Disruptive, Impulse-Control, and Conduct Disorders Flashcards
What are the core deficits in disruptive, impulse-control, and conduct disorders (CDs)?
A core deficit in self-regulation of anger, aggression, defiance, and antisocial behaviors.
What are the primary disorders included under disruptive, impulse-control, and CDs?
Oppositional defiant disorder (ODD), intermittent explosive disorder (IED), conduct disorder (CD), pyromania, kleptomania, and antisocial personality disorder.
What is the primary characteristic of oppositional defiant disorder (ODD)?
A persistent pattern lasting at least 6 months of angry/irritable mood, argumentative/defiant behavior, and/or vindictiveness.
How is the severity of ODD determined?
Mild: symptoms in one setting, Moderate: symptoms in two settings, Severe: symptoms in three or more settings.
What characterizes intermittent explosive disorder (IED)?
Recurrent verbal or physical aggression disproportionate to the provocation or stressor, impulsive and/or anger-based, lasting <30 minutes.
What are the four major symptom categories of conduct disorder (CD)?
Aggression to people and animals, destruction of property, deceitfulness or theft, and serious rule violations.
What are the subtypes of conduct disorder based on age of onset?
Childhood-onset type, adolescent-onset type, and unspecified.
What specifier in CD indicates lack of remorse or empathy?
The ‘with limited prosocial emotions’ specifier.
What percentage of children with ODD progress to conduct disorder (CD)?
Approximately 30%, especially when ODD is comorbid with ADHD.
What symptoms of ODD are most associated with the risk for CD?
Defiant, argumentative, and vindictive symptoms.
What are the DSM-5 diagnostic criteria for ODD?
Angry/irritable mood, argumentative/defiant behavior, vindictiveness lasting at least 6 months with at least four symptoms present.
What distinguishes IED from ODD and CD?
IED lacks serious aggression seen in CD and non-aggressive symptoms of ODD.
What percentage of individuals with CD develop antisocial personality disorder?
A substantial fraction.
What are the risk factors for developing disruptive behavior disorders?
Neurobiologic markers, cognitive impairments, difficult temperament, ineffective parenting, peer rejection, and exposure to violence.
What comorbidities are common with conduct disorder?
ADHD, ODD, anxiety, depression, bipolar, learning, language, and substance-related disorders.
What are the DSM-5 criteria for intermittent explosive disorder (IED)?
Recurrent aggressive outbursts disproportionate to stressors, occurring at least twice weekly for 3 months or three significant outbursts in 12 months.
What family-level factors increase the risk of behavioral disorders?
Ineffective parenting, harsh discipline, impaired parent-child attachment, exposure to violence, and family genetic liability.
What individual-level risk factors are associated with behavior disorders?
Cognitive rigidity, hostile attributions, impulsivity, and abnormalities in the prefrontal cortex and amygdala.
What social outcomes are associated with disruptive behavior disorders?
Delinquency, unplanned pregnancy, social instability, academic failure, and criminality.
How does ODD differ from CD?
ODD lacks physical aggression and serious rule violations seen in CD.
What is the Fast Track program and its outcomes?
“Fast Track is a multicomponent school-based intervention targeting conflict resolution
What are the outcomes of the Seattle Social Development Project?
“The program decreased lifetime drug use and delinquency in males by age 19
What is a typical screening question for conduct problems in children?
“Does [name] have a lot of trouble controlling [his/her] anger or behavior?”
What screening tools are used in primary care to identify conduct problems?
“Pediatric Symptom Checklist and Strengths and Difficulties Questionnaire.”
What should pediatric practitioners do when youth self-report aggressive behavior?
“Engage in active listening
What is guided self-help in addressing mild behavior problems?
“Providing educational materials
What are examples of self-help parenting programs?
“Positive Parenting Program (Triple P) and Incredible Years.”
What should be provided to parents in primary care settings for universal prevention?
“Brief versions of behavioral parent training like Incredible Years and Triple P.”
What is the duration and focus of behavioral parent training programs?
“10-15 weeks; focuses on social learning principles
What predictors are associated with nonresponse to parent training?
“Greater symptom severity and parent involvement with child protection services.”
What is a common issue limiting the effectiveness of parent training programs?
“High rates of premature termination
What are key techniques used in CBT for disruptive behavior?
“Identifying triggers
What are examples of multicomponent treatments for serious behavior disorders?
“Multidimensional Treatment Foster Care and Multisystemic Therapy.”
When should pharmacotherapy be considered for disruptive behavior?
“When psychosocial interventions are insufficient or in cases of severe presentations where safety is compromised.”
What medications have evidence for managing impulsive aggression in youth?
“Stimulants
What is the typical dose range for guanfacine in treating oppositionality?
“1-4 mg/day
What are the short-term and ultimate goals of medication treatment for aggression?
“Short-term: ≥50% reduction in aggressive symptoms; Ultimate: Symptom remission.”
What is the recommended level of care for most youth with behavior disorders?
“Outpatient care; severe cases (e.g.
