Conduct Disorders Flashcards
What are the main symptoms of conduct disorder?
Often initiate violent or aggressive behaviour Have little respect for property Are lying and deceitful Display little empathy with the feelings and intentions of others Regularly display risk taking, frustration, irritability, impulsivity and temper tantrums Associated with early onset sexual behaviour, drinking, smoking, substance abuse and risk-taking behaviour
What are the Sub-Types of Conduct Disorder
Childhood-onset conduct disorder (prior to 10-years-of-age) Adolescent-onset conduct disorder (after 10-years-of-age) Oppositional Defiant Disorder (ODD)
What is Oppositional Defiant Disorder?
Oppositional defiant disorder (ODD): A mild form of disruptive behaviour disorders reserved for children who do not meet the full criteria for conduct disorder.
What are the Changes in the DSM 5 for ODD?
Conduct disorder: New descriptive specifier added for individuals with callous unemotional personal style Oppositional defiance disorder: - Symptoms grouped into 3 types - Removal of exclusion criteria for CD- Frequency and severity guidance added
The Prevalence & Course of Conduct Disorder
Prevalence rates range from 4-16% in boys and 1.2-9% in girls (Loeber et al., 2000) Comorbidity is the rule rather than the exception Childhood conduct disorder predicts adult antisocial personality disorder, but only in lower socioeconomic-status families (Lahey et al., 2005)
Genetic Factors to CD and ODD
Twin studies suggest that both conduct disorder and aggressive and violent behaviour has a significant genetic component Adoption studies also suggest substantial inherited rather than environmental causes (Simonoff, 2001) Recent studies have identified the genes MAOA and GABRA2 with conduct disorder (Caspi et al., Dick et al., 2006)
Neurological Deficits of CD
Conduct Disorder is associated with deficits in executive functioning, verbal IQ and memory (Lynam & Henry, 2001) However, executive functioning deficits may only be found in individuals where conduct disorder is comorbid with ADHD (Oosterlaan et al., 2005)
Prenatal Factors to CD
Prenatal factors include maternal smoking and drinking during pregnancy, and prenatal and postnatal malnutrition Delinquent behaviour is more common in children prenatally exposed to alcohol (Schonfeld et al., 2005) Confounding influence of other risk factors such as low socioeconomic status and genetic factors
Psychological Factors to CD
Family Environment & Parent-Child Relationships Media & Peer Influences Cognitive Factors Socioeconomic Factors
Family Environment & Parent-Child Relationships
Risk factors for ODD include parental unemployment, having a parent with antisocial personality disorder, and childhood abuse and neglect (Lahey et al., 1995) Inconsistent and harsh parenting is associated with conduct disorder Childhood abuse is generally associated with increased aggression, violence and criminal behaviour in adulthood (Fergusson et al., 1996)
Cognitive Factors to CD
Cognitive distortions: highly biased ways of interpreting the world Hypervigilance for hostile cues (Dodge, 1993) Hostile attributional bias (Nasby et al., 1979)
Socioeconomic Factors to CD
Delinquent, violent behaviour is highly associated with poverty, low socioeconomic status, unemployment, urban living and poor education A natural experiment by Costello et al. (2003) indicated that poverty may have a causal effect on symptoms of conduct disorder
Treatment of Conduct Disorders
(1) Individual Approaches (e.g., skills training )(2) Parent management training / family therapy(3) Multi-systemic therapy (MST)
Individual Approaches
Cognitive problem solving techniques /social skills training to address the cognitive processes used in everyday social situations Model and reward pro-social behaviour Role play, homework, music, video vignettes,, child-size puppets, practical activities, letters and phone calls to parents and teachers.
Parental Management Training
Encourage ‘positive parenting approaches’ with the therapist key in demonstrating helpful techniques
