Disruptive Behaviour Problems

Question 1

Conduct disorder

Answer 1

A repetitive and persistent pattern of behaviour involving violation of accepted social norms or the basic rights of others

Question 2

Main symptoms of conduct disorder

Answer 2

Often initiate violent or aggressive behaviour
Have little respect for property
Are lying and deceitful
Display little empathy with the feelings and intentions of others
Regularly display risk taking,frustration,irritabilty,tantrums and impulsivity
Assoc with early onset sexual behaviour,drinking,smoking substance abuse and risk taking behaviour

Question 3

Sub types of conduct disorder

Answer 3

Childhood onset conduct disorder 10 years
Adolescent onset conduct disorder post 10 years of age
Oppositional defiant disorder

Question 4

Oppositional defiant disorder

Answer 4

A mild form of disruptive behaviour disorders reserved for children who do not meet the full criteria for conduct disorder

Question 5

Wording to differentiate conduct disorder from. Typical naughty behaviour in childhood and adolescent

Answer 5

Conduct disorder…new descriptive specifier added for individual with callous unemotional personal style

Oppositional defiance disorder… Symptoms grouped into three types, removal of exclusion criteria for CD, frequency and severity guidance. Added.

Question 6

The prevalence and course of CD

Answer 6

Prevalence rates range from 4-16 percent in boys and 1.2-9 percent in girls
Co morbidity is the rule rather than exception
CDD predicts adult antisocial personality disorder but only in ,lower socioeconomic status(Lacey et al 2005)

Question 7

The aetiology of CD

Answer 7

Biological factors
.neuropsychological deficits
. Prenatal factors
Psychological factors
Genetic factors
. Twin studies suggest both CD and aggressive,violent behaviour significant genetic component
. Adoption studies suggest substantial inherited rather than environmental causes(simonoff 2001)
. Recent studies identified the genes

Question 8

Neurological deficits

Answer 8

Conduct disorder assoc with deficits in memory,verbal IQ,executive functioning(Lynsey &the ry 2001)
However exec functioning deficits may only be found in indivs where CD is co morbid with ADHD(oosterlaan et al)

Question 9

Prenatal factors

Answer 9

Include maternal smoking and drinking during pregnancy and pre post natal malnutrition
Delinquent behaviour assoc more commonly in children prenatal lyk exposed to alcohol(schmo fled et al 2005)

Question 10

Psychological factors

Answer 10

Family environment and parent child relationships
Media and peer influences.
Cognitive factors

Socioeconomic factors

Question 11

Family environment and parent child relationship

Answer 11

Risk factors for ODD inc parental unemployment,parent with antisocial personality disorder and childhood abuse and neglect (Lacey et al 1995)
Inconsistent and harsh parenting assoc with CD
Childhood abuse generally assoc with …

Question 12

Media and peer influences

Answer 12

Children may mimic violent activities they see on media

HOWEVER this has most effect when the children are already emotionally disturbed
Asse with peers who indulge in violence may cause CD symptoms(capaldi and Patterson 1994)
HOWEVERbmost likely in indivs who already display ODD CD or ADHD

Question 13

Cognitive factors

Answer 13

Cognitive distortion… Highly biased way of interpreting the world
Hyper vigilance for hostile cues (dodge 1993)
Hostile attributional

Question 14

Socioeconomic factors

Answer 14

Delinquent violent behaviour highly assoc with poverty low status unemployment urban living and poor education
socioeconomic
A natural exp by Costello et al 2003 Indic that poverty may have causal effect on symptoms of CD

Question 15

Individual approaches

Answer 15

Cognitive problem solving techniques /social skills training to address cognitive processes used in everyday situ
Model and reward pro social behaviour
Role play,homework,,music,video vignettes,letters and phone calls home?..this is the incredible years!! Carolyn Webster Stratton &dreidel 2008

Question 16

What might be the core features of such an approach

Answer 16

Therapists model appropriate behaviour positive parenting
Parents practice strategies to deal with childrens behaviour cognitive therapies to build children’s esteem…. More to add

Question 17

Multi systemic therapy

Answer 17

Addresses the multi dimensional nature of behavioural problems (bronze brender 1979)
Therapists act as advocates specific treatment package is built

Question 18

Evaluation of treatments

Answer 18

Importance of early intervention (perhaps prevention)

Need for long term treatment and follow up booster sessions

Difficult is due to confounding and co morbidity

Question 19

Externalising disorders

Answer 19

Outward directed behaviour problems such as aggressiveness hyperactivity non compliance or impulsiveness