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Clinical and Neuropsychology 2 > Conduct Disorder - CP > Flashcards

Conduct Disorder - CP Flashcards

1
Q

General Info

A
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2
Q

What is Conduct Disorder?

A

Like Antisocial Personality Disorder (not identical, but similar). The main difference is that it is diagnosed in childhood or adolescence (age<18)

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3
Q

What are the defining symptoms of CD?

A
  • Aggressive behaviors (physical, verbal etc.)
  • Destroying property
  • Serious rule violations
  • Deceitfulness (lying or stealing)
    !!! In general, behavior is often marked by callousness, viciousness, or lack of remorse !!!
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4
Q

(What’s a diagnostic specifier?)

A

It’s an extension to a diagnosis to help further clarify a disorder

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5
Q

What is the limited prosocial emotions diagnostic specifier?

A

It’s a specifier for children with callous and unemotional traits. Unemotional traits are:
- Shallow emotions
- Lack of:
~ Remorse
~ Empathy
~ Guilt
Higher levels of callous and unemotional traits results in:
- more problems with peers and family
- more and more severe cognitive deficits
- more antisocial behavior
- poorer response to treatment

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6
Q

What disorders are comorbid with CD?

A
  • Internalizing Disorders
  • Substance Use Disorders (Some research says that CD precedes SUD, others say that both CD and SUD occur at the same time and that one makes the other worse)
  • Anxiety and Depression
    ~ 15-45% comorbidity
    ~ CD usually precedes Anxiety and Depression (Apart from Specific Phobias and SAD: they precede CD)
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7
Q

What is the onset of CD?

A

Preschool years.
7% of preschool kids have CD symptoms
!!! Important to assess CD early on, given that symptoms start and increase from such a young age !!!

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8
Q

What are the 2 types of CD (Moffit)?

A
  • life-course-persistent pattern of antisocial behavior: conduct problems arise from a young age and continue into adulthood. (Even up until 32 years old people have serious problems)
  • Adolescence-limited: CD problems exist only in adolescence
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9
Q

What is an explanation for the Adolescence-limited CD?

A

It happens due to the maturity gap between an adolescent’s:
- Physical maturation
- Opportunity to assume adult responsibilities and obtain rewards that come about from problematic behaviors

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10
Q

What is a problem with the adolescence-limited CD?

A

Not limited to adolescence: People with CD continue having problems until mid 20’s.
(Change name to adolescence onset)

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11
Q

What are some gender differences in CD?

A

Both men and women have same amount of problems and defiant behaviors, men’s behavior is just a bit more violent than women’s

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12
Q

What is the prevalence of CD?

A
  • Life-course-persistent type: 10.5% boys, 7.5% girls
  • Adolescence-type: 19.6% boys, 17.4& girls
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13
Q

What is the prognosis of CD?

A

Difficult to determine.
(Study) Half of the boys with CD didn’t meet criteria later for diagnosis at a later assessment (1-4) years later, despite demonstrating some conduct problems

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14
Q

Related Disorders

A
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15
Q

What is Intermittent Explosive Disorder?

A

Verbal/Physical aggressive outbursts that are far out of proportion to the circumstances. Aggression though is IMPUSLIVE, NOT PLANNED (as in CD)

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16
Q

What is Oppositional Defiant Disorder (ODD)?

A

Disorder characterized by behaviors such as:
- Losing temper
- Arguing with adults and repeatedly refusing to comply with requests from them
- Deliberately doing things to annoy others
- Being angry, spiteful, touchy and vindictive (desire for revenge)

17
Q

When is ODD diagnosed?

A

If child doesn’t meet criteria for CD, specifically if the child doesn’t not meet the criteria for extreme physical aggressiveness

18
Q

What is the prevalence of ODD?

A

Within ages 13-17, 8.3%

19
Q

What disorders are comorbid with ODD?

A

ADHD

20
Q

What are some gender differences in ODD?

A

Boys are slightly more likely than girls to have ODD (very small differences though, maybe even non-existent)

21
Q

What is a general debate on ODD?

A

Is it different from CD?
Is it a precursor of CD?
Is it a milder manifestation of CD?

22
Q

Etiology - Genetic Influences

A
23
Q

What plays a very big role in CD’s Etiology?

A

Gene-environment interaction:
- Aggressive behavior is more heritable than rule-breaking behavior, BUT, in wealthy neighborhoods, genetics played a bigger role in rule-breaking behaviors (interaction of SES - genes for behaviors)
- Combination of conduct problems and unemotional traits is more heritable than conduct problems alone, BUT, parenting of adopted child exerted a buffer against this predisposition.

24
Q

What are some specific genes that play a role in CD?

A

MAOA and 5HTTLPR (Both play a role in the serotonin system)
Problems with studies on these genes and their relationship with CD:
- FX of genes is too small
- problems in MAOA gene and its expression may only be restricted to men

25
Q

Etiology - Neurobiological influences

A
  • Deficits in regions that support emotion, especially empathetic responses (children with CD, problems in perceiving distress/happiness, but not anger)
  • Reduced activation of brain regions associated with emotion and reward: amygdala, PFC, ventral striatum. (Can’t associate behavior with a reward or punishment because of this problem)
  • Deficits in Autonomic Nervous System: Lower heart rates, which results in lower arousal levels. (Adolescents may not fear punishment as much as controls because of this)
26
Q

Etiology - Psychological Influences

A
  • Children with CD lack moral awareness, and lack remorse for their wrongdoing
  • Parents can play a role in the development of callous and unemotional traits
  • Social info processing of children: They have a hostility bias
27
Q

Etiology - Peer influences

A
  • Acceptance/rejection by peers
    ~ As early as 1st grade can predict later aggression
    ~ Children more prone to react negatively to situations: more likely to be rejected: more likely to become aggressive
  • Associating with other deviant peers (due to modelling or persuasion from other peers)
    –> Due to genetic influences, children might choose more deviant peers: likelihood for CD increases
  • Just being in a bad environment (just being around deviant peers) also plays a role whether a child will associate with peers: Increases likelihood for CD
28
Q

Treatment

A
29
Q

What are the 3 main types of treatment for CD?

A
  • Family interventions
  • Multisystemic Treatment
  • Prevention Programs
30
Q

Family interventions

A

2 aspects to it:
- Family Checkup (FCU): 3 meetings to get to know, assess and provide feedback to parents regarding their parenting, practices and children
- Parent Management training (PMT): Parents modify responses so they can reward prosocial and not antisocial behavior
~ Parents are taught techniques such as positive reinforcement and time-out
~ Most efficacious treatment for CD & ODD: decreases antisocial and aggressive behaviors of child
(The earlier the intervention, the better)

31
Q

Multisystemic treatment

A

Based on the idea that CD is influenced by many factors
- Therapy services for family, adolescent, peer group, and school sometimes
- Strategies: Behavioral, Cognitive, Family-based, and case management techniques (professional helps client develop a plan that coordinates and integrates the support services that the client needs in order to gain the maximum output from his treatment)(what to use and how for the biggest benefit)
- Emphasizes individual and family strengths and identifies social context for problems.
- Uses present and action oriented interventions, using interventions that require effort by family members

32
Q

Prevention programs

A

Fast Track Interventions: help children academically, socially and behaviorally by focusing on areas that are problematic in CD (e.g. aggressive behavior, peer, and family relationships, social info processing and more)
–> Works very well, in part due to reduction of the hostility bias

Clinical and Neuropsychology 2 (12 decks)

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