Impulse control and conduct disorders Flashcards
basic definition of ODD
pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness
how long do symptoms have to persist for dx of ODD
at least 6 months
how many manifestations does there have to be for dx ODD
at least 4 from any combination of the 3 domains
3 angry/irritable mood symptoms in ODD
-often loses temper
-easily annoyed
-often angry/resentful
4 argumentative/defiant behavior symptoms
-often argues with authority figures
-Defies/refuses to comply with rules/requests from authority figures
-deliberately annoys others
-blames others for mistakes/behaviors
vindictiveness symptoms of ODD
spiteful/vindictive at least twice in past 6 months
what disorder cannot be comorbid with ODD
disruptive mood dysregulation disorder
severity specifiers for ODD
mild - sx in one setting
mod - sx in at least 2 setting
severe - sx in 3+ settings
most common comorbidities of ODD
ADHD
conduct disorder
when do first symptoms of ODD usually appear
preschool
rarely later than early adolescence
ODD dx may precede what other dx
conduct disorder
temperamental risk factors for ODD
high emotional reactivity
low frustration tolerance
difference between ODD and conduct disorder
-ODD behaviors are less severe and do not involve aggression, theft, or destruction of property
-ODD emotion dysregulation symptoms not present in conduct disorder
what diagnosis automatically excludes ODD
disruptive mood dysregulation disorder
2 possible manifestations of intermittent explosive disorder
-verbal/physical aggression at least 2x/wk for 3 months
or
3 outbursts involving destruction of property or assault w/ injury in 12 months
required diagnostic characteristics of outbursts in intermittent explosive disorder
-out of proportion to provocation
-impulsive
-cause distress or functional impairment
age requirement for intermittent ex[plosive disorder
developmental age of at least 6
common characteristics of outbursts in intermittent explosive disorder
-rapid onset with little/no prodromal period
-last less than 30 minutes
which diagnosis excludes intermittent explosive disorder
disruptive mood dysregulation disorder
what are 2 environmental risk factors for intermittent explosive disorder
-trauma before the age of 20
-long-term displacement from home or separation from family
2 factors that differentiate disruptive mood dysregulation disorder from intermittent explosive disorder
-disruptive mood dysregulation disorder has persistent irritable mood between outbursts and symptoms have to have manifested before age 10
difference between aggressive outbursts in intermittent explosive disorder and antisocial or borderline personality disorders
personality disorder outbursts are less impulsive
difference between aggression in intermittent explosive disorder and conduct disorder
conduct disorder is typically premeditated and intermittent explosive disorder is impulsive
basic definition of conduct disorder
repetitive persistent behavior that violates the rights of others or major social norms/rules
number and timeframe of manifestations required for dx of conduct disorder
at least 3 in 12 months with at least one present for at least 6 months
7 possible aggressive manifestations of conduct disorder
-bullies, threatens, intimidates others
-often initiates fights
-used a weapon that can cause serious harm
-physically cruel to people
-physically cruel to animals
-stolen while confronting a victim
-forced sexual activity
2 possible manifestations of conduct disorder involving destruction of property
-deliberately sets fires w/ intent to cause harm
-deliberately destroys others property
4 categories of manifestations for conduct disorder
-aggression
-destruction of property
-deceitfulness/theft
-serious violation of rules
3 possible manifestations of conduct disorder involving deceitfulness/theft
-broken into house/building/care
-often lies to obtain things or avoid obligations
-stolen nontrivial things w/o confronting victim
3 possible manifestations of conduct disorder involving serious violation of rules
-stays out at night against rules beginning before age 13
-run away overnight at least twice or for a substantial period of time at least once
-frequent school truancy starting before 13
-
can diagnosis of antisocial personality disorder be made before age 18
no
specifiers for conduct disorder
-onset
-severity
-if with limited prosocial emotions
conduct disorder onset specifiers
childhood type - sx prior to age 10
adolescent type - no sx prior to 10
unspecified onset - not enough info to discern when sx started
how many manifestations are required for “with limited prosocial emotions” in conduct disorder
-at least 2 manifestations consistently over 12 months in multiple relationships/settings
-must be typical pattern of functioning
4 possible manifestations for “with limited prosocial emotions” specifier in conduct disorder
-lack of remorse/guilt
-callous - lack of empathy
-unconcerned about performance
-shallow or deficient affect (only shows shallow emotions or only for personal gain)
typical behavior traits of those with conduct disorder
(not required for diagnosis)
-negative emotionality
-poor self-control
-irritability/temper outbursts
-suspiciousness
-insensitivity to punishment
-thrill-seeking or reckless behavior
what is a common precursor to conduct disorder
ODD
family level environmental risk factors for conduct disorder
-parental rejection/neglect
-inconsistent parenting/frequent change in caregivers
-harsh discipline
-physical/sexual abuse
-early institutional living
-parental criminology or psychopathology
community level environmental risk factors for conduct disorder
-peer rejection
-association with delinquent peers
-neighborhood disadvantage
-exposure to violence
what are frequent comorbidities with conduct disorder that predict poorer prognosis
ADHD and ODD
6 requirements for dx of pyromania
-deliberate fire setting more than once
-fire setting not for another purpose
-arousal prior to act
-pleasure/gratification from fire setting or dealing with aftermath
-attraction to all things fire
-not better explained by another mental disorder
which dx are often associated with pyromania in juveniles
-conduct disorder
-ADHD
-adjustment disorder
5 diagnostic criteria for kleptomania
-failure to resist urge to steal
-increasing tension before stealing
-relief when stealing
-not for a particular purpose
-not better explained by another mental disorder
typical characteristics of items stolen in kleptomania
typically of little significance and could have been easily afforded
typical features of kleptomania
-not in concert with others
-impulsive
