Oppositional Defiant Disorder and Conduct Disorder

Question 1

How do the gender differences in ODD vary across development?

Answer 1

Boys are more likely to have conduct problems than girls. In children under six the difference is insignificant. During school age children boys are 3x more likely to have a conduct problem that girls. By high school age it evens out as 2:1.
Girls have covert conduct disorders but boys are overt.

Question 2

What are the three behavior categories of ODD diagnosis?

Answer 2

Vindictiveness, Angry/irritable mood, Argumentative/defiant behaviour

Question 3

What are the features of Vindictiveness?

Answer 3

Has been spiteful or vindictive at least twice in the past month.

Question 4

What are the features of Argumentative/ Defiant behaviour?

Answer 4

Often argues with authority figures, Actively defies or refuses to comply with requests from authority figures or rules, often deliberately annoys others, Often blames others for his/hers mistakes or misbehaviors

Question 4

What are the features of Angry/irritable mood?

Answer 4

Often looses temper, Often touchy or easily annoyed, Often angry or resentful

Question 5

How many symptoms ( and for how long) do you need to be diagnosed with ODD?

Answer 5

You need 4 symptoms from any 3 categories. The symptoms must’ve lasted at least 6 months at least once a week (multiple times a week if the child is under five).

Question 6

What is the difference between conduct disorder and Oppositional defiant disorder?

Answer 6

• ODD is less severe and does not involve physical harm towards people or animals, destruction of property or a pattern of deceit. But CD does.
• ODD also covers emotional regularity issues that are not present in CD.

Question 7

What should you do if you think a patient has ADHD and ODD?

Answer 7

You should confirm that the patient is unable to complete tasks or instructions that do not require them to be still or concentrate. If they can not do this they then can be co morbid.

Question 8

Can someone with a mood disorder be diagnosed with a conduct disorder? why?

Answer 8

Someone with a mood disorder can not be diagnosed with a conduct disorder because the mood disorder will often produce the same symptoms as the conduct disorder.

Question 9

What did Frick and Brocki, 2019 say about ADHD and ODD?

Answer 9

They explained why ADHD and ODD is so often comorbid. Theorized that the symptoms are dimensional traits found in the general population but its how the environment shapes the genetics that causes a disorder. The same genetics lead to different disorders based on the environment.

Question 10

Who talks about ODD and ADHD?

Answer 10

Frick and Brocki, 2019

Question 11

Why do conduct disorder symptoms vary with age?

Answer 11

Sexual maturity, cognitive abilities, physical strength

Question 12

What is Conduct Disorder?

Answer 12

Persistent repetitive pattern of behaviour in which the basic rights of others, major age appropriate societal norms or rules are violated.

Question 13

How many criteria/in what time frame do you need to meet to be diagnosed with Conduct disorder?

Answer 13

3 of the 15 criteria must have been violated in 15 months.

Question 14

Name three criteria for CD

Answer 14

Aggressive to people and animals. 
Bullies, threatens, or intimidates others.
Initiates physical fights. 
Has used a weapon that can cause serious physical harm to others.
Physically cruel to animals. 
Forced someone into sexual activity. 
Destruction of Property. 
Deceitfulness or Theft. 
Serious violation of rules.

Question 15

What is childhood onset conduct disorder? why does it matter?

Answer 15

Conduct disorder is said to be childhood onset if the patient has at least one symptom before age ten.
The CD can be reactive: impulsive and defensive after provocation or Proactive: planned for gain or goal orientated.
Childhood onset conduct disorder is more likely to be aggressive during adolescence and greater neuropsychological issues, cognitive, temperamental, familial, and psychosocial risk factors.

Question 16

What types of study did Dick et al., 2005 complete?

Answer 16

Adoption and twin studies.

Question 17

what did Dick et al., 2005 find in adopted children