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PSYC 412 > Day 9-10 - Disruptive Behavioural Disorders > Flashcards

Day 9-10 - Disruptive Behavioural Disorders Flashcards

1
Q

What are the core features of disruptive behaviour disorders? What diagnoses are possible in DSM-5?

A
  • age-inappropriate actions and attitudes that violate family expectations, societal norms, and personal or property rights of others
  • ODD and CD
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2
Q

What 2 dimensions characterize most behaviours seen in ODD/CD?

A

destructuve-nondestructive and covert-overt

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3
Q

What are the 3 categories of symptoms for ODD? What are the symptoms for each (total 8)?

A

Angry/Irritable Mood
- often loses temper
- often touchy or easily annoyed
- often angry or resentful
Argumentative/Defiant Behavior
- often argues w adults
- often actively defies requests from adults or rules
- often deliberately annoys others
- often blames others for own mistakes/misbehavior
Vindictiveness
- has been spiteful or vindictive at least twice in last 6mo

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4
Q

For a diagnosis of ODD, __ symptoms need to be present

A

4 (across any categories)

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5
Q

What are 2 additional requirements (beyond symptoms) for ODD diagnosis?

A
  • often means more than is normative for dev level
  • behavior needs to occur w at least one person who is NOT a sibling
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6
Q

What are the 3 specifiers for ODD? How are they determined?

A
  • mild: occurs in only one setting
  • moderate: occurs in two settings
  • severe: occurs in three or more settings
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7
Q

(T/F) fighting/aggression between siblings is common and usually harmless

A

FALSE, very common but mounting evidence that sibling aggression is harmful

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8
Q

What are two ways we generally assess ODD?

A
  • interviews and checklists
  • observation
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9
Q

Disruptive Behavior Diagnostic Observation Schedule (DB-DOS) is used to assess ____. How does it work?

A
  • assesses ODD in preschoolers
  • have them interact in 3 contexts (interactive examiner, busy examiner, parent)
  • “press” for disruptive behaviour (compliance, frustration, rule-breaking)
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10
Q

Conduct disorder is defined as a repetitive and persistent pattern of violating ____ and/or ____, including ____, ____, ____, and _____

A
  • violating basic rights of others and/or age-appropriate societal norms or rules
  • including aggression to ppl or animals, destruction of property, deceitfulness or theft, serious violations of rules
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11
Q

What are the 7 symptoms for CD falling under the “Aggression to people and animals” category?

A
  • Often bullies, threatens, or intimidates others.
  • Often initiates physical fights.
  • Has used a weapon that can cause serious physical harm to others (e.g., a bat, brick, broken bottle, knife, gun).
  • Has been physically cruel to people.
  • Has been physically cruel to animals.
  • Has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery).
  • Has forced someone into sexual activity.
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12
Q

What are the 2 symptoms for CD falling under the “destruction of property” category?

A
  • Has deliberately engaged in fire setting, with the intention of causing serious damage.
  • Has deliberately destroyed others’ property (other than by fire setting).
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13
Q

What are 3 symptoms for CD falling under the “deceitfulness or theft” category?

A
  • Has broken into someone else’s house, building, or car.
  • Often lies to obtain goods or favors or to avoid obligations (i.e., “cons” others).
  • Has stolen items of nontrivial value without confronting a victim (e.g., shoplifting, but without breaking and entering; forgery).
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14
Q

What are 3 symptoms for CD falling under the “serious violations of rules” category?

A
  • Often stays out at night despite parental prohibitions, beginning before age 13 years.
  • Has run away from home overnight at least twice while living in parental or parental surrogate home, or once without returning for a lengthy period.
  • Is often truant from school, beginning before age 13 years
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15
Q

What are the diagnostic requirements for conduct disorder?

A
  • 3 or more behaviours within last 12mo, at least one in last 6mo
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16
Q

What are the 3 types of specifiers for conduct disorder?

A
  • childhood onset (before 10) vs adolescent onset
  • mild: few symptoms in excess of requirement, cause mild impairment and harm to others
  • moderate: number of conduct problems and impact on others between mild and severe
  • severe: many conduct problems or behaviours are causing serious harm
  • with limited prosocial emotions (2/4 characteristics persistent over 12mo and multiple settings; lack of remorse, callous/lack of empathy, unconcerned ab performance, shallow affect)
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17
Q

What are CU traits?

