Conduct Disorders, Juvenile Deliquency, Adolescent Drug & Alcohol Probs - Allen Flashcards
What is the difference between an Internalizing Disorder and an Externalizing Disorder?
- Externalizing disorder - conduct disorder, “acting out” feelings of aggression
- Internalizing disorders - depression, keeping things internal
What is the DSM-5 Diagnostic Criteria for Conduct Disorder?
- A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated
- What is at the core of the person to make the incapable of forming relationship with others → lack empathy
- As manifested by the presence of three (or more) of the following criteria in the past 12 months, with at least one present in the past 6 months
- Aggression to people and animals
- Destruction of property
- Fire setting is a diagnostic behavior
- Deceitfulness or theft
- Serious violations of rules
What are the gender differences in prevalence rates of Conduct Disorder?
- 9-10% in boys
- 3-4% in girls
- Males prevalence predominates prior to adolescents, but prevalence rates between genders are closer by age 15
- Girls are more likely to follow the nonaggressive pathway with late onset, covert offenses, and greater likelihood of recovery
- Indirect aggression (spreading malicious rumors) is more common in girls
What are the core features of Conduct Disorder?
- Little/No empathy and concern for the feelings of others
- Lack of conscience
- Failure to learn from experience
What is the DSM-5 Diagnostic Criteria for Oppositional Defiant Disorder?
- A pattern of negative, hostile, and defiant behavior lasting at least 6 months, during which 4 or more of following included
- Loses temper, argues, defies request, deliberately annoys people, blames others, touch or easily annoyed, angry, resentful
What etiologic factors are similar in infants between ODD and CD?
- Temperamentally hyperreactive
- Irritable
- Difficult to soothe
- Slow to adapt to new circumstances
What etiologic factors are similar in families between ODD and CD?
- Highly stressed environment
- Marital discord
- Parental psychopathology (parent is pre-occupied with own problems)
- Socioeconomic disadvantage
- Inconsistent limit setting - ignored with sporadic repetitive cycles of hard coercive punishment
What is the developmental psychopathology of ODD/CD?
Normal youth acting out intensifies → ODD (25%) → CD (25-40%) → Antisocial Personality Disorder
How should ODD/CD be assessed?
- Multiple sources/informants (pt, parent, teacher, coach, etc.)
- Multiple observations (home, school, community)
- Multiple methods (interviews, checklists, observations)
What is the best treatment for ODD?
- Positive parenting program
- Problem-solving communication training
- Look for teachable moments when the child is being good and praise the child for that
- Reward/award for compliance
What is the treatment for CD?
- Multisystemic Family Therapy (MST)
- positive strengths bsed
- promotes responsible behavior
- identify & target sequences of behavior
- requires daily effort of family members
What is the DSM-5 Diagnostic Criteria for Substance-Related Disorders in Adolescents?
- Maladaptive pattern of substance use leading to the clinically significant impairment or distress, as manifested by two or three of the following symptoms within 12 month period:
- Recurrent substance use resulting in failure to fulfill major role (school)
- Recurrent substance use in situations in which it is physically hazardous
- Recurrent substance-related legal problems
- Continued substance use despite having persistent or recurrent social or interpersonal problem
How did DSM-5 change the criteria for Substance-Related Disorders?
- Combined substance abuse and substance dependence to Substance Use Disorder
- Strengthened threshold for diagnostic criteria
- DSM-IV - required only 1 symptom
- DSM-5 - requires 2-3 symptoms
What are the consequences of alcohol and other drug use among adolescents?
- Associated with the three leading causes of mortality among adolescents
- Motor vehicle accidents, homicide, & suicide
- Associated with violent behavior, rape, and unprotected sex
What are the experimental substance use statistics by age 18 years?
- 80% have drunk alcohol
- 2/3 have smoked cigarettes
- 50% have used at least one illicut drug once (marijuana primarily)
