Disruptive Behavior in Children

Question 1

What is the neurobiological etiology of disruptive behavior in children?

Answer 1

-For ODD & CD: there is a weak biological response to the prospect of punishment and of punishment itself, reduced cortisol reactivity, reduced amygdala response, difficulty learning associations
-ADHD: under-aroused, under-reactive, under-responsive, reward pathway and prefrontal cortex, need dopamine, hyperactivity = attempts to stimulate, amphetamine medications increase baseline arousal so that ordinal stimulation brings the person up to a comfortable level

Question 2

What is the cognitive etiology of disruptive behavior in children?

Answer 2

-Distortions vs. Deficiencies: flawed reasoning and misunderstandings for depression & anxiety, insufficient quantity of cognition (disruptive
-Executive cognitive functioning: emotional self-regulation, anticipating consequences (poor impulse control), problem solving
-Consequential thinking: “If ____, then ____”, limited in social skills so when presented with interpersonal problems, may only think of 1-2 actions to take

Question 3

What is the behavioral-systemic etiology of disruptive behavior in children?

Answer 3

-Strong associations between disruptive behavior disorder in children and maladaptive child management practices in parents
-Many of these parents vacillate between inadequate supervision and counteractions to misbehavior
-Parent-child interaction patterns seem aversive to both parents
-Mutual conditioning that maintains both sides of the aversive interactions
-Reinforcements are hidden but they are there

Question 4

What are the clinical considerations of disruptive behavior in children?

Answer 4

-Treatment planning must include joint consideration of research and clinical considerations
-Assess etiological factors, then choose techniques that address factors such as capability vs motivation

Question 5

Behavioral-system parenting training

Answer 5

-Based on the principles:
>Reward should predominate over punishment
>Consequence should be clear and immediate
>Success should be attainable for the child
>Parent should follow through on all promises and
threats
>Increasing the warmth of the parent-child
relationship is a top priority
-BST changes interactions around discipline by replacing yelling and emotion with calm implementation of procedures

Question 6

Collaborative Problem Solving

Answer 6

-Parent training intervention but differs from BST by emphasizing compliance less and emphasizing remediating of emotion dysregulation more
-If noncompliance is associated with distress, parents:
>Express empathy by reflecting child’s feelings
>Soothe child with gentle words and touch
>Couch child through emotional regulation
>Problem-solve to find mutually acceptable solutions
by stating nonnegotiable priorities and modifying
negotiable aspects of the directive

Question 7

Social Problem Solving

Answer 7

-Type of cognitive therapy that consists of structured procedures for slowing down impulsive reactions, anticipating consequences, and planning reasonable responses
-5-step technique that consists mostly of questions the client asks himself and then answers
1. What is the problem? → first step asks for a concise verbal definition of the problem
2. What are the possible solutions? → child brainstorms at least two
3. What are the probable consequences of the options? –? Involves realistic, critical thinking
4. Choose best option and do it. → best option is the one with the best probably consequence
5. Did it work?