Conduct Problems and Antisocial Behaviour in Young People Flashcards
Describe the main features of antisocial and offending behaviour Define the criteria of conduct disorder and its subtypes Gain an understanding of the epidemiology of conduct disorder in young people and some important aetiological and maintaining factors Be familiar with the Structured Assessment of Violence and Risk in Youth Describe the interventions which may ameliorate the problem
Define conduct disorder
A repetitive and persistent pattern of antisocial, aggressive, or defiant behaviour with a frequency and severity beyond age appropriate norms that would violate others peoples’ expectations or rights
Describe the typical mindset of an individual with conduct disorder
Easily annoyed, angry, resentful, spiteful, vindictive, actively defiant of requests or rules, blameful of others for one’s own mistakes, deliberately annoying to others, argumentative, disconnected from others’ pain
Describe the typical behaviour of an individual with conduct disorder
Aggression to people and animals, serious violation of rules (truancy, running away from home, confrontational crime), deceiftulness or theft (shoplifting, burglary, forgery), destruction of property
Name the three subtypes of conduct disorder in ICD-10
Conduct disorder confined to the family context, unsocialised context disorder, and socialised conduct disorder
State some differential diagnoses of conduct disorder
ADHD, oppositional defiant disorder (ODD), adjustment reaction, mood disorders, autism spectrum disorder
State some common comorbidites with conduct disorder
Depression, PTSD, learning disability, autism spectrum disorder, dyslexia
Describe the symptoms of early childhood conduct disorder
Defiance of adults’ wishes, disobedience, angry outbursts, physical aggression, destruction of property, blaming others, provocation, arguing
Describe the symptoms of later childhood conduct disorder
Swearing, lying, stealing others’ belongings, persistent rule-breaking, physical fights, bullying, animal cruelty, fire-setting
Describe the symptoms of adolescent conduct disorder
Cruelty to other people, assault or robbery using force, vandalism, breaking and entering, joyriding, running away from home, truancy, drug and alcohol misuse
Define oppositional defiant disorder
Childhood-onset negativistic, defiant, disobedient, provocative, and hostile behaviour towards authority figures lasting at least 6 months
How is oppositional defiant disorder differentiated from conduct disorder?
The absence of more severe dissocial or aggressive acts that violate the law or the rights of others
State some typical symptoms of oppositional defiant disorder
Loss of temper, arguing with adults, deliberately annoying others, blaming others for one’s own mistakes, active defiance of requests and rules, anger or resentment, easy annoyance
Describe the relationship between age of onset and prognosis in ODD and conduct disorder
Younger age of onset indicates a poorer long-term prognosis
What percentage of children have a conduct disorder?
2-8%
What is the male to female ratio of conduct disorder?
2.5:1
Name the 2 strongest predictors of antisocial behaviour in young people
Gender and quality of parenting
What percentage of adults with a criminal record had conduct disorder as a child?
Over 90%
Name 5 things conduct disorder is a predictor of
Homelessness, difficulties finding work, engaging in early childbearing, dependence on tobacco, alcohol, or drugs, offending and violence, poor parenting practices, mental health issues (anxiety, depression, suicide)
State 2 individual factors increasing the risk of conduct disorder
Temperament (callous-unemotional traits), developmental problems (e.g. autism spectrum disorder, learning disability), hyperactivity, difficulties with friends and school
State 2 familial factors increasing the risk of conduct disorder
Parental approach (poor supervision, erratic and harsh discipline, parental disharmony, abuse), parent-child attachment difficulties, witnessing domestic violence
State 2 social factors increasing the risk of conduct disorder
Lower socio-economic class, neighbourhood (inner city, overcrowding, high crime and unemployment), school (low teacher satisfaction, deviant peer groups)
Name the diagnostic questionnaire used to diagnose conduct disorder
Structured Assessment of Violence and Risk in Youth (SAVRY)
Name the historical risk factors assessed by the SAVRY
History of violence, non-violent offending, past interventional failures, self-harm or suicide attempts, exposure to violence at home, childhood maltreatment, parent or caregiver criminality, poor school achievement
Name the social risk factors assessed by the SAVRY
Peer delinquency, peer rejection, stress and poor coping, poor parental management, lack of personal or social support, community disorganisation
Name the individual risk factors assessed by the SAVRY
Negative attitudes, risk taking or impulsivity, substance use, anger management problems, lack of remorse or empathy, poor compliance, low interest in or commitment to school
Name the protective factors assessed by the SAVRY
Prosocial environment, strong social support, strong attachment and bonds, positive attitude towards intervention and authority, strong commitment to school, resilient personality traits
State some interventions for conduct disorder
School interventions, parenting programs, cognitive problem-solving and skills training, multi-systemic therapy
What do parenting programs for conduct disorder teach?
They promote play and good times between children and parents, as well as the importance of praise and recognition for good behaviour with clearly expressed expectations and consistent and calm consequences for misbehaviour
State the focuses of CBT for anger management
Stopping and thinking in challenging situations, recognising one’s own emotional state, recognising and defining problems, developing alternative responses, anticipating consequences, crediting oneself for staying in control, reviewing actions afterwards
