Disruptive, impulse control and conduct d/o Flashcards
duration requirement for intermittent explosive d/o
frequent- 2x/wk for 3 mo w/o phys damage
OR
rare- at least 3x/yr with phys damage
Associated lab findings with impulsiveness and aggression
low levels of serotonin in CSF
onset of intermittent explosive d/o
late childhood/adolescence and progress until middle age
treatment of intermittent explosive d/o
SSRI (fluoxetine most studied), anticonvulsants or lithium
CBT, group/fam therapy
what psych d/o is associated with kleptomania
bulimia-65% of pts also suffer from if they have kleptomania
also mood d/o, anxiety and sustance use
tx for kleptomania
CBT, SSRI, some evidence for naltrexone
tx for pyromania
most don’t go into tx, will remain chronic, poor prognosis
can use CBT, SSRIs, mood stabilizers and APS
ADHD duration criteria
sx > 6 mo and present in 2 or more settings
onset prior to age 12 but can be diagnosed retrospectively
Tx for ADHD
meds in conjunction with education and behavioral interventions
Meds for ADHD
1st line is stimulants- methylphenidate compounds, dextroamphetamine and mixed amphetamine salts
2nd line- atomoxetine, alpha 2 agonists (clonidine, guanfacine)
What is the MC known single gene to cause ASD
fragile X syndrome
What are the 2 most impt prognostic factors for ASD?
level of intellectual functioning and language impairment
Tx for ASD
early intervention
remedial education
behavioral therapy
psychoeducation
low dose APS (risperidone, aripiprazole) to dec disruptive behavior, aggression and irritability
cruelty ot animals
conduct d/o
no difficulties getting along with peers but will not comply to rules from parents or teachers
oppositional defiant d/o
oppositional defiant disorder (ODD) DSM5
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
duration criteria for ODD
at least 6 mo
tx for oppositional defiant disorder
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)
Conduct Disorder DSM5
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
tx for conduct disorder
behavior modification, family and community involvement
Parent Management Training
medications to target comorbid sx and aggression (SSRI,, guanfacine, propranolol, mood stabilizers, APS)