A
  • callous and unemotional traits
  • trats for with limited prosocial emotions specifier of CD
  • lack of remorse/guilt
  • callous, lack of empathy
  • unconcerned ab performance
  • shallow/deficient affect
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18
Q

__-__% of youth w CD have significant CU traits

A

2-6%

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19
Q

CU traits are associated with…

A
  • earlier onset CD
  • more severe and instrumental aggression
  • insensitivity to punishment
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20
Q

Can you have CD and ODD?

A

YES (in DSM-4 CD subsumed ODD but can now be diagnosed w both at same time)

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21
Q

Nearly __% of all children with CD have NOT been diagnosed with ODD

A

50%

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22
Q

About __% of children with ODD do NOT progress to more severe CD

A

50%

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23
Q

What is the lifetime prevalence for ODD? For CD?

A
  • ODD: 12%
  • CD: 8%
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24
Q

The Ontario child health study found that the 6 month prevalence for ODD is ____ and is ___ for CD

A
  • ODD: 7.5%
  • CD: 1.3%
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25
Q

Prevalence of disruptive behavior disorders is strongly correlated with ____ and _____

A

poverty and exposure to violence
(CD diagnosis should not be applied when the behavior is only a reaction to environment/is adaptive in that bad environment)

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26
Q

What are the 2 theories about the cause for the link between poverty and disruptive behavior disorders?

A
  • social causation: stress of poverty leads to increase in child psychopathology
  • social selection: families w genetic predisposition drift down towards poverty
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27
Q

What was the Great Smoky Mountains study, and which theory for the link btw poverty and DBDs did findings support?

A
  • longitudinal study of child psychopathology
  • partway through, casino opened and many families got a stipend
  • had 4 groups: persistently poor, ex-poor, never poor, and newly poor (excluded bc low numbers)
  • kids in ex-poor families reported decrease in disruptive behaviors!!!
  • results support social causation theory
28
Q

What mediator(s) did the Great Smoky MOuntain study identify for the ass btw increase in income and decrease in behavioral symptoms?

A
  • increased parental supervision fully mediated relationship!
29
Q

Conduct problems are __-__x more common in male kids

A

2-4x

30
Q

In early-onset persistent CD, there is a __ male to __ female ratio

A

10 male : 1 female

31
Q

In adolescent-limited CD, there is a __ male to __ female ratio

A

2 male : 1 female (or no difference)

32
Q

(T/F) girls engage in much more relational aggression than boys

A

FALSE, slightly more but not meaningful diff

33
Q

What are the most common comorbidities for ODD/CD

A
  • ADHD (35%+ in ODD; over 50% in CD)
  • Depression and anxiety (50% for both ODD/CD)
34
Q

What are 5 common correlated of ODD/CD?

A
  • cognitive and verbal challenges (not intellectual impairment but specific verbal deficits)
  • poor academic functioning
  • higher family conflict, lack of family cohesion
  • peer problems (often rejected, form friendships w other antisocial peers)
  • health risks
35
Q

Boys with conduct problems are __x more likely to die before age 30

A

3-4x

36
Q

How do disruptive behavior disorders present in infants?

A
  • difficult temperament
  • fussy/irritable
37
Q

What are 2 diagnostic challenges for DBDs in preschoolers?

A
  • impossible or improbable symptoms (eg truancy, staying out all night)
  • normative misbehavior (preschoolers generally misbehave more than older groups and this is normal)
38
Q

Normative misbehavior in preschoolers:
- children’s physical aggression increases until ____mo
- __% of girls and __% of boys are reported by parents to hit, kick, and bite occasionally
- __% of preschoolers have temper tantrums

A
  • 27 months
  • 40% and 50%
  • 75%
39
Q

What are 5 ways to distinguish typical preschool misbehavior from problematic behavior?

A
  • frequency
  • severity
  • flexibility (can you shape behavior w conditioning)
  • expectability
  • pervasiveness (how many settings)
40
Q

describe the early-onset/lifecourse persistent pathway for DBDs (onset age, gender ratio, persistance)

A
  • at least 1 symptom before 10y
  • 10:1 male to female ratio
  • 50% persist in antisocial behavior in adulthood
  • aggression in childhood, less serious but antisocial behavior in middle childhood, more serious delinquency in adolescence
41
Q

describe the late-onset/adolescent-limited pathway for DBDs (onset age, gender ratio, persistance)

A
  • onset in adolescence, frequently w social change
  • 2:1 or 1:1 male female ratio
  • less extreme antisocial behavior, less likely to commit violent offenses
  • less likely to persist
42
Q

What are snares?

