Disorders of childhood conduct

Question 1

Two main disorders of childhood conduct

Answer 1

Conduct disorder
Oppositional defiant disorder

Question 2

Differences between ICD 10 and DSM V in diagnosing conduct disorder and oppositional defiant disorder concurrently

Answer 2

In ICD 10 ODD is a subtype of conduct disorder
In DSM V oppositional disorder is excluded if conduct disorder is present

Question 3

Four categories of behaviour shown by children with conduct disorder

Answer 3

Physical aggression or threats towards other people or animals
Destruction of property
Theft or deceitful acts
Frequent and serious violation of age appropriate rules

Question 4

Length of time symptoms are required for a diagnosis of conduct disorder in ICD 10

Answer 4

6 months

Question 5

Length of time symptoms are required for a diagnosis of conduct disorder in DSM V

Answer 5

12 months

Question 6

Prevalence of conduct disorder in the UK

Answer 6

5-7%

Question 7

Male:female ratio of conduct disorder

Answer 7

4:1

Question 8

Neurochemical findings in children with conduct disorder

Answer 8

Low CSF serotonin
Autonomic under arousal
Low salivary cortisol levels

Question 9

Imaging findings in children with conduct disorder

Answer 9

Reduced volumes in prefrontal regions

Question 10

Parental risk factors for conduct disorder

Answer 10

Maternal smoking in pregnancy
Parental criminality
Parental substance abuse
Harsh and inconsistent parenting

Question 11

Family risk factors for conduct disorder

Answer 11

Large family
Low socioeconomic status/income
DV/child abuse in the family

Question 12

Relationship between urban living and conduct disorders

Answer 12

Exposure to urban life does not increase risk
Some studies have found higher rates in urban areas

Question 13

Protective factors for conduct disorder

Answer 13

Female sex
High IQ
Resilient temperament
Good parenting

Question 14

Poor prognostic factors for conduct disorder

Answer 14

Onset <10 years
Increased aggression at a young age
Aggression alone, not just in groups
Low IQ
Low socioeconomic status
Poor school achievement
Poor parenting
Parental criminality

Question 15

Target age range for functional family therapy, used to treat conduct disorder

Answer 15

11-18

Question 16

Number of sessions given in functional family therapy used to treat conduct disorder

Answer 16

8-12 one hour sessions
12-16 sessions offered for difficult cases

Question 17

Four phases of functional family therapy used to treat conduct disorder

Answer 17

Engagement
Motivation
Behavioural change
Generalisation

Question 18

Percentage reduction in reoffending rates following treatment of conduct disorder with functional family therapy

Answer 18

50%

Question 19

Key features of multisystemic therapy used to treat conduct disorder

Answer 19

Team available 24 hours a day
Clinicians only take on 4-6 cases at a time
Treatment given for 3 months then stopped
Assessment takes place at home
Therapist is responsible for making sure appointments are kept, not the family
Written feedback on progress towards goals is collected by the therapist regularly

Question 20

Length of time symptoms should be present for a diagnosis of oppositional defiant disorder

Answer 20

6 months

Question 21

Prevalence of oppositional defiant disorder

Answer 21

2-5%

Question 22

Percentage of children with ODD who show no signs as an adult

Answer 22

25%

Question 23

Sex patterns of ODD

Answer 23

Males more affected before puberty
Males and females equally affected post puberty

Question 24

Setting in which symptoms of ODD are most often present

Answer 24

At home

Question 25

Most common childhood disorder according to the Isle of Wight study

Answer 25

Conduct disorder

Question 26

Strongest risk factor for criminality in a in adulthood among children with behavioural problems

Answer 26

Harsh, punitive parenting

Question 27

Percentage chance of a 12 year old with conduct disorder developing antisocial personality disorder as an adult

Answer 27

50%

Question 28

Most common adverse outcome of conduct disorder in adulthood

Answer 28

Antisocial personality disorder

Question 29

Average age of onset of oppositional defiant disorder

Answer 29

3-8

Question 30

First line intervention for conduct disorder

Answer 30

Parent management training

Question 31

Antipsychotic licensed for short term management of severely aggressive behaviour in people with conduct disorder

Answer 31

Risperidone

Question 32

Age of onset of adolescent onset conduct disorder

Answer 32

> 10

Question 33

Length of time symptoms should be present for a diagnosis of conduct-dissocial disorder in ICD11

Answer 33

12 months

Question 34

Type of aggression more commonly experienced by females with conduct-dissocial disorder

Answer 34

Relational aggression only

Question 35

Features of relational aggression

Answer 35

Covert or indirect aggression
Bullying
Harm is done through damage to relationships or social status

Question 36

First line treatment for conduct disorder in children aged 3-11

Answer 36

Group parent based training programmes

Question 37

First line treatment for conduct disorder in children aged 9-14

Answer 37

Child focused programmes

Question 38

First line treatment for conduct disorder in children aged 11-17

Answer 38

Multimodal interventions with a family focus

Question 39

Usual length for a course of multimodal interventions to treat conduct disorder

Answer 39

3-5 months