Disruptive Behavior Disorders: Oppositional Defiant Disorder and Conduct Disorder

Question 1

ODD

Answer 1

Pattern of angry/irritable mood, defiant behavior, or vindictiveness lasting 6 mos with 4 or more sx

and exhibited during interaction with a least one non-sibling

Question 2

ODD criteria

Answer 2

Angry/irritable mood
Argumentative/defiant
Vindictiveness (spiteful or vindictive at least twice in last 6 months)

Disturbance associated with distress in individual or others in social contacts

Question 3

ODD onset

Answer 3

Before 8 years old typically

Starts in home and spreads

Question 4

Biology of ODD

Answer 4

Underarousal has been cfound consistently

Underutilize social cues, misattirbute hostile intent to peers, cannot generate solutions to own problems

Question 5

ODD Nautrla course

Answer 5

Most kids no longer have diagnosis ater 3 years

Early onset is owrse

30% will progress to CD

Question 6

Differential for ODD

Answer 6

Unlike CD, ODD does NOT include physcal aggression, destruction of property or theft

in 50% of children with ADHD

Question 7

Tx of ODD

Answer 7

For preschool, use programs like Head Start or home visits

For school age, parent managment strategies

Adolescents - CBT, training, academics

Question 8

Pharm ODD

Answer 8

Adjunctive and should not be the only thing

Atypical antipsychotics are most common

Question 9

Ineffective interventions

Answer 9

Inoculation approaches - boot camps/shock incarceration

Exposrue to frightening situatins

Question 10

Conduct disorder

Answer 10

Repetitve and persistent pattern of behavior in which basic rights of others or major norms are violated

Question 11

CD diagnosis

Answer 11

Aggression to people and animals
Destruction of property
Deceitfulness or theft
Serious violations of rules

Question 12

CD genetics and sex

Answer 12

Males more like to exhibit aggression, girls more covert crimes

There is a gneetic risk

Question 13

APD

Answer 13

Antisocial personality disorder
Evidence of CD before age 15

ODD–>CD–>APD but some skip ODD

Question 14

Evaluation and tx of CD

Answer 14

Refer to specialized testing
Consider lab tests
There is no single tx

Multimodal is best and must be delivered long term to malke a difference

Question 15

Psychosocial tx for CD

Answer 15

Parent management - reinforce positive and eeal with bad

Probelm solving skills to teach about options

Multi-systemic therapy in a home based model with 24/7 therapists

Question 16

CD pharm

Answer 16

Some psychotropic meds work

Best case can be made for comorbid ADHD with stimulants

Must be careful about abuse/diversion of stimulant meds