Externalising Disorders - ODD and Conduct Flashcards
Children of conduct disorders and ODD are at high risk of both ________ and __________ disorders as adults
internalising, externalising
Oppositional Defiant Disorder criterion A (part a): a pattern of…. (part a)
negative, hostile and defiant behaviour lasting at least 6 months
Oppositional Defiant Disorder criterion A (part b): during which 4 or more of the following are present
Angry/Irritable mood
- loses temper
- touchy, or easily annoyed
- angry/resentful
Argumentative/Defiant
- argues with authority
- acts defiantly / refuses to comply with adults requests
- deliberately annoys people
Spitefullness
- spiteful/vindictive
ODD and Conduct Disorder symptoms can be classified under 3 dimensions, these are?
- Negative affectivity - grumpy, irritable and hostile mood.
- Argumentative/defiant
- Vindictiveness
Negative affectivity dimension is mostly associated with…
mood and anxiety disorders; reactive aggression.
What is the difference between reactive and instrumental aggression?
Reactive aggression involves thinking the world is against them (they stole my book)
Instrumental aggression is deliberately targeting others to get what they want - proactive aggression
The augmentative/defiant dimension is mostly associated with…
ADHD
The vindictiveness dimension is uniquely associated with…
Callousness (insensitive and cruel disregard for others), empathic deficits and proactive/instrumental aggression.
Patterson’s Coercion Theory is a ______ model of how conduct problems and ODD _______. It states that the mechanisms by which we develop this ___________ is embedded in the _____-__-________ interactions between parents and children. This theory is embedded in _______ conditioning theory
causal, develops, psychopathology, moment-to-moment, operant
Explain the reinforcement schedules evident in Patterson’s Coercive Theory. What are the immediate implications of it?
The child is positively reinforced - their attack eventually gets the other person to back down so they get what they want - they are rewarded for that behaviour as they get out of, for example, cleaning their room. Some children also benefit from the emotional intensity they receive from their parents.
The parent is negatively reinforced - they get a negative thing removed when they back down (the child calming down)
So one person is positively reinforced and the other is negatively reinforced SIMULTANEOUSLY. So this pattern is likely to continue.
Eventually, these coercive cycles will continue over time, reaching higher levels more ______, and reaching higher and higher levels of _________.
rapidly, amplitude
Unfortunately, the majority of the interactions between parents and child will consist of _____ ______, thereby reducing the amount of reinforcement of ________ behaviour. As soon as the child does something pro-social, the parent ______ or even _____ the child instead of _______ this good behaviour. This is known as a _______ ________ pattern - most of the attention is given to these coercive interchanges.
coercive cycles, positive, relaxes, ignores, rewarding, differential attention
What are the wider consequences of these coercive cycles, at school, with peers, for learning, etc?
- The child will become increasingly more difficult to discipline and socialise
- Without proper external regulatory systems, and compliance to these systems, the child does not learn to self-regulate
- With only these coercive system to rely on, coercive behaviours become their only social skill - limited social skills - generalises to teachers and peers
- At school, they interact with peers similar to them, and reinforce each others behaviour - “gangs”
- rejected status in society
Explain the externalising trajectory of ODD and CD.
These behavioural issues with children often start in the home, and generalise to the school by middle-childhood. The ODD can amplify into CD by adolescence which can lead to drug-use/criminality.
In the externalising trajectory, early childhood is associated with family coercion, _______, and conflict with _______. In middle childhood, often poor ______ is seen, and at school they experience ______ and form ________. Finally, by adolescence, there is often poor ________ of children by their parents, and _______ behaviour with friends, leading to drug-use/crime.
rejection, siblings
poor parenting, rejection, clique
monitoring, deviant
Conduct disorder is characteristic of a persistent pattern of behaviour in which the basic ______ of others or age-appropriate societal _____ are violated. This is manifested by _____ or more of the following 15 criteria in the last ____ months AND ___ criterion present in the last ____ months
rights, norms, 3, 12, 1, 6
Conduct disorder criteria are divided into four dimensions, these are:
- Aggression to people and animals
- Destruction of property
- Deceitfulness or theft
- Serious violation of rules
Aggression to People and Animals involves…
- bullying, threatening or intimidating others
- initiating fights
- use of a weapon
- physically cruel to people
- physically cruel to animals
- stolen with victim present
- forced sexual activity
Destruction of Property involves…
- Deliberately engaging in fire-setting
2. Deliberately destroyed others’ property
Deceitfulness or Threat involves…
- Breaking into someone’s house/car
- Intentionally lying to obtain goods
- Stealing without victim present
Serious Violation of Rules involves…
- Staying out at night despite parental rules
- Running away from home
- Absence from school
What are the two sub-types of CD and what does this suggest about treatability/prognosis?
Child-onset type - prior to 10 years. This is often life-course persistent (or chronic)
Adolescent-onset type - after to 10 years. This often desists and is considered a “normal” teenage behaviour
Conduct disorder, gender effects?
More common in males, often female CD starts in adolescence if at all.
The child-onset subtype of CD is associated with __________ deficits, temperament/personality factors (such as _______ and poor ______ ______, potentially _____) as well as _______ cycles with parents.
neurocognitive, impulsivity, emotion regulation, ADHD, coercive
