externalizing behavior Flashcards
ODD
oppositional defiant disorder
ODD DSM5 criteria
pattern of
negativistic, angry/irritable mood, argumentative/defiant behavior, or vindictiveness
lasting at least 6 months as evidenced by
at least 4 symptoms of any of the following categories,
and exhibited during interaction with at least one individual who is not a sibling
ODD specifiers
mild - symptoms are confined to one setting
moderate - some symptoms are present in at least two settings
severe - some symptoms are present in three or more settings
for the diagnosis of ODD, there has to be
functional impairment
the diagnosis of ODD requires
symptoms in only one setting
ODD epidemiology
rates vary from 2-11%
decreases with age
greater stability with more severe ODD/CD
stability as high or higher for females
more common in lower SES
ODD natural history more prevalent in
males prior to puberty; rates equalize after puberty
gender differences don’t emerge until after 6 y/o
ODD symptoms often emerge at
home but generalize with time
common comorbidities
ADHD, LD, communication disorder
50% of kids w ADHD have ODD or CD
70% of kids w ODD or CD have ADHD
what contributes to the severity of the symptoms
temperament of the child
parental characteristics
stress
CD
conduct disorder
CD criteria
a repetitive and persistent pattern of behavior in which the basic rights of others or major age-approriate societal norms or rules are violated,
as manifested by the presence of three or more of the following criteria in the past 12 months,
with at least one criterion present in the past six months
CD specifiers
- childhood-onset type
- adolescent-onset type
- unspecified onset
childhood-onset type CD
unsocialized
at least one criterion before age 10 yo
usually male; frequently aggressive
disturbed peer relations
often suffered ODD as a child; may have concurrent ADHD
most likely to have persistent CD and to develop APD
APD
antisocial personality disorder
adolescent-onset type CD
socialized
absence of criteria prior to age 10
less likely to display aggressive behavior
tend to have normative peer relations
less likely to suffer persistent CD and to develop APD
still more males; but a lower ratio
CD rates
1-10%; 6% overall
rate increases with age
__ is a common precursor for CD
ODD
CD onset is rare after
16 yo
CD best predict later diagnosis in children
cruelty to people and weapon use
below age 13, ___ highly predictive of later CD
cruelty, running away, and breaking and entering
a model of delinquency
–> early childhood: poor parental monitoring and discipline
–> child: conduct problems
–> middle childhood: rejection by normal peers and academic difficulties
–> commitment to deviant peer groups
–> late childhood and adolescence: delinquency
child biological factors possibly contributing to ODD and CD
family history
neuroanatomy
neurotransmitters
autonomic nervous system
neurotoxins
temperament
attachment
intelligence
impulsivity and behavioral inhibition
social cognition
puberty
parenting
assortative mating
child abuse
peer effects
neighborhood and socioeconomic factors
factor: family history
maternal smoking
parental substance abuse
pregnancy and birth problems
