DSM

Question 1

Why Diagnosis

Answer 1

• In order to receive treatment (bill insurance) – need to have a formal diagnosis
• Communicates information to other treatment providers
• Title carries with it treatment and prognosis implications

Question 2

Disruptive Behavior Disorders

Answer 2

• Attention Deficit Hyperactivity Disorder
• Oppositional Defiant Disorder
• Conduct Disorder

Question 3

ADHD types?

Answer 3

– Primarily Inattentive Type
– Primarily Hyperactive Type
– Combined Type

Question 4

Diagnostic Criteria adhd – Inattention and Disorganization Symptoms

Answer 4

• A. 6 of 9 symptoms
– Inattention and Disorganization Symptoms
– 1. often fails to give close attention to detail
– 2. often has difficulty sustaining attention
– 3. does not seem to listen
– 4. often does not follow instructions or fails to finish things

– 5. difficulty organizing work
– 6. avoids or dislikes to engage in tasks that require sustained attention
– 7. often loses things necessary for tasks
– 8. easily distracted
– 9. forgetful in daily activities

Question 5

Diagnostic Criteria adhd –– Motor Hyperactivity symptoms

Answer 5

• 6 of 9 symptoms– 1. excessive running and climbing
– 2. often leaves seat in classroom or other situations
– 3. excessive fidgeting with hands or feet
– 4. motor restlessness
– 5. always on the go
– 6. often talks excessively

– 7. often acts before thinking
– 8. frequently calls out in class
– 9. difficulty waiting turn
– 10. often interrupts or intrudes on others

Question 6

Other DSM-IV Criteria adhd

Answer 6

• Developmentally inappropriate
• 6 months or longer
• Onset before age 7
• Cross-setting
• Impairment

Question 7

Prevalence adhd

Answer 7

• For school-aged children overall rate = 3%
• Sex ratio 6:1 boys to girls
– 1. ADHD, predominantly inattentive (20-25% of cases)
– 2. ADHD, predominantly hyperactive (5% of cases)
– 3. ADHD, combined type (70-75% of cases)

Question 8

Diagnostic Criteria for ODD

Answer 8

• 4 or more symptoms for at least 6 months
– 1. often loses temper
– 2. often argues with adults
– 3. actively defies or refuses to comply with requests or rules
– 4. often deliberately annoys people
– 5. often blames others for their mistakes

– 6. touchy or easily annoyed
– 7. often angry and resentful
– 8. often spiteful or vindictive
• Significant Impairment

Question 9

Diagnostic Criteria for CD

Answer 9

• At least 3 symptoms in the past 12 months and at least 1 in the last 6 months
– Aggression towards people and animals
• Has been physically cruel to people; animals
– Destruction of Property
• Deliberately engaged in fire setting
– Deceitfulness or Theft
• Often lies to obtain goods or favors or to avoid obligations
– Serious Violations of Rules
• Run away home at least twice while living in home
CD criteria (cont’d)
• Clinically significant impairment
• IF individual is 18 or older – don’t meet criteria for Antisocial Personality Disorder (Dx supercedes CD)
• Also note: an individual cannot have a diagnosis of CD and ODD
– CD supersedes ODD

Question 10

Subtypes Based on Age of Onset

Answer 10

• 1. Childhood onset: tend to show Oppositional Defiant Disorder and add more conduct problems to repertoire of behavior as age
• 2. Adolescent onset: Later age of onset and a better prognosis than the childhood onset group.

Question 11

Prevalence CD ODD

Answer 11

• 2-4% in population

* sex ratio 4:1 boys to girls

Question 12

Comorbidities

Answer 12

• 1. ADHD & CD- 65-90% of CD are ADHD
• 2. Anxiety & CD- 22-33% of CD are also dx with an anxiety disorder
• 3. More than half children in will have both Depression & CD

Question 13

Stability and Prognosis

Answer 13

• Although one type of conduct problem may not be stable the disorder tends to be stable.
• Behaviors/diagnosis are more stable:
– a. showing a high rate of multiple types of conduct problems
– b. having an attention deficit disorder
– c. being diagnosed with lower IQ
– d. having a parent with antisocial disorder