A
  • outcomes of antisocial behavior that put ppl on a problematic path
  • eg unplanned pregnancy, dropping out of school, drug addiciton
  • make it more likely that adolescent-limited pathway will actually be persistent
43
Q

Adoption and twin studies indicate that __% of variance in antisocial behavior is hereditary

A

50% or more

44
Q

What are prenantal/birth related risk factors for DBDs?

A
  • low birth weight
  • malnutrition during pregnancy
  • led poisoning
  • mother use of nicotine, alcohol, weed, or other drugs
45
Q

What is the genotype x maltreatment interaction in the development of antisocial behavior?

A
  • childhood maltreatment is universal risk factor
  • likely that vulnerability to these adversities is conditional and dependent on genetic factors (eg MAOA enzyme)
46
Q

The relationship between childhood maltreatment and antisocial behavior is (weaker/stronger) for those with low MAOA activity. This is a(n) (mediation/moderation) effect

A

STRONGER; MODERATION

47
Q

(T/F) negative parenting behaviors that do not constitute abuse are not associated with DBDs

A

FALSE

48
Q

What is coercion theory?

A
  • cycle of increasingly negative interactions btw parent and child
  • problematic parent behaviors end up acting as reinforcers for child misbehavior
49
Q

What are the 5 social information processing steps and what problems can occur at each one in DBDs?

A
  • Encoding (what I pay attention to; little is known)
  • Interpretation (aggressive behavior linked to hostile attribution bias)
  • Response Search (usually just think of aggression options)
  • Response Decision (high self-efficacy for aggression and think it will get them the outcome they want)
  • Enactment (little work looking at this)
50
Q

How do parents and peers reinforce the development of problematic social information processing?

A
  • moms of aggressive boys also show hostile att bias
  • parents may reinforce or approve of behaviors
  • aggression usually works against peers/children
51
Q

What are the 3 main treatments for DBD?

A
  • parent management training
  • problem solving skills training
  • multisystemic treatment
52
Q

What is the underlying theory of problem solving skills training for DBD?

A

social-information processing theory

53
Q

What are the STEPS for problem solving in problem solving skills training

A

S: say what the problem is (encoding/interpretation)
T: think of solutions (response search)
E: examine each one (response selection)
P: pick one and try it out (response decision/enactment)
S: see if it worked

54
Q

What 4 cognitive biases does the anger coping program focus on?

A
  • interpretation (hostile attribution bias)
  • distorted perceptions of aggressiveness
  • faulty emotional identification (misidentify other emotions as anger)
  • response search and selection
55
Q

What are the 3 steps of anger coping program?

A
  • inhibit early angry and aggressive reactions
  • cognitively relabel stimuli perceived as threatening
  • solve problems by generating alternative coping responses and choosing adaptive alternatives
56
Q

Why are problem solving skills training (and anger coping) often not enough?

A

in real world, problematic behaviors may be reinforced

57
Q

What are the 3 main elements of parent management training?

A
  • operant conditioning
  • education
  • communication (clearly established consequences and reasoning)
58
Q

Time outs involve removal of _____. As a rule of thumb, they should last 1 minute for every ___

A

positive reinforcement (eg toys, electronics)
1 minute for every year of age

59
Q

(T/F) time outs are not recommended by the american academy of pediatrics

A

FALSE, one of only discipline strategies recommended

60
Q

Why are claims that time outs are bad for kids not correct?

A
  • cited data on social exclusion in adults and not clear that time outs are comparable to experiences adults have
  • research suggests no association between time outs at age 3 and emotional and behavioral health in grade 5
61
Q

Is parent management training effective? Which age group does it work best with?

A
  • yes, reduction in problem behaviors
  • stronger effects for preschoolers and elementary vs adolescents (might have more significant impairment and might have more other ppl reinforcing wrong behavior)
62
Q

What is MST and how does it work?

A
  • treatment that acts at multiple levels of ecological system
  • involves problem solving skills training, parent management training, AND changes in global reinforcement context
  • services in the home and other settings, available 24/7 for 4 months
63
Q

What did Littel’s 2021 systematic review and meta-analysis of multisystemic therapy for youth 10-17 find?

A
  • mixed evidence for increased efficacy of MST vs other tx
  • reduced self-reported delinquency and increases in family functioning but not other important outcomes
  • might be better than other methods but we don’t rly know
64
Q

MST may work primarily by ___

A

improving family functioning

65
Q
A

PSYC 412 (9 decks)

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