L19, 20 - Conduct Problems Flashcards
What was the relationship Kim-Cohen et al. (2003) drew between conduct problems and later disorders?
- Followed 90% of a child cohort into adulthood.
- Early onset conduct problems were common for all later disorders.
- Suggested that conduct problems are an early sign of problematic emotional & behavioural development.
What is the DSM-5 criteria for Oppositional Defiant Disorder (ODD)?
- A pattern of negativistic, hostile, and defiant behaviour lasting at least 6 months.
- ≥ 4 symptoms (e.g. often lose temper, argue with adults, often angry resentful).
Symptoms are grouped across 3 dimensions:
- Angry/irritable mood.
- Argumentative/defiant behaviour.
- Vindictiveness.
The each of the 3 symptom dimensions are associated with specific comorbidities; what are they?
1) Angry/irritable mood:
- Anxiety/mood (depressive) disorders.
2) Argumentative/defiant behaviour:
- Uniquely associated with ADHD.
3) Vindictiveness:
- Uniquely associated with callousness, lack of empathy, & instrumental aggression.
What is Patterson’s (1982) Coercion Theory?
- Centred on the moment to moment child-parent interactions.
- Based in operant conditioning theory.
- Escalating cycle between child and parent.
Parent gives directive -> non-compliance from child -> attack -> counter attack -> repeat (escalating).
- Child becomes more skilled and therefore more difficult to disciple, making the cycle very hard to break.
What are some implications of such coercive behaviour?
- Failure to establish normative compliance/cooperation.
- Disruption of the developmental trajectory of self-regulation.
- Coercive behaviour substitutes as social skills continuing into school.
What is the DSM-5 criteria for Conduct Disorder?
A) Aggression to people and animals.
B) Destruction of property.
C) Deceitfulness or theft.
D) Serious violations of rules.
- Child-onset type: <10yr.
- Adolescent-onset type: >10yr.
What are the 2 types of Conduct Disorder?
- Low CU (callous/unemotional) Traits:
- emotionally dis-regulation.
- over reactive to emotional cues.
- reactive aggression.
- hostile attributional biases.
- moderate gene influence (0.30)
- moderate environmental influence. - High CU Traits:
- more severe and chronic.
- proactive aggression.
- reward-dominance.
- under-reactive to emotional cues.
- high genetic influence (0.81).
- low environmental influence.
What are the 4 main considerations to be made by therapists when treating Conduct Disorders?
- Target the ecology of the child (family or school).
- Take a developmental perspective (when is the best time for intervention?).
- Be formulation/hypothesis-driven (change things systematically and observe results).
- Form a therapeutic team (with family/school).
What is the model of effective discipline for children with these conduct problems?
Child misbehaves
- > gain child’s attention (state inappropriate behaviour and appropriate alternative behaviour)
- > child complies and receives praise or child complains
- > give clear instruction again -> if child escalates, give time out (or other logical consequence).
What is the aim of treatment of Conduct Disorders in terms of the coercive family process and positive and negative behaviours?
Pre-treatment:
- Positive behaviour is ignored, and is attachment neutral.
- Negative behaviour is given attention, and is attachment rich.
The aim of treatment is to switch this reinforcement so that positive behaviours are met with attention and praise.
What is time-out and what are some of it’s common problems?
- Time-out is a brief period (~1 min) where access to reinforcers is denied.
- Time-out should end when child is quiet and under control.
Problems:
- Parents wait too long.
- Child gets distressed.
- What to do with multiple children?
