Disruptive Behavior in Adolescents

Question 1

What is the neurobiological etiology of disruptive behavior in adolescents?

Answer 1

-Weak biological responses to the prospect of punishment and punishment itself
-Reduced functioning of autonomic nervous system
-Reduced cortisol reactivity
-Reduced amygdala response
-Difficulty learning associations

Question 2

What is the psychodynamic etiology of disruptive behavior in adolescents?

Answer 2

-Impaired parent-child attachment and inadequate superego development
-Secure and affectionate → children are willing to give
up immediate gratification to gain parent approval
-Insecure or ambivalent → children are less willing to
make this trade
-Quality of attachment relationship governs the degree to which children internalize parents’ values and moral standards
-Loving internal images of parents: making parental
norms and values their own
-Rejecting or hurtful: view adults as selfish and
uncaring, if not hurtful and cruel → lying,
manipulation, and intimidating seem like reasonable
ways to deal with authority figures

Question 3

What are the clinical considerations for disruptive behaviors in adolescents?

Answer 3

-If assessment indicates motivational factors are etiologically important, hard aspects of therapy and parenting should be emphasized → strengthening parental authority with strict monitoring, enforcement of rules, and rewards for positive behavior
-If capability factors are prominent, soft aspects of therapy and parenting should be emphasized → soothing the client’s emotional distress and helping with executive functioning
-If both etiological factors are important, therapy and parenting should include hard and soft aspects in similar proportions
-If social-ecological factors seem important, therapy should include efforts to involve the client with positive peers, organizations, and activities
-If client has problems in school, therapist should coach the parent in working with teachers (role play effective interactions, etc.)