Disruptive Behavior Disorder

Question 1

What are the disruptive behavior disorders?

Answer 1

1. Oppositional Defiant Disorder
2. Conduct Disorder
3. Disruptive Behavior Disorder NOS

Question 2

Are disruptive behaviors internalizing or externalizing disorders?

Answer 2

Disruptive behavior disorders are EXTERNALIZING conditions. Collateral contact are key

Question 3

True:false: the child is often the least reliable historian for their disorder

Answer 3

The child is often the least reliable historian regarding the impact of their own behavior.

Question 4

What are the 3 domains of childhood functioning? Why are they important?

Answer 4

1. HOME, SCHOOL, FRIENDS (SOCIAL).
2. Look for disparities between the three. Why better at school and worse at home? Why better with mom and worse with dad?

Question 5

What are the components of assessment?

Answer 5

1. When did the symptoms start?
2. Establish specifics regarding behavior of concern: antecedents, behavior, consequences. Frequency, intensity, duration, context. Insist on specific examples.
3. Assume all children want to succeed. Ask yourself what purpose the “acting out” behavior is serving the youth.
4. Try to UNDERSTAND, rather than label the symptoms.

Question 6

What are biological predisposing factors?

Answer 6

difficult temperament, executive functioning deficits (ADHD, LD), genetic loading, substance use, mood disorder (depression/bipolar), PTSD/anxiety disorder, medical conditions.

Question 7

What are social predisposing factors?

Answer 7

Unhealthy role-modeling by caregivers, disrupted attachments, peer influences, mismatch of fit with school/caregiver, abuse, poverty.

Question 8

What are psychological predisposing factors?

Answer 8

negative attribution style, “no internalized authority”, SUPEREGO deficient

Question 9

What are the Parent management program options?

Answer 9

The Incredible Years.

• -Common Sense Parenting.
• -Parent Effectiveness Training

Question 10

What are the treatment options?

Answer 10

1. If under 12 years old insist on a Parent Management Program
2. In adolescence often some form of family therapy will be needed.

Question 11

What are the family therapy treatment options?

Answer 11

Multisystemic Family Therapy

Functional Family Therapy

Question 12

What are the target symptoms?

Answer 12

Poor impulse control, angry outbursts, sleep problems, irritability, anxiety, mood lability, poor focus/attention, rejection sensitivity.

Question 13

What are the medication options?

Answer 13

SSRI
Stimulant
Alpha-agonist
Anticonvulsant
Atypical antipsychotic

Question 14

What are examples of internalizing conditions?

Answer 14

Depression

Anxiety

Question 15

Define ODD

Answer 15

1. Oppositional Defiant Disorder: frequent and persistent pattern of anger, irritability, arguing, defiance or vindictiveness toward you and other authority figures.
   A. Angry and irritable mood:
   B. Often loses temper
   C. Is often touchy or easily annoyed by others
   D. Is often angry and resentful
2. Argumentative and defiant behavior:
3. Often argues with adults or people in authority
4. Often actively defies or refuses to comply with adults’ requests or rules
5. Often deliberately annoys people
6. Often blames others for his or her mistakes or misbehavior
7. Vindictiveness:
8. Is often spiteful or vindictive
9. Has shown spiteful or vindictive behavior at least twice in the past six months
   These behaviors must be displayed more often than is typical for your child’s peers. For children younger than 5 years, the behavior must occur on most days for a period of at least six months. For individuals 5 years or older, the behavior must occur at least once a week for at least six months.

Question 16

Define Conduct disorder

Answer 16

Conduct disorder is a severe condition characterized by hostile and sometimes physically violent behavior and a disregard for others. Children with CD exhibit cruelty, from early pushing, hitting and biting to, later, more than normal teasing and bullying, hurting animals, picking fights, theft, vandalism, and arson.

1. Aggressive behavior that causes or threatens harm to other people or animals, such as bullying or intimidating others, often initiating physical fights, or being physically cruel to animals.
2. Non-aggressive conduct that causes property loss or damage, such as fire-setting or the deliberate destruction of others’ property.
3. Deceitfulness or theft, such as breaking into someone’s house or car, or lying or “conning” others.
4. Serious rule violations, such as staying out at night when prohibited, running away from home overnight, or often being truant from school.

Question 17

define Disruptive behavior disorder NOS

Answer 17

Disruptive Behavior Disorder: Disruptive Behavior Disorder Not Otherwise Specified (NOS) is a term used to describe a pattern of serious troublesome behavior that does not constitute the terms of Conduct Disorder or Oppositional Defiant Disorder. The child has symptoms of both of these disorders, but not enough to truly be considered affected by the disorder entirely, or perhaps there isn’t enough information yet about the child’s situation. Therefore, we refer to this as Disruptive Behavior Disorder NOS.
A. Consistent defiance of authoritative figures
B. Inability to take responsibility for bad behavior
C. Temper tantrums on a regular basis
D. Vengeful behavior and resentment
E. Aggressiveness toward people or animals
F. Destroying property
G. Stealing and lying
H. Bullying
I. Constant rule breaking

Question 18

What are risk factors for conduct disorder?

Answer 18

1. Genetics
2. Dysfunctional family unit
3. environmental factors
4. ADHD
5. ODD
   ? impulsiveness, low IQ and low school achievement, poor parental supervision, punitive or erratic parental discipline, cold parental attitude, child physical abuse, parental conflict, disrupted families, antisocial parents, large family size, low family income, antisocial peers, high delinquency rate schools, and high crime neighbourhoods ?