Lecture 7 Flashcards
Description of Conduct Problems
Age-inappropriate actions and attitudes that violate family expectations, societal norms, and personal or property rights of others
Also described as antisocial behaviour
Disruptive and or rule breaking behaviour
On a dimension- severe or not
More serious= vandalism, assault, serious aggression
Conduct problems- highly prevelant and normative
6% report it- associated with anxiety and social withdrawal
Typical and normative to some extent
Disorder= problematic= more severe and frequent
Associated with unfortunate family and neighborhood circumstances
Mental health and juvenile Justice system and general public and criminal justice system
Don’t excuse behaviour bit provide normative context
Difference in approaches
Mental health- protect at risk and provide care for those who experience adversity and how to mitigate neg outcomes
Criminal justice- punishment to protect them
Context
Behaviors vary in severity
Some may decrease, some stay consistent, and some increase with age
Gender differences narrow into adolescence
Provide features of antisocial behaviour in normative development
1- disobeying at home- less severe- most prominent in ealry childhood, decreases later on
Fights- different paths for different people
Peer affiliation- due to opportunity, can inc it over time
Range in severity
Some Dec while others stay constant and some Dec in age
Social and Economic Costs
5% of children show early, persistent, extreme antisocial behavior
These children account 50% of all crime in the U.S.
Annual public cost is ~$10,000 per child with conduct problems
Perspectives of conduct problems
Many perspectives used to refer to conduct problems
Different terms and focuses in how we define antisocial behaviour and patterns of it
Legal Legal- antisocial= criminal acts
Result in arrest r court involvement
Delinquency- children who broke law- stealing, truancy, serious assault
Vary depend on existing laws
Exclude behaviours of very young children
Minimum age of responsibility- 8i-12- cant be applied to younger child
qualifies for conduct disorder- need 1 - 2 behaviour while it is persistent behaviour
Psychological Dimensional approach
Antisocial defined on continuum of externalinzng behaviour
Don’t fit into mean= diagnosed
Rule breaking behaviour- vandalism
Vs aggressive behaviour- fighting, serious destruction
4 categories emerge from the 2 dimension
Overt- visible acts
Covert- more hidden
Destructive behviour vs non destructive behaviour- arguing, temper
4 types of conduct problems
Destructive overt= most long lasting
Psychiatric
Categorical focus
Distinct categories based on dsm symptoms
General category- impulse/ conduct problems
Refereed to as disruptive behaviour disorders
Public health
Blends previous 3
Focus on intervention and prevention
Goal- view these problems as public health concerns- can lead to more productive society
Worry abt car accidents, smoking
Cuts across different areas- politics, science
Understand problems and how to treat and prevent them
Two DSM-5 Disruptive Disorders
ODD Negative affect, defiance, and hurtful behavior
Conduct disorder Aggressive and rule-violating behavior towards anyone
Both have routes in self control issues
ODD- problems being controlled
Cd- being controlled and exert control problems
Predict future psychopathology
CD- more severe
Oppositional Defiant Disorder
Age-inappropriate recurrent pattern of stubborn, hostile, disobedient, and defiant behaviors
Usually appears by age 8
Angry irritable mood
Argumentative defiant behaviour
Vindictiveness
3 categories of behavior
Correlated dimensions but first 2- co occur most frequently, vindictive is less involved(may be CD)
DSM-5 Criteria for ODD
A. A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at
least 6 months as evidenced by at least 4 symptoms from any of the following categories, exhibited during interaction with at least 1 individual who is not a sibling:
Angry/Irritable Mood
Often loses temper.
Is often touchy or easily annoyed.
Is often angry or resentful.
Argumentative/Defiant Behavior
Often argues with authority figures or, for children and adolescents, with adults.
Often actively defies or refuses to comply with
requests from authority figures or with rules.
Often deliberately annoys others.
Often blames others for his or her mistakes or misbehavior.
Vindictiveness
8. Has been spiteful or vindictive at least twice within the past 6 months.
5 years or younger- should be very frequent- every day
B. The disturbance in behavior is associated with distress in the individual or others in his or her
immediate social context (e.g., family peer group, work colleagues), or it impacts negatively on social, educational, occupational, or other important areas of functioning.
C. The behaviors do not occur exclusively during the course of a psychotic, substance-use, depressive, or bipolar dis-order. Also, the criteria are not met for disruptive mood disorder.
Specify current severity:
Mild: Symptoms are confined to only one setting (e.g., at home, at school, at work, with peers).
Moderate: Some symptoms are present in at least two settings.
Severe: Some symptoms are present in three or more settings.
Also has to cause impairement
Cant be caused by substance abuse or mental disorder
Conduct disorder
Repetitive, persistent pattern of severe aggressive and antisocial acts
Emerges in some before age 10 (child-onset) and some after (adolescent-onset)
Agression to people and animals
Destruction of property
Decidtdulness apr theft
Serious violations of rules
Inflicting pain on others or restricting rights of others
More severe behaviors than CD
Emerges later- before age 10
DSM-5 Criteria for Conduct Disorder
A. A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate
societal norms or rules are violated, as manifested by the presence of at least 3 of the following 15 criteria in the past 12 months from any of the categories below, with at least 1 criterion present in the past 6 months:
Aggression to People and Animals
Often bullies, threatens, or intimidates.
