impulse control disorders

Question 1

oppositional defiant d/o

Answer 1

behaviors exceed boundaries, dont see problem, dont think theyre wrong
criminal justice, self defeating, resist help
negative, hostile, defiant, vindictive
pattern of irritability and angry mood, sweating, mood lability (angry outburst), low frustration tol (cant tolerate being told no)
stubborn, resist directions, unwilling to negotiate with adults, test limits, ignore rules, verbally aggressive

Question 2

oppositional defiant d/o: interpersonal conflicts

Answer 2

argue, disobedience, tendency to blame others
dont think of themselves as angry or oppositional

Question 3

oppositional defiant d/o: rf

Answer 3

genetic (fam hx MI), neurobio, env (fam dysF), temperamental

Question 4

oppositional defiant d/o: tm

Answer 4

psychosocial interventions: parent training (more +, less frustration), group, anger management
psychobio: valproic acid -> control anger and aggression

Question 5

conduct d/o

Answer 5

increased severity of - behaviors
onset = late child, early adol
guarded prognosis
pyromania and kleptomania
persistent violation of basic rights of others, age appropriate rules/norms
unmanageable at home
argumentative, irritable, angry, defiant, “-“, hostile
lack empathy (no guilt), only remorse at being caught
risk taking, cruelty to animals, aggressive behavior towards people/animals, disruptive in comm, destruction of property

Question 6

conduct d/o: rf

Answer 6

phy or sexual abuse (any exposure), inconsistent parenting with harsh discipline, lack of supervision, early institutional living or out of home placement, association with delinquent peer group, parental substance abuse or criminally genetic

Question 7

conduct d/o: tm

Answer 7

pharm tm for s/s: antidep, mood stabilizers, stim, antipsych, anticonvulsants, adrenergic meds
fam support, psychosocial interventions, anger management, parent management

Question 8

intermittent explosive d/o

Answer 8

cant control aggressive impulses (verbal/phys, @ animals, people, property, self
mean onset 13 - 21
overreact, triggered by anything
not just anger -> emotional dysregulation, stronger than anger
leads to problems with interpersonal relationships, occupational and criminal difficulties

Question 9

intermittent explosive d/o: stages

Answer 9

tension and arousal
event: explosive behavior and aggression -> feel release and relief
remorse

Question 10

intermittent explosive d/o: comorbid

Answer 10

DM and htn
increase testosterone and inflam markers
dep, anx, SUD, antisocial, borderline PD

Question 11

intermittent explosive d/o: rf

Answer 11

neurobio abn (serotonin), conflict or violence in fam (esp at early age)

Question 12

intermittent explosive d/o: tm - psychosocial

Answer 12

safety, rapport, limites and expectations, conssitent consequences of rule breaking, structure and boundaries, activities and opportunities for achievement of goals to promote purpose
Discuss how to make the home a safe environment, especially regarding weapons and drugs; attempt to talk separately to members if possible

Question 13

intermittent explosive d/o: tm - pharm

Answer 13

SSRI: bc serotonergic dysF
Li
anticonvulsant
antipsych
BB: calm, bp, hr
no bezos (decreased inhibition)