Disruptuve Impulse Control Flashcards
bright and articulate new student ability to express on paper cannot take no for an answer does not follow rules and directions socially isolated not many friends starts fights happens both at home and public pt feels behavior is fine
Oppositional defiant disorder
Oppositional defiant disorder?
persistent pattern of hostile, angry, argumentative and defiant behaviors
Oppositional defiant disorder-time line?
6 mo or more
Oppositional defiant disorder -dx?
angry irritable mood argumentative vindictiveness (seeking revenge) NOT a sibling interaction longer than 6 mo
Oppositional defiant disorder-age?
5yo: can still dx but keep in mind children may not have coping mechanisms
5yo+: more than once a week
Oppositional Defiant disorder-RF?
marital discord
poor parenting/inconsistent limit-setting
low family cohesion
parental mental disorder/substance abuse
biological
environmental
societal/socioeconomic
Oppositional Defiant disorder - comorbidity?
ADHD
Oppositional Defiant disorder-tx?
cautious dx: consider age appropriate expectations
parent management training
peer training (through a school system: antibully, etc)
pyschotherapeutics (referral)
meds tx related disorders sometimes helpful
Intermittent explosive disorder?
recurrent episodes of inability to control aggressive impulses
Intermittent explosive disorder-sx?
verbal or physical agrresison to people, property or animals in 3mo
OR
3 outbursts of damage, destruction, or injury over 12 mo
Intermittent explosive disorder-etiology?
hx of traumatic exposure
heredity?
Intermittent explosive disorder-tx?
pharmacologic tx + psychotherapy: managed by psychiatry
CBT is SOMETIMES helpful
REFER
Conduct Disorder?
persistent and recurrent behavior style that violates rules/societal norms, and fundamental rights of others
Conduct disorders - sx?
aggressive behavior: threatens or x bodily harm to people/animal
nonaggressive behavior: results in property damage or loss
theft or deceitfulness
breaches of rules and regulation
Conduct disorders - associated weapons/hx?
guns and knives BROKEN bottles break ins damaged property fires injuries
Conduct disorder - specifiers?
lack of remorse or guilt
callous (lack of empathy)
unconcerned
shallow or deficient affect
What can CD turn into?
antisocial personality disorder
Conduct disorder - tx?
parent management
prob solving skills
multisystem therapies
pharmacology (hard to choose) - REFER
Conduct disorder cormobidity?
ODD ADHD IED depressive bipolar
Pyromania?
pahtological fire setting
Pyromania -timeline?
adolescence or early adulthood
Pyromania - sx?
deliberate and purposeful repeated fire-setting
tension or affective arousal preceding
fascination/interest/curiosity/attraction to fire
pleasure/gratification/relief whens netting/witnessing fires
NO monetary gain/ideology
Pyromania - cycle?
tension–> set fire –> relief/pleasure –> goes away
Pyromania - tx?
no meds are approved
impulse control drugs may help - opiod antagonists; topiramate, escitalopram, sertaline, lithium
children: fire safety education and CBT
Kleptomania?
inability to resist repetitive urges to steal specific items: NOT REQUIRED FOR PERSONAL FXN
NOT an expression of anger, vengeance, hallucination, etc
Kleptomania cycle?
tension –> steal –> relief
Kleptomania- tx?
off label opiod antagonists
SSRI
Kleptomania - etiology?
low inhibition (serotonin inhibition) and pathologically elvated urge (low in dopamine)
