs with at least one person who is NOT a sibling;
Angry/irritable mood (loses temper, touchy or easily annoyed, angry and resentful often)
Argumentative/defiant behavior (argues with authority figures or adults, actively defies or refuses to comply with requests from authority figures or with rules, deliberately annoys others, blames others for his/her mistakes or misbehavior)
Vindictiveness (spiteful or vindictive at least twice within past 6 months)

B. disturbance in behavior associated with distress in individual or others in his/her immediate social context, or impacts negatively on social, educational, occupational, or other important areas of functioning

C. Behaviors not occurring during course of a psychotic, substance use, depressive, or bipolar disorder; criteria are not met for disruptive mood dysregulation disorder

Specify: mild- symptoms confined to one setting; moderate- some symptoms present in at least 2 settings; severe - some symptoms present in 3+ settings

Question 4

Treatment of ODD:

Answer 4

Parent Child Interaction Therapy: uses both attachment and social learning principles; teaches authoritative parenting (nurturance, good comm, firm control), differential social attention to shape behavior

Problem-Solving Skills Training (focus on cognitive processes)

PMT

Question 5

Conduct Disorder:

Answer 5

Repetitive and persistent pattern of behavior in which basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by at least 3 of the following in the past 12 months (from any category; at least one present in past 6 months)
Aggression to people and animals (bullies, threatens or intimidates others; initiates fights; used weapon that could cause serious physical harm; physically cruel to people or animals; stolen while confronting a victim; forced someone into sexual activity)

Destruction of property (deliberately engaged in fire setting with intention of causing serious damage; deliberately destroyed others’ property)

Deceitfulness or Theft (broken into someone else’s house or car; lies to obtain goods or favors, or avoid obligations; stolen items of nontrivial value w/o confronting a victim)

Serious Violations of Rules (stays out at night despite parental prohibitions before age 13; run away from home overnight at least twice while in parental or surrogate home, or once without returning for lengthy period; often truant from school before age 13)

Question 6

Conduct Disorder specifics:

Answer 6

Specify: Onset (childhood-onset with at least 1 symptom prior to age 10; adolescent-onset with no symptoms prior to age 10; unspecified onset with criteria met but not enough to determine if onset before or after age 10)

With limited prosocial emotions: must have 2+ of following persistently over at least 12 months in multiple relationships or settings: 1. lack of remorse or guilt 2. callous: lack of empathy 3. unconcerned about performance 4. shallow or deficient affect

Question 7

Conduct Disorder: Treatment

Answer 7

1. Multisystem therapy (MST): addresses multiple risk factors at multiple levels (individual, family, school, peer, neighborhood); focus on understanding behavior in context
2. Multidimensional Treatment Foster Care (MTFC): comm-based alternative to residential treatment; child lives in foster care for 6-9 mos while parents receive PMT
3. Functional Family Therapy (FTT): family systems approach (understand function of misbehavior)
4. Anger Control Training
5. PSST
6. PMT