Lecture 19 - Conduct Problems

Question 1

What chapter are ODD and CD in?

Answer 1

Disruptive, Impulse-Control, and Conduct Disorders

Question 2

Which disorder is this criteria for?

A. A pattern of negativistic, hostile, and defiant behaviour lasting at least 6 months, during which four (or more) of the following are present:

(1) often loses temper
(2) often argues with adults
(3) often actively defies/refuses to comply with adults’ requests/rules
(4) often deliberately annoys people
(5) often blames others for mistakes/misbehaviour
(6) is often touchy or easily annoyed by others
(7) is often angry and resentful
(8) is often spiteful or vindictive

Answer 2

Oppositional Defiant Disorder (ODD)

Question 3

Which disorder is this criteria for?

A. A repetitive and persistent pattern of behaviour in which the basic rights of others or major age-appropriate 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 6 months:

1. Aggression to people and animals
2. Destruction of property
3. Deceitfulness or theft
4. Serious violations of rules

** probably don’t really need to know

Answer 3

Conduct Disorder (CD)

Question 4

What co-morbid conditions are associated with each Oppositional Defiant Disorder (ODD) type?

Answer 4

Type 1: associated with mood and anxiety disorders

Type 2: associated with ADHD

Type 3: associated with callousness, empathetic deficits, instrumental aggression

Question 5

FIX CARD

Patterson’s (1982) coercion theory
The dominant causal model of conduct problems

Answer 5

• similar to operant theory
• Parent-child interactions play out as an interlocking pattern of reinforcement
• when one person stops (the parent) the battle - simultaneously rewarded.
• “everyone is both a victim, and an architect in the system”
• A 3-step escape-avoidant dance (attack-counterattack-positive outcome)

Question 6

Which is the more severe disorder?

Answer 6

CD - it is like ODD on steroids

Question 7

What are the two sub-categories for Conduct Disorder (CD)?

Why might this distinction be important to note?

(Moffitt, 2006)

*important to know

Answer 7

1. Childhood-Onset Type
2. Adolescent-Onset Type

If onset is at adolescence, it has no risk factors, but is more ‘…an exaggeration of the normative process of adolescent rebellion’.

HOWEVER, the childhood-onset type has:

• Neurocognitive risk factors (e.g., executive function deficits, low verbal IQ)
• Temperamental/personality risk factors (e.g., impulsivity and problems in emotional regulation)
• Coercive parent-child dynamics

The earlier the onset, the longer problem in life it is.

Question 8

In Conduct Disorder (CD), is early onset more common in males or females?

Answer 8

Females.

Question 9

FIX CARD

Summary

Answer 9

1. Conduct problems (ODD, CD) begin early and represent substantial risk for a range of health problems
2. Coercion theory emphasizes causal, moment to moment interchanges with caregivers; these are traps of positive and negative reinforcement;
3. Gradually ‘differential attention’ patterns trap the child and parent in repeated, escalating cycles;
4. These interchanges are the main targets for evidence based treatments;
5. The child generalizes their behaviour to school and other environments, fails to learn how to self-regulate, and gravitates to ‘deviant’ peer groups or rejected status;
6. CP children are heterogeneous, with implications for causes, symptom profiles, trajectories, and treatment needs

Question 10

What are the 3 dimensions that Oppositional Defiant Disorder (ODD) symptoms are grouped into?

Answer 10

(1) Angry/irritable mood
(2) Argumentative/defiant behaviour
(3) Vindictiveness

Question 11

FIX CARD

What are the implications for early dvlpt.

Answer 11

Coercive patterns disrupt the developmental prerequisites for emerging self-regulation
(internal controls over behaviour / emotion / thinking)

In order to develop self-regulation… …a child must first develop the capacity for compliance with external regulation

Failure to establish normative compliance in early childhood

Coercive behaviour functions as a substitute social skill

Child becomes increasingly harder to discipline and socialise

Enters school with social skills deficits

Entrained coercive exchanges generalise to teachers and peers

Question 12

What is ‘Deviancy training’?

Answer 12

Through the contingencies supplied by peers, antisocial children mutually reinforce such behaviour in one another…

Question 13

What are the specifiers for Conduct Disorder (CD)?

Answer 13

Specify type and severity, and specify if: has ‘limited prosocial emotions’.

Question 14

Characteristics of children with/without the LPE specifier

Note: “Limited prosocial emotions” = “callous-unemotional (CU) traits” … = “psychopathic traits”

Answer 14

Low CU Traits:
Emotionally dysregulated 
Over reactive to emotional cues 
Reactive aggression 
Hostile attributional biases

High CU Traits:
More severe & chronic
Proactive aggression 
Reward-dominance 
Under-reactive to emotional cues

Question 15

FIX CARD

Jones, Laurens, Herba, Barker, & Viding, 2009

Answer 15

Boys with CU traits (age 11yrs):

Reduced amygdala reactivity to emotional (fear) stimuli

Question 16

What emotions are people with high CU most likely to recognise?

Answer 16

Fear

Question 17

What did the study on the heritability of conduct problems in 7 year olds find?

(Viding, Blair, Moffitt, & Plomin, 2005)
(twin study)

Answer 17

Low CU traits had a moderate genetic & environmental influence

High CU traits had an extremely strong genetic influence; minimal environmental influence.