ODD & CD Flashcards
Core characteristics of ODD
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
4 core disruptive behavior dimensions
- 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
core characteristics of CD
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
legal perspective of conduct problems
defined as delinquent or juvenile acts
- property crimes, violent crimes
- includes apprehension and court contact
psychological perspective of conduct problems
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
psychiatric perspective of conduct problems
defined as distinct mental disorders
based on DSM-5 symptoms, categorical approach
associated characteristics of conduct problems (just list them)
- cognitive
- physical/health
- social family
- social peers
cognitive characteristics of conduct problems
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
physical/health characteristics
higher risks for injuries, substance abuse, overdoses, STDs
- rates of premature death is 3-4X higher in adolescent boys w/ conduct probs
social family characteristics
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
social peers characteristics
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)
sex and age differences in ODD and CD
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
life-course-persistent path
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
adolescent-limited path
conduct problems begin around puberty and continue into adolescence, but stop in adulthood
comorbidities in ODD
co-occurs w/ ADHD (most common); also SLD, depression, anxiety
- often presents after ADHD diagnosis but before anxiety/depression
comorbidities in CD
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
cause of ODD and CD
environmental factors and biological factors interact
environmental factors of conduct problems
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
biological factors of conduct problems
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
early developmental factors of conduct problems
low birth weight, malnutrition in pregnancy, substance use in pregnancy all pose risk of developing CD but is not specific to it
3 interventions for conduct problems
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)
ODD outcomes
higher risk for emot/beh/interpersonal probs as adol/adults
- social difficulties w/ peers, romantic partners
- can experience just as much impairment as CD
adolescent-onset CD
may achieve okay social/acad/occup functioning unless encounter snares (drop out of school, unplanned parenthood, etc)
childhood-onset CD
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
parent management training
- 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
