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Behavioral Med: Test 3 > Disruptive Behavior Disorders > Flashcards

Disruptive Behavior Disorders Flashcards

1
Q

Name 3 Disruptive Behavior Disorders

A

Oppositional Defiant Disorder
Conduct Disorder
Disruptive Behavior Disorder NOS

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2
Q

What are the 3 domains of functioning for a child?

A
  1. Home
  2. School
  3. Friends (Social)
    Look at disparities between the three - why better at school and worse at home? Better with mom and worse with dad?
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3
Q

What are some predisposing factors for disruptive behavior disorders?

A 
1. Biologically 
A. Difficult temperament
B. Executive functioning deficits (ADHD)
C. Genetic loading, substance abuse, mood disorder, medical conditions
2. Socially
A. Unhealthy role modeling, disrupted attachments, peer influences, poverty, abuse
3. Psychologically
A. Negative attribution style, Superego
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4
Q

What are two types of Family Therapy Treatment?

A
  1. Multi-systemic Family Therapy

2. Functional Family Therapy

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5
Q

Medication options for disruptive behavior disorders

A
  1. SSRI
  2. Stimulant
  3. Alpha-agonist
  4. Anticonvulsant
  5. Atypical antipsychotic

No pill for disruptive behavior disorder - never treat alone with medication

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6
Q

Risk Factors for conduct disorder

A
  1. Being male
  2. Living in a city
  3. Having a family history of conduct disorder
  4. Having other psychiatric disorders
  5. Having parents who have mental illness
  6. Having parents who abuse drugs or alcohol
  7. Being abused or neglected
  8. Having a dysfunctional home environment
  9. Having a history of traumatic events
  10. Living in poverty
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7
Q

What is oppositional defiant disorder

A

Persistent pattern of negative, hostile & defiant (uncooperative) behavior towards adults

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8
Q

How should we manage patients with oppositional defiant disorder?

A

Behavioral Therapy

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9
Q

What is conduct disorder?

A

Social & academic difficulty: lack of guilt/remorse, defies authority (causes fights, throws tantrums, fails in schools, sets fires, steals, cruel to people/animals, sexually uninhibited

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10
Q

What is the prognosis for conduct disorder? What do most go on to develop?

A
  1. Poor Prognosis

2. 40% develop antisocial personality disorder

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11
Q

There is a high comorbidity between conduct disorder and what?

A
  1. ADD
  2. ADHD
  3. Learning Disability
  4. Mood disorders
  5. Substance abuse disorder
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12
Q

How do you diagnose conduct disorder?

A

Established on the basis of a pattern of behavior that involves violation of the basic rights of others or of social norms with at least 3 acts of the following:
A. Aggression towards people & animals
B. Destruction of property
C. Deceitfulness (cannot keep friends for long)
D. Serious violations of rules

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13
Q

What is the treatment for conduct disorder?

A

A multimodal approach is used involving environmental and behavioral modifications and family therapy, with the use of pharmacotherapy for certain behaviors

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14
Q

With conduct disorder what is used to treat aggressive/assaultive behaviors?

A
  1. Stimulants (Dextroamphetamine, methylphenidate)
  2. Bupropion
  3. Clonidine
  4. Lithium
  5. Valprioic Acid
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15
Q

With conduct disorder which drugs may aid in reducing impulsivity and mood lability/irritability?

A

SSRI’s

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16
Q

When does ODD usually present by?

A

Age 8 ! Affects 16 to 22% of children. Can remit in 25% or progress to conduct disorder

17
Q

There is a high comorbidity between ODD and what?

A
  1. Substance Abuse Disorders
  2. Mood Disorders
  3. ADD
  4. ADHD
18
Q

Diagnostic Criteria for ODD

A 
Includes at least 6 months of negative, hostile, and defiant behavior, including at least 4 of the following:
A. Frequent loss of temper
B. Arguments with adults
C. Defying adults rules
D. Deliberately annoying others
E. Easily annoyed, anger, & resentment
F. Spitefulness
H. Blaming others for mistakes or misbehaviors
19
Q

Treatment for ODD

A
  1. Family intervention using training skills in child management for the parents/caregivers
  2. Individual psychotherapy, focusing on behavior modification and problem solving skills (recommended)
  3. Treat comorbid psychiatric disorders with medications as needed

Behavioral Med: Test 3 (5 decks)

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