Disruptive, impulse control and conduct d/o

Question 1

duration requirement for intermittent explosive d/o

Answer 1

frequent- 2x/wk for 3 mo w/o phys damage
OR
rare- at least 3x/yr with phys damage

Question 2

Associated lab findings with impulsiveness and aggression

Answer 2

low levels of serotonin in CSF

Question 3

onset of intermittent explosive d/o

Answer 3

late childhood/adolescence and progress until middle age

Question 4

treatment of intermittent explosive d/o

Answer 4

SSRI (fluoxetine most studied), anticonvulsants or lithium

CBT, group/fam therapy

Question 5

what psych d/o is associated with kleptomania

Answer 5

bulimia-65% of pts also suffer from if they have kleptomania

also mood d/o, anxiety and sustance use

Question 6

tx for kleptomania

Answer 6

CBT, SSRI, some evidence for naltrexone

Question 7

tx for pyromania

Answer 7

most don’t go into tx, will remain chronic, poor prognosis

can use CBT, SSRIs, mood stabilizers and APS

Question 8

ADHD duration criteria

Answer 8

sx > 6 mo and present in 2 or more settings

onset prior to age 12 but can be diagnosed retrospectively

Question 9

Tx for ADHD

Answer 9

meds in conjunction with education and behavioral interventions

Question 10

Meds for ADHD

Answer 10

1st line is stimulants- methylphenidate compounds, dextroamphetamine and mixed amphetamine salts

2nd line- atomoxetine, alpha 2 agonists (clonidine, guanfacine)

Question 11

What is the MC known single gene to cause ASD

Answer 11

fragile X syndrome

Question 12

What are the 2 most impt prognostic factors for ASD?

Answer 12

level of intellectual functioning and language impairment

Question 13

Tx for ASD

Answer 13

early intervention
remedial education
behavioral therapy
psychoeducation

low dose APS (risperidone, aripiprazole) to dec disruptive behavior, aggression and irritability

Question 14

cruelty ot animals

Answer 14

conduct d/o

Question 15

no difficulties getting along with peers but will not comply to rules from parents or teachers

Answer 15

oppositional defiant d/o

Question 16

oppositional defiant disorder (ODD) DSM5

Answer 16

at least 4 sx present for at least 6 mo w/ at least 1 individual who is not a sibling:

anger/irritable mood- lose temper, easily annoyed, often angry

argumentative/defiant behavior-breaks rules, argues with authority

vindictiveness- spiteful at least 2x in past 6 mo

Question 17

duration criteria for ODD

Answer 17

at least 6 mo

Question 18

tx for oppositional defiant disorder

Answer 18

behavior modification, conflict management training
Parent Management Training can help with setting limits and enforcing consistent rules
Medications for co-morbid conditions (such as ADHD)

Question 19

Conduct Disorder DSM5

Answer 19

pattern of recurrently violating the basic rights of others or societal norms with at least 3 behaviors over the last year and at least 1 recurring within the past 6 mo:

aggression to ppl and animals- physical fights, weapons, bullies, steal while confronting, force into sexual activity

destruction of property- fire setting

deceitfulness or theft- broken into home/building/car, lied to obtain goods

serious violation of rights- stays out late before 13 yo, runs away at least twice

Question 20

tx for conduct disorder

Answer 20

behavior modification, family and community involvement
Parent Management Training
medications to target comorbid sx and aggression (SSRI,, guanfacine, propranolol, mood stabilizers, APS)