ODD & CD

Question 1

Core characteristics of ODD

Answer 1

recurrent pattern of anger/irritability, defiance/disobedience, hurtful behavior, temper tantrums
- justify behavior as response to unreasonable requests from others, think that someone else is imposing on them

Question 2

4 core disruptive behavior dimensions

Answer 2

• temper loss: difficulty calming down, tantrums until exhausted
• aggression: hitting, hurting someone on purpose
• noncompliance: does exactly what told not to do, shows off/laughs while misbehaving
• low concern for others: indifferent to pleasing others, enjoy making others mad

Question 3

core characteristics of CD

Answer 3

violate personal and property rights of others, and age appropriate family and societal rules and norms
- can include antisocial behaviors (vandalism, theft)
- initiate fights, use weapons, cruel to others/animals, struggle w/ self control of emotions

Question 4

legal perspective of conduct problems

Answer 4

defined as delinquent or juvenile acts
- property crimes, violent crimes
- includes apprehension and court contact

Question 5

psychological perspective of conduct problems

Answer 5

conduct problems
fall along a continuous dimension of externalizing
behavior
- label it as “rule-breaking behavior” and “aggressive behavior”

looks at 2 dimensions:
- overt-covert - range from visible acts (fighting) to covert hidden acts (lying, stealing)
- destructive-nondestructive - range from cruelty to animals to arguing/irritability

Question 6

psychiatric perspective of conduct problems

Answer 6

defined as distinct mental disorders
based on DSM-5 symptoms, categorical approach

Question 7

associated characteristics of conduct problems (just list them)

Answer 7

• cognitive
• physical/health
• social family
• social peers

Question 8

cognitive characteristics of conduct problems

Answer 8

average intelligence, lower verbal skills, executive functioning and social cognitive deficits, often underachieve at school, drop out

cool exec functions (seen in ADHD) - attention, WM, planning, inhibition

hot exec functions (conduct probs) - incentives, motivations

Question 9

physical/health characteristics

Answer 9

higher risks for injuries, substance abuse, overdoses, STDs
- rates of premature death is 3-4X higher in adolescent boys w/ conduct probs

Question 10

social family characteristics

Answer 10

general family problems (marital conflict, family instability, parental psychopathology) AND specific ineffective, harmful parenting practices (harsh discipline, little supervision)
- strongest correlate to conduct probs

the two interact (maternal depression leads to poor parenting practices

Question 11

social peers characteristics

Answer 11

poor social skills, verbally and physically aggressive, rejected by prosocial peers, friends w/ deviant peers (they interact w/ each other, support and encourage each other to engage in poor bxrs)

Question 12

sex and age differences in ODD and CD

Answer 12

no/small diff in youths from various ethnic/racial groups
ODD - more boys in childhood, no diff in adolescence, often first seen in preschool
CD - childhood-onset type: more boys; adolescent-onset type: no sex diff, more common in adol than childhood

Question 13

life-course-persistent path

Answer 13

describes children who engage in aggression and antisocial behavior at an early age and continue it into adulthood
- most children do not have this, it’s a very low percentage that continues into adulthood
- this path is linked to family history of externalizing disorders

Question 14

adolescent-limited path

Answer 14

conduct problems begin around puberty and continue into adolescence, but stop in adulthood

Question 15

comorbidities in ODD

Answer 15

co-occurs w/ ADHD (most common); also SLD, depression, anxiety
- often presents after ADHD diagnosis but before anxiety/depression

Question 16

comorbidities in CD

Answer 16

co-occurs with ADHD (esp. boys), depression and anxiety (girls), substance use disorders (no sex diff). higher suicide risk

as many as 40% w/ CD develop APD as young adults
- those w/ CD who have lack of concern for others are at higher risk of extreme antisocial/aggressive acts, poor long-term outcome
- callous and unemotional interpersonal style

Question 17

cause of ODD and CD

Answer 17

environmental factors and biological factors interact

Question 18

environmental factors of conduct problems

Answer 18

family context: general problems (marital conflict, chronic stress, interparental conflict) AND ineffective parenting (harsh discipline, little supervision, low warmth)

other contexts: deviant peers, poor quality school, living in poverty, community violence

Question 19

biological factors of conduct problems

Answer 19

genetics: heritability up to .50; gene-environment interactions likely, family twin studies show genetic component

neurobiology: lower arousal, higher reactivity; impulsive/sensation-seeking temperament, underdeveloped prefrontal cortex, smaller amygdala

Question 20

early developmental factors of conduct problems

Answer 20

low birth weight, malnutrition in pregnancy, substance use in pregnancy all pose risk of developing CD but is not specific to it

Question 21

3 interventions for conduct problems

Answer 21

parent management training (PMT) - teach parents to change child’s behavior at home and other settings

problem solving skills training (PSST) - child learns to handle social situations differently (more sensitive to how others feel, appraising situations, generate better actions)

multisystemic training (MST) - for adolescents w/ severe conduct problems that draws on PMT/PSST and specialized interventions (substance abuse treatment, legal services, special education, etc)

Question 22

ODD outcomes

Answer 22

higher risk for emot/beh/interpersonal probs as adol/adults
- social difficulties w/ peers, romantic partners
- can experience just as much impairment as CD

Question 23

adolescent-onset CD

Answer 23

may achieve okay social/acad/occup functioning unless encounter snares (drop out of school, unplanned parenthood, etc)

Question 24

childhood-onset CD

Answer 24

may have emot/beh/sub abuse/health/occup/relational problems; higher risk of APD
- higher risk of anxiety, depression, substance use
- harder time keeping job, forming stable and non-violent relationships, more health probs

Question 25

parent management training

Answer 25

• teach parents to change their child’s behavior at home and in other settings
• change how they interact w/ child, leads to improvement in child behavior
• parent learns specific new skills
• monitor child bxr, have clear rules, rewards and minor punishments (time out)
• child shows better adjustment when parents participate than 80% who don’t