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Psychosocial Conditions > Disruptive, Impulse-Control, and Conduct Disorders > Flashcards

Disruptive, Impulse-Control, and Conduct Disorders Flashcards

1
Q

Name the 3 Disruptive, Impulse-Control, and Conduct Disorders

A
  • Oppositional Defiant Disorder
  • Intermittent Explosive Disorder
  • Conduct Disorder
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2
Q

What category was Disruptive, Impulse-Control, and Conduct Disorders included in in previous version of the DSM?

A

included with disorders of Infancy, Childhood, and Adolescence

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3
Q

Are Disruptive, Impulse-Control, and Conduct Disorders included with ADHD?

A

no, now conceptualized as separate from ADHD

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4
Q

What addition was added to Disruptive, Impulse-Control, and Conduct Disorders and why was it controversial?

A
  • Addition of Intermittent Explosive Disorder

- Controversial because of concerns this is insufficiently distinct from normal temper outbursts

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5
Q

What is the diagnostic criteria for Oppositional Defiant Disorder?

A

A pattern of angry or irritable mood with argumentative, defiant, or vindictive behavior, lasting at least six months, with:

  • Angry/irritable mood
  • Argumentative/defiant behavior
  • Vindictiveness: at least 2x in 6 months
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6
Q

What are symptoms of Oppositional Defiant Disorder often associated with?

A

distress in the individual or in others

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7
Q

What are the differential diagnosis for Oppositional Defiant Disorder?

A
  • ADHD

- Developmental disorders

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8
Q

What are the comorbidities for Oppositional Defiant Disorder?

A
  • ADHD

- Developmental disorders

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9
Q

What are the genetic/biological etiologies for Oppositional Defiant Disorder?

A
  • Reduced cortisol reactivity to stress
  • Reduced amygdala reactivity to negative stimuli
  • Altered serotonin and noradrenaline neurotransmission
  • Abnormalities in the amygdala and frontal cortex
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10
Q

What are the environmental etiologies for Oppositional Defiant Disorder?

A
  • Prenatal maternal cigarette smoking, alcohol use, or viral illness
  • Maternal stress and anxiety
  • Low birthweight
  • Early neonatal complications
  • Parental stress
  • Dysfunctional parenting (can be the reason, but not in most cases)
  • Early deprivation or adoption all are implicated in development of the disorder
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11
Q

What is the prognosis for Oppositional Defiant Disorder?

A
  • Strong predictor of adult antisocial personality disorder
  • Strong predictor of conduct disorder and depression
  • Worse prognosis if early onset
  • More severe ODD predicts personality disorder
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12
Q

What are the implications for function for Oppositional Defiant Disorder?

A
  • Negatively affects family, school, social, and work performance
  • Difficulty in areas of interpersonal skills, emotional regulation
  • Difficulty in associating behaviors with +ve or –ve consequences
  • Decreased problem solving, attention, decision making
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13
Q

What treatments are used for Oppositional Defiant Disorder?

A
  • Interventions focused on social learning
  • Psycho-therapies including cognitive-behavioral therapy, parent training and family therapy
  • Collaborative problem solving has shown some modest success-develop skills in problem solving, flexibility, frustration tolerance
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14
Q

What are the implications for OT for Oppositional Defiant Disorder?

A
  • Parent training- understand behavior & social learning
  • Behavioral interventions emphasizing engagement in meaningful and acceptable forms of activity, with emphasis on improved social awareness and skill
  • Teach problem solving, decision making; train frustration tolerance and attention
  • Clear expectations and consequences are essential- Consistent with classroom rules, house rules
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15
Q

What is the diagnostic criteria for Intermittent Explosive Disorder?

A

-Frequent behavioral outbursts and failure to manage aggressive impulses:
-Verbal aggression- no damage/destruction or
physical injury
-Behavioral outbursts- cause damage/destruction or
physical injury to others twice a week for at least 3
months
-Behavior out of proportion with provocation
-The outbursts are not premeditated to accomplishing some identifiable objective
-The outbursts cause distress in the individual or dysfunction, legal or financial consequences

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16
Q

How old must a child be to be diagnosed with Intermittent Explosive Disorder?