Often initiates physical fights.
Has used a weapon that can cause serious physical harm to others (e.g., bat, brick, broken bottle, knife, gun).
Has been physically cruel to people.
Has been physically cruel to animals.
Has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery).
Has forced someone into sexual activity.
Destruction of Property
Has deliberately engaged in fire setting, with the intention of causing serious damage.
Has deliberately destroyed others’ property (other than by fire setting).
Deceitfulness or Theft
Has broken into someone else’s house, building, or car.
Often lies to obtain goods or favors or to avoid obligations (i.e., “cons” others)
Has stolen items of nontrivial value without confronting a victim (e.g., shoplifting, but without breaking and entering; forgery).
Serious Violations of Rules
Often stays out at night despite parent prohibitions, beginning before age 13 yrs.
Has run away from home
overnight at least twice while living in parental or parental surrogate home, or once without returning for a lengthy period.
Is often truant from school, beginning before 13
B. The disturbance in behavior causes clinically significant impairment in social, academic, or
occupational functioning.
C. If the individual is 18 years or older, criteria are not met for Antisocial Personality Disorder.
Specify whether:
Childhood-onset type: Individuals show at least one symptom characteristic of conduct disorder prior to age 10 years.
Adolescent-onset type: Individuals show no symptom characteristic of conduct disorder prior to age 10 years.
Unspecified onset: Criteria for a diagnosis of conduct disorder are met, but there is not enough information available to determine whether the onset of the first symptom was before or after age 10 years.
Specify if:
With limited prosocial emotions: Must have displayed at least 2 of the following characteristics persistently over at least 12 months and in multiple relationships and settings:
Lack remorse or guilt, callous lack of empathy, unconcerned about performance and shallow or deficient affect Specify severity:
Mild: Few if any conduct problems in excess of those required to make the diagnosis are present, and conduct problems cause relatively minor harm to others (e.g., lying, truancy, staying out after dark without permission, other rule breaking).
Moderate: The number of conduct problems and the effect on others are intermediate between those specified in “mild“ and those in “severe” (e.g., stealing without confronting a victim, vandalism).
Severe: Many conduct problems in excess of those required to make the diagnosis are present, or conduct problems cause considerable harm to others (e.g., forced sex, physical cruelty, use of a weapon, stealing while confronting a victim, breaking and entering).
Conduct Disorder Age of Onset
Childhood-Onset CD
Display one or more symptoms before age 10
Adolescent-Onset CD
Display symptoms at of after age 10
Evidence uggesting age of onset is important
Childhood= more boys than girls
More aggressive symptoms
Behaviour persists over time
More severe family adversity and dysfunction
Adolescent- gender doesn’t matter
Not as severe
Less likely to commit violent offences
More likely to stop showing symptoms
In some. Cases ODD thought of precursor to CD- emerges before it and can be associated with it, many have ODD and don’t get CD
Are CD and ODD Separate?
Most children who display ODD do not progress to more severe CD
Nearly half of all children with CD have no prior ODD diagnosis
Very small amount go on to receive diagnosis of CD
More strong predictor of future deviant disorder, doesn’t signify future conduct problems
Antisocial Personality Disorder (ADP) and Psychopathic Features
Pervasive pattern of disregard for and violation of the rights of others; involvement in multiple illegal behaviors
~40% of children with CD develop APD as young adults
Psychopathic features
Display callous and unemotional (CU) interpersonal style
Diagnosable above age 18
CD-may lead to ADP
APD- show psychopathic behaviour, present in CD
Tend to be aware behaviour is causing others z to suffer
Goals= dominance, revenge
CD at risk for ADP- esp antisocial
Associated Characteristics
Cognitive and Verbal Deficits
Executive functioning deficits
CD- show normal intelligence
Verbal- emerge early, before conduct problems- challenges with reading, expressive language, communication- can contribute to CD- cant control behaviours, cant communicate emotions or solve problems= more aggressive behaviour
Cant communicate needs- more Leakey to act out with overt/problematic behaviour
EF deficit= also in ADHD
Hot vs cold EF
Hot- reward/motivational element- reward at end of task- motivation
Cold- cognitive processes, stroop task- no reward
ADHD= cold EF deficits
CD- deficits in hot EF
Have both adhd and CD- show deficits in both
School and Learning Problems
Dropout, suspension, and expulsion
Academic underachievement
Grade retention
Special education placemen
Language deficits to reading and communication difficulties to associate with delinquents peers to conduct problems to loss of i yersent in school
Different ,mechanisms
Early language deficit- cant read/ communicate= CD
Disinterested in school, look for stimulation elsewhere= conduct problems s
Family problems
General family disturbances cause child conduct problems
Child conduct problems cause Specific disturbances in parenting practices and family functioning
Vicious cycle
Family disturbance- marital discord
Contribute to parenting disturbances– cant engage in responsive/sensitive parenting
Increasing CD
Increasing family conflict and problems== cycle
