Conduct D/O

Question 1

Oppositional Defiant D/O

Prevalence _____, more common in _____ younger than ____ y/o (usually presents during preschool years, rarely later)

Answer 1

3%

boys, younger than 13 y/o

Question 2

ODD is a dx for children and adolescents with difficult and challenging behaviors
NOT generally ________,________ or _____

Minimum ___ out of 8 sx, for more than ______mos

Answer 2

physically violent, dangerous or illegal

4/8 sx, 6 mo

Question 3

T/F

ODD may precede conduct d/o, and all children w/ ODD progress to a conduct d/o

Answer 3

F not all do

Question 4

ODD is often comorbid w/ ______

DMDD and ODD are similar but ODD is [more/less] severe in its temper outbursts

Answer 4

ADHD

ODD is less severe

Question 5

ODD Tx:

Answer 5

No pharmaceutical tx
R/o medical illness, Manage comorbid d/o (ADHD)
Child and Family therapy
CBT, anger mgmt, improve problem solving skills, techniques to delay impulsive responses
School-based programs

Question 6

Disruptive Mood Dysregulation D/O only given to ___-___ y/o

Sx start at less than____y/o and last more than ___mo
Sx must occur at home and in school

Subset of children w/ extreme mood swings that did not mature into _____ d/o

Answer 6

6-18 y/o
Sx start <10 y/o and last > 12 mo

Bipolar d/o

Question 7

DMDD tend to develop _____, ______, _______, and _____

If child meets criteria for ODD and DMDD, they are given the dx of _______

Answer 7

anxiety, depression, ODD, ADHD

DMDD

Question 8

In DMDD Temper outbursts are _____, _____ and _____ w/ circumstances
Child is persistently angry and irritable→ not a “passing thing”

Answer 8

severe, regular and inconsistent

Question 9

DMDD tx

Answer 9

Mainly supportive, no meds
Individual & family therapy, CBT
Manage comorbid illnesses

Question 10

Intermittent Explosive D/O generally affects
1.
2.
3.

Answer 10

1. young men (7%)
2. younger pts
3. ↓ education level

Question 11

Intermittent explosive D/O can be dx in____ y/o and older

It is characterized by ______ aggression/______ outbursts from failure to control aggressive impulses

Answer 11

6+ y/o

verbal aggression/behavioral outbursts

Question 12

T/F
IED outbursts are out of proportion to the psychological stressor and out of character for pts usual behavior (not pattern of overreacting)

Answer 12

T

Question 13

IED TX

Answer 13

No FDA approved meds
SSRIs and oxcarbazepine help control sx; 2nd gen antipsychotics (Risperidone) for aggressive sx
CBT

Avoid BZD: ↓ anxiety, and “release” impulse behaviors

Question 14

Pyromania Onset:

Deliberate fire setting on more than ____ occasion

_____ or ____ arousal before the act
______, ______, _____ when setting fires or when witnessing aftermath

Answer 14

Late teens or early 20s, gender equal

More than 1 occasion
Tension or affective before
Pleasure, gratification, relief when setting fires

Question 15

T/F: Arsonists w/ monetary/political agenda qualify for a pyromania dx

Answer 15

F

Question 16

Unknown general prevalence of pyromania, but in inpatient psych setting ____% fulfilled diagnosis

Common comorbid conditions:

Answer 16

6%

mood d/o, substance abuse and impulsive behavior

Question 17

Pyromania tx

Answer 17

Tx any co-existing d/o
No clear role for meds, educate parents on non-punitive discipline measures
Individual and family therapy

Question 18

Conduct D/O
____% of boys, _____% of girls meet criteria (_____% of boys and ______% of girls, will develop antisocial PD).
Only children and adolescents

Answer 18

8% of boys, 3% of girls meet criteria (40% of boys and 25% of girls, will develop antisocial PD).

<18 y/o

antisocial personality d/o

Question 19

Childhood-onset <10 yrs→ better/worse px

Adolescent-onset 10-18 y/o→ better/worse px

Answer 19

childhood: worse
adolescent: better

Question 20

Conduct D/O
3 of 15 behaviors over _____month period

Four domains of behavior:
1.        
2. 
3.                             
4.

Answer 20

12 mo period

1. Aggressive towards people/animals
2. Destruction of property
3. Deceitfulness/theft
4. Serious violations of rules

Question 21

Conduct D/o tx

Answer 21

Meds in general are not indicated for conduct d/o

Mild cases: individual and family therapy

Extreme cases: usually end up involving violations of the law and pts end up in group homes or juvenile detention facilities

Best approach is to educate/help the parents
Parental management training communicate more effectively, appropriate discipline, cull peer groups; intensive CBT

Tx comorbid illnesses (ADHD)
Aggressive sx→ may tx off-label: lithium, haloperidol, 2nd gen anti-psychotic

Question 22

Conduct d/o

Limited prosocial emotions in severe cases: “fearlessness” 
Lack of \_\_\_\_\_ or guilt
Callous- lack of \_\_\_\_\_\_
Unconcerned about performance
Shallow or deficient affect

**These subtypes include pts who are considered the childhood equivalents of adults w/ psychopathy/antisocial personality d/o

Answer 22

remorse

empathy

Question 23

Conduct d/o has _____ and psychosocial factors

High comorbidity rate w/ _____, ____and ______ d/o, and ______d/o (10%)

Answer 23

Genetic

ADHD, mood and anxiety d/o, and learning d/o

Question 24

Disruptive, Impulse control and Conduct D/o

Hallmark: impaired ________ and _________

Often referred to as [internalizing/externalizing] d/o (they result in conflict w/ others).

Physical or verbal injury to oneself or others is [common/uncommon].

Severe emotional and occupational impairment for both the pt and loved ones
_______ personality d/o is also considered a conduct d/o

Answer 24

impulse control, self-regulation

externalizing

common

Antisocial

Question 25

Compulsive shopping is the irresistible urge to____ ________ __________
Tension and gratification occurs ____ and ______
Typically starts _______ and is chronic
No standard treatments but _____ may be helpful as well as ____

Answer 25

buy unnecessary things [so literally most females]
before and during
late teens/early 20s
SSRIs, CBT

Question 26

Internet addiction is defined as:

Tension, arousal before logging on
_____ or______ when using too long
No consensus on treatment
Self-limitation, safeguards best bet, CBT

Answer 26

excessive computer use leading to distress

Guilt or depression