A

least six years old

17
Q

What are the neurocognitive changes in Intermittent Explosive Disorder?

A
  • Serotonergic abnormalities, particularly in the limbic system and orbitofrontal cortex, with differential activation of the corticolymbic system
  • Individuals with a first degree relative with IED were at higher risk
18
Q

What gender, education level, and socioeconomic status are most at risk for developing Intermittent Explosive Disorder?

A

Male gender and low education and income

19
Q

What is the prognosis for Intermittent Explosive Disorder?

A
  • Chronic

- High risk of heart disease in later life

20
Q

What are the implications for function in Intermittent Explosive Disorder?

A
  • Negatively affects school, social, and work performance
  • Difficulty in developing positive relationship
  • Legal difficulties
21
Q

What techniques in cognitive behavior therapy are used for treatment of Intermittent Explosive Disorder?

A
  • Cognitive restructuring-identify and change negative thoughts
  • Coping skills
  • Relaxation training
22
Q

What medications are used for treatment of Intermittent Explosive Disorder?

A

Antidepressants, mood stabilizers, and antipsychotic drugs to decrease outbursts

23
Q

What are the implications for OT for Intermittent Explosive Disorder?

A
  • Emotional control strategies; practice skills
  • Appropriate expression of emotions
  • Focusing on personal strengths
  • Assist to gain insight- Identify past situation if possible, rationalize
  • Assist to identify appropriate career choice
24
Q

What is the diagnostic criteria for Conduct Disorder?

A
  • Persistent pattern of behavior with serious violation of the rights of others or rules of conduct
  • Aggression to people and animals
  • Destruction of property by fire, etc
  • Deceitfulness or theft
  • Stays out late despite parental rules (younger than 13)
  • Often truant from school
  • Symptoms cause dysfunction
  • At least 3 episodes in one year, with symptoms in past six months
25
Q

What are the differential diagnoses for Conduct Disorder?

A

Antisocial personality disorder

26
Q

What are the comorbidities for Conduct Disorder?

A
  • Substance use disorders
  • ADHD
  • Intellectual disabilities
  • Learning disabilities
27
Q

What is the etiology of Conduct Disorder?

A
  • Subtle neurological deficits like poor verbal abilities and inhibitory control
  • Gray matter volume reductions in the areas that process socioemotional stimuli
  • Family histories of antisocial behavior and either harsh or inconsistent parenting- controversial
28
Q

Is the adolescent form of conduct disorder more or less severe?

A

Adolescent form less severe

29
Q

What is the prognosis for Conduct Disorder?

A
  • Poor with associated alcohol or substance abuse
  • High probability of developing adult antisocial or borderline personality disorders- may cause financial and legal difficulties
  • Early onset of the behavior predicts a worse outcome, including a high potential for violence and criminal behavior over time
  • Worst with callous/unemotional traits
30
Q

What are the implications for function for Conduct Disorder?

A
  • Negatively affects school, social, and work performance
  • Difficulty in areas of interpersonal skills, emotional regulation
  • Difficulty transitioning to adult roles- work & family life
  • Can contribute to legal difficulties which further affect performance
31
Q

What treatments are used for Conduct Disorder?

A
  • Preventive interventions attempted with early signs
  • Parent training- positive child-parent interaction, consistency in discipline
  • Behavioral interventions reinforcing prosocial behavior
32
Q

What are the implications for OT for Conduct Disorders?

A
  • Channel energy to more appropriate activities
  • Reinforce acceptable behavior
  • Consistent expectations
  • Engagement in recreation- provide experience of success
  • Opportunities for appropriate expression of emotion – movement, music, art, play; build self-concept
  • Anger management, coping strategies
  • Parent training for the above
  • Treatment of ADHD and other co-existing conditions

Psychosocial Conditions (9 decks)

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