Child Psychiatry I - Disruptive Behavior Disorders Flashcards
Diagnose ADHD.
A. Persistent pattern of inattention &/or hyperactivity/impulsivity that interferes with functioning/development, characterized by 1 &/or 2: 1 - Inattention (6+ for 6+ months, 5+ at age 17): Forgetful, Avoids tasks, Distracted, Cannot sustain attention, Loses things, Poor attention –> mistakes, Does not listen, Does not follow through, Does not organize. 2 - Hyperactivity (6+ for 6+ months, 5+ at age 17): Runs/Climbs, Interrupts, Blurts out, Cannot wait turn, Not quiet, Talks a lot, Leaves seat, Fidgets (w/hands)/Squirms (with trunk), Acts as if motor driven. B - Several symptoms prior to age 12. C. Several symptoms in 2+ settings. D - Symptoms interfere with or reduce the quality of functioning. E. Not better explained by another disorder.
What are the “presentations of ADHD?”
ADHD commbined, ADHD predominantly inattentive, ADHD predominantly hyperactive/impulsive.
What is the major pharmacological and behavioral treatments for ADHD?
Pharmacological: See other ADHD lecture. Behavioral: Direct contingency management, Teacher Training, Parent Management Training.
Diagnose Oppositional Defiant-Disorder.
A. For 6+ months, 4+ of the following symptoms with 1+ person who is not a sibling: (“Angry/Irritable Mood”) - Loses temper, Angry/Resentful, Touchy/Easily annoyed; (“Vindictiveness”) - Vindictive/Spiteful 2+ times in last 6 months; (“Argumentative/Defiant”) - Blames others, Argues with adults/authority figures, Defies/Refuses rules/requests from authority, Annoys (deliberately). B - Causes stress in the individual or others or impacts negatively on functioning. C - Not explained by any other disorder, incl. disruptive mood dysregulation disorder.
What is the severity of ODD?
Mild: 1 setting, Moderate: 2 settings, Severe: 3+ settings.
What is treatment for ODD?
Parent Child Interaction Therapy (focuses on parents), Problem-Solving Skills Training (focuses on child), Parent Management Training (focuses on parent-child interaction)
Diagnose Conduct Disorder.
3+ symptoms for 12+ months, with 1 system present for 6+ months: (Aggression to People/Animals) Bullies/Threatens/Intimidates, Initiates physical fights, (has used/has been…) Used a weapon, Physically cruel to people/animals, Stolen, Forced someone into sex; (Destruction of Property) (Has…) Fire setting with intent of causing serious damage, Destroyed others property; (Deceitfulness or Theft) Lies, (Has…) Broke in, Stolen items of nontrivial value; (Serious Violations of Rules) Stays out at night despite prohibitions before age 13, Has run away, Truant from school. B - Symptoms cause significant impariment in functioning. C - If 18+, criteria are not met for Antisocial PD.
What does “limited prosocial emotions” mean? When does Conduct Disorder onset?
“With limited prosocial emotions” = 2+ for 12 months: Lack of remorse/guilt, Lack of empathy, Unconcerned about performance, Shallow/deficient affect. Childhood onset: 1 sx before 10. Adolescent onset: No sx before 10. Unspecified onset: Not enough info.
What is treatment for Conduct Disorder?
Multisystemic therapy, Multidimensional Treatment Foster Care, Functional Family Therapy, Anger Control Training, Parent Management Therapy, Problem-Solving Skills Training.
As an adult, what does ADHD look like? What about Oppositional Defiant Disorder? Conduct Disorder? Which condition is most common? What gender is more affected? Especially in which?
Inattentive symptoms persist, Passive-Aggressive disorders, Antisocial Personality Disorder. ADHD is the most common condition. All conditions affect boys more often, especially ADHD.
