ODD and Conduct Disorder Flashcards
ODD vs. CD
ODD is a pattern of negativistic, disobedient, and hostile behavior
CD is more severe antisocial and aggressive behavior that involves serious violations of others’ rights or deviations from major age-appropiate norms.
Categories of behavior
- Aggressiveness to people and animals
- Property destruction
- deceptiveness or theft
- and serious rule violations (e.g. running away from home, being truant from school before age 13).
CP’s two bipolar dimensions
- Overt-covert dimension, the overt pole comprises directly confrontational behaviors such as oppositional defiant behaviors and aggression.
• Overt-destructive (e.g. aggression)
• Overt-nondestructive (e.g. oppositional) - In contrast, the covert pole comprises behaviors that are nonconfrontational in nature (e.g. stealing, lying). → This is more important for explaining the covariation of CPs.
• Covert-destructive (property violations)
• Covert-nondestructive (status offenses; truancy).
Keystone behavior in development in CP
NONCOMPLIANCE
Retaliatory vs. instrumental aggression
retaliatory - associated with social isolation and rejection
instrumental - less anxious, more positive outcomes for behavior
(also relational aggression)
Comorbidity
ADHD - 36% boys and 57% of girls (poor outcomes)
Depression/anxiety
substance abuse
underachievement - 20-25%
Associated risks
Irregularities in CNS
o Cognitive correlates
• Lower intelligence scores (esp. verbal intelligence)
• Learning style more sensitive to rewards than punishments (reward-dominant response style)
• Show a variety of deficits in social cognition, which is they way they interpret and use social cues to respond in social situations (issues with how they process information)
o Family context
• Insecure attachment to parent
• Coercive style of parent-child interaction
Mediated and or moderated by parenting practices, maternal depression, family adversity
• Parenting practices
Inconsistent or irritable
Explosive discipline
Low supervision and involvement
Inflexible, rigid discipline
• Other familial factors
Parental social cognitions (e.g. perceptions of te child)
Parental personal and marital adjustment
Parental stress, as well as parental functioning in extrafamilial social contexts
HOWEVER CP MAY CAUSE THESE FAMILIAL PROBLEMS
Low SES - poor housing, schools, neighborhoods, violence
Childhood onset
• Childhood onset → more severe, antisocial and criminal behavior in adulthood. More of the dispositional and contextual correlates associated with CP are more strongly associated with the childhood-onset subtype. Develop CP behavior through a transactional process involving a difficult and vulnerable child (e.g. impulsive, with verbal deficits, with a difficult temperament) who experiences an inadequate rearing environment (e.g. poor parental supervision, poor quality schools). Dysfunctional transactional process disrupts the child’s socialization, leading to poor social relations with persons both inside and outside the family, which further disrupts the child’s socialization.
Adolescent Onset
Adolescent-onset pathway as showing an exaggeration of the normative developmental process of identity formation that takes place in adolescence. Their engagement in antisocial and delinquent behaviors is conceptualized as a misguided attempt to obtain a subjective sense of maturity and adult status in a way that is maladaptive but encouraged by an antisocial peer group.
Callous and unemotional (CU) traits
Don’t care attitude. Decreased sensitivity to punishment cues.
Deficits in their processing of negative emotional stimuli.
Those who do not show callous and unemotional (CU) traits have high levels of emotional distress, are more reactive to the distress of others in social situations, and are highly reactive to negative emotional stimuli. This can lead to very impulsive, unplanned, aggressive and antisocial acts.
Assessment Considerations
- 1st determine if CP is really the problem or unrealistic parental or teacher expectations.
- Comorbidity
- Risk factors that led to development of CP, contribute to present problems
- Developmental pathway
- Understand that CP traits are somewhat normal in preschool-age children and adolescents.
Stages of Assessment
o Multistage assessment strategy is typically recommended.
• First stage: Broad-band screening instruments and unstructured clinical interviews to identify the relevant CP behaviors, as well as likely comorbid conditions.
• Second stage: The, more focused and/or labor-intensive measures are administered to provide more detailed information concerning the youth’s CP behavior, to assess factors that could help to identify the youth’s most likely developmental trajectory (e.g. age of onset of the Cps, level of CU trais, problems in emotional regulation), and to assess associated conditions in multip settings based on the results of this initial assessment. Also determine the functional impairment or adaptive disability.
• Third stage: an array of risk factors needs to be assessed, guided by the information obtained in stage 1 + 2 as to the most likely developmental pathway that the youth may be following, and guided by the protypical descriptions of these pathways provided earlier.
Treatments
Parent Management Training (PMT)
- establishing rules , positive reniforment, mild forms of punishment, negotiating compromises
goal is to increase prosocial beahvior and decrease deviate behavior
Multisystemic Therapy (MST)
- rationale-child is embedded in multiple systems including..thus multiple techniques must be used
- PMT, problem solving skills training, and marital therapy, alter parent-child interactions at home.
- present focused and action oriented
Functional Family Therapy (FFT) -
relies on systems, behavioral, and congitive views of dysfuntion
goal is to alter interaction and communication patterns in such a way as to foster more adaptive functioning
-very relational focus
-reduce negativeity, blaming, redefine problem with a family focus (reframing)
NO GROUP THERAPY!!!
Olympia et al (2004)
CD vs. SMA
