Conduct problems and anti-social behaviour

Question 1

What is the ICD-10 definition of conduct disorder?

Answer 1

A repetitive pattern of antisocial, aggressive or defiant behaviour that persists over a period of 6 months. The frequency and severity of these behaviours should be beyond the age appropriate norms and violate other peoples expectations or rights.

Question 2

What are the 4 symptom domains of CD?

Answer 2

Aggression to people/animals
(Cruelty, fighting/bullying, weapons, sexual assault)

Violation of rules
(lying, truancy, running away, crime)

Deceitfulness/Theft
(stealing from home/outside home, burglary)

Destruction of
property
(fire setting, destruction of others property.)

Any of these domains for >6months constitutes a diagnosis of CD.

Question 3

What are different types of conduct disorders?

Answer 3

Unsocialised conduct disorder: Absence of lasting friendships, peer rejection

Socialised conduct disorder: Presence of lasting friendships

    OR

Childhood onset type

Adolescent-onset type

Question 4

What are some risk factors for CD?

Answer 4

Family history of criminality
Family alcohol abuse
Poor family history
ADHD diagnosis.

Question 5

What is oppositional defiant disorder (ODD)?

Answer 5

This is behaviours characterised by persistently negative, defiant, disobedient, provocative or hostile behaviours towards authority figures for at least 6 months. There should be 4 of the following:

• Loss of tempter
• Arguing with adults
• Active defiance
• Deliberately annoying others
• Blaming others for their mistakes
• Being easily annoyed, angry

There is an absence of severe dissocial/aggressive acts that violate the law.

Question 6

Describe the epidemiology of conduct disorder.

Answer 6

Most common mental disorder in children and adolescents- prevalence of 2-8%.

Gender and quality of parenting strongest predictors of anti-social behaviours.

Question 7

What are some interventions for CD?

Answer 7

Multi systemic therapy
Cognitive problem solving skills training
Managing underlying hyperactivity
Parenting programs
Interventions at schools
Major modifiable RF at early age

Question 8

How do CBT programs work?

Answer 8

Slow down impulsive responses to challenging situations- stop and think.

Recognising the own level of physiological arousal and their own emotional state.

Recognising and defining problems.

Developing alternative responses to problems.

Overall, increase positive social behaviours, make skills for friendships and social interactions.

Question 9

What is multi systemic therapy?

Answer 9

A method used to improve family functioning, targeting cause of youth anti social behaviours. Improves:

• Parent adolescent relationship
• Parenting skills, understanding
• Decreasing deviant peer associations
• Enhancing school performance
• Developing family support network.