Lecture 11: Personality disorders: Chapter 13 (382-389)

Question 1

What is intermittent explosive disorder (IED)?

Answer 1

Recurrent verbal or physical aggressive outbursts that are out of proportion to the circumstances

Question 2

What is the difference between intermittent explosive disorder (IED) and conduct disorder?

Answer 2

IED: impulsive and not preplanned toward other people

Question 3

What is oppositional defiant disorder (ODD)? What is the difference with conduct disorder?

Answer 3

If a child doesn’t meet criteria for conduct disorder, but exhibits aggressiveness as losing his/her temper, arguing with adults, deliberately doing things to annoy others etc.

It’s debatable if it’s distinct from conduct disorder, a precursor to it or an earlier and milder manifestation of it

Question 4

What is a common comorbidity of oppositional defiant disorder (ODD)? What is the difference between these disorders?

Answer 4

ADHD –> but in ODD defiant behavior doesn’t arise from attentional deficits or impulsiveness

Children with ODD are more deliberate than children with ADHD

Question 5

What is the difference in prevalence of conduct disorder between genders?

Answer 5

3 or 4x more likely among boys

(boys are only slightly more likely to have ODD than girls though)

Question 6

What is conduct disorder and what are the 4 defining symptoms of conduct disorder?

Answer 6

A pattern of repeated destructive and harmful behavior that can take different forms:

1. Aggressive behavior (bullying, hurting animals/people)
2. Destroying property (vandalizing, setting a fire)
3. Lying/stealing (shoplifting, breaking in, lying about behavior)
4. Breaking rules (skipping school, missing curfew)

Question 7

What are 3 things that marks behavior in conduct disorder?

Answer 7

1. Callousness, lack of emotions
2. Viciousness
3. Lack of remorse, empathy, guilt

Question 8

What are callous and unemotional traits in children with conduct disorder associated with (2)?

Answer 8

1. More cognitive deficits, more severe course, more antisocial behavior, poorer response to treatment
2. More problems with symptoms, peers and families

Question 9

What are 2 common comorbid problems in children with conduct disorder?

Answer 9

1. Substance abuse
2. Internalizing disorders (depression, anxiety disorders)

Question 10

Which disorders often prcedes conduct disorder?

Answer 10

Depression and most anxiety disorders (no specific phobias or social anxiety)

Question 11

How early does conduct disorder begin?

Answer 11

Preschoolers (age 3) can show symptoms, which can develop throughout childhood

Question 12

What are the 2 different causes of conduct problems?

Answer 12

1. Life course pattern of antisocial behavior, starting from age 3
2. Adolescence limited conduct problems (typical childhoods, high level antisocial behavior during adolescence, nonproblematic adulthood)

Question 13

What can explain the adolescence limited pattern of conduct disorder?

Answer 13

Maturity gap between adolescent’s physical maturation and his/her opportunity to assume adult responsibilities

Question 14

What is the difference in problems between life-course-persistent and adolescence-limited conduct disorder?

Answer 14

Life: most severe problems, psychopathology, poorer health, lower SES, low education, violent behavior

Adolescence: substance use, impulsivity, crime, mental health issues mid-20s

Question 15

How prevalent is conduct disorder?

Answer 15

5-6%, more common in boys

life persistent: 10% (b) - 7% (g)
adolescence: 19% (b) - 17% (g)

Question 16

What is the prognosis of conduct disorder?

Answer 16

Life course: throughout adulthood

Childhood conduct disorder doesn’t inevitably lead to antisocial behavior in adulthood

Question 17

Why is the evidence for genetic influences in conduct disorder mixed?

Answer 17

Genetic influences for conduct disorders are shared with other disorders and some genetic influences are specific to conduct disorder or antisocial behavior

Question 18

What type of behavior in conduct disorder is most heritable?

Answer 18

Aggression, not other rule-breaking behavior (stealing)

Question 19

When do genetics play more of a role in rule-breaking behavior?

Answer 19

When someone grows up in a wealthy neighborhood

Question 20

What are the results of adoption studies on antisocial behavior?

Answer 20

If biological mother had antisocial behavior, the children were more likely to exhibit callous and unemotional behaviors, but not if the adoptive mother gave a lot of positive reinforcement

Question 21

What did neuroimaging studies show in children with conduct disorder?

Answer 21

1. Deficits in regions of the brain that support emotion, especially empathy –> they recognise anger in faces, but have difficulties perceiving distress or happiness
2. Reduced activation emotion reward systems (amygdala, ventrial striatum, PFC) –> not learning to associate behavior with reward or punishment

Question 22

What are some autonomic nervous system anomalies of antisocial behavior in adolescents? What is the interpretation of that?

Answer 22

Lower skin conductance and heart rates –> less arousal (not fearing to get caught)

Question 23

What are psychological influences in conduct disorder?

Answer 23

1. Deficient moral awareness, lacking remorse
2. Harsher parenting leads to more callous/unemotional traits
3. Hostile bias in information processing

Question 24

What is the hostile bias? What is the consequence of this?

Answer 24

Tendency to interpret ambiguous acts as evidence of hostile intent

This leads to more aggressive behavior with a response from peers with more aggressive behavior = vicious cycle

Question 25

What are 2 things research on peer influences in aggression has focused on?

Answer 25

1. Acceptance/rejection by peers
2. Affiliation with deviant peers

Question 26

Do children with conduct disorder choose to associate with like-minded peers (continuing path of antisocial behavior) or does simply being around deviant peers help initiate antisocial behavior?

Answer 26

Both views are correst. Genetic influences can influuence selection of friends, but the environment (neighborhood, family) play a role in wheter the children associate with deviant peers

Question 27

When is treatment of conduct disorder most effective?

Answer 27

When addressing multiple systems in the life (family, peers, school, neighborhood)

Question 28

What is the family check up (FCU) intervention?

Answer 28

3 meetings to get to know, assess and provide feedback to parents regarding their children and parenting practices

–> Positive effects in preventing conduct problems and aggression in children

Question 29

What are considered high risk families for conduct disorder? (2)

Answer 29

1. Presence of conduct/substance problems in parents
2. Early signs of conduct problems in child

Question 30

What is the parent management training (PMT)?

Answer 30

Parents are taught to modify their responses to their children so that prosocial behavior is consistently rewarded

It alters parent child interactions, which decreases antisocial and aggressive behavior

Question 31

What is multisystemic treatment (MST)? What idea is it based on?

Answer 31

Delivering intensive and comprehensive therapy in the community, targeting the adolescent, family, school and sometimes the peer group

Based on view that conduct problems are influenced by multiple factors within the family and interactions with other social systems

Question 32

Why is multisystemic treatment so unique?

Answer 32

It emphasizes individual and family strengths, identifies social context for conduct problems and uses present-focuesed and action-oriented interventions

Question 33

What is the Fast Track intervention?

Answer 33

Prevention method that helps children academically, socially and behaviorally, focusing on problematic areas in conduct disorder (peer relations, aggressive and disruptive behavior and parent-child relations)

Question 34

Is the Fast Track intervention effective?

Answer 34

Yes –> less likely to have conduct disorder diagnosis or another externalizing disorder –> decreases hostile attribution bias