Disruptive, Impulse-Control, and Conduct Disorders

Question 1

Oppositional Defiant Disorder

Answer 1

essential feature is a recurrent pattern of an angry/irritable mood, argumentative/defiant behavior, or vindictiveness as evidenced by at least four characteristic symptoms that are exhibited during interactions with at least one person who is not a sibling; symptoms have persisted for at least six months and have caused distress for the individual or others in his/her immediate social environment

Question 2

Intermittent Explosive Disorder

Answer 2

characterized by recurrent behavioral outbursts that are related to an inability to control aggressive impulses as manifested by

a) verbal or physical aggression that occurs, on average, twice a week and has persisted for at least three months or
b) three behavioral outbursts that caused damage or destruction of property and/or physical assault that injured people or animals during a 12 month period

severity of aggressiveness is not proportional to provocation or the precipitating social stressor, and outbursts are not premeditated or committed to achieve a tangible outcome and cause significant distress, impaired functioning, or financial or legal consequences

assigned only to individuals who are at least 6 years of age or equivalent developmental level

Question 3

Conduct Disorder

Answer 3

requires a persistent pattern of behavior that violates the basic rights of others and/or age-appropriate social norms or rules as evidenced by the presence of at least three characteristic symptoms during the past 12 months and at least one symptom in the past six months
characteristic symptoms are divided into four categories:
- aggression to people and animals
- destruction of property
- deceitfulness or theft
- serious violation of rules

Female symptoms include lying, truancy, running away, and substance abuse
Males likely to exhibit both physical and relational aggression, while females exhibit more relational aggression

Question 4

Etiology of Conduct Disorder- Moffitt

Answer 4

life-course-persistent type- begins early (sometimes by age 3) and involves a pattern of increasingly serious transgressions that continues into adulthood; Moffitt attributes this type to a combination of neurological impairments (especially deficits in verbal skills, executive functioning, and memory), a difficult temperament, and adverse environmental circumstances

Adolescence limited type- temporary form of antisocial behavior that reflects a maturity gap between the adolescents behavioral maturation and the lack of opportunities for adult privileges and rewards; for individuals with this type, antisocial acts are usually committed with peers and are inconsistent across situations

Question 5

Treatment of Conduct Disorder

Answer 5

Interventions for conduct-disordered youth are more effective when they target preadolescents (rather than adolescents) and when they include a family intervention

Parent management training- teaches parents to reward the positive behaviors of their children and replace physical punishment for undesirable behaviors with time-out, response cost, and similar techniques

Multisystemic treatment (MST)- alternative approach that targets the individual, family, school, and community and combines behavioral, cognitive, family systems, and case-management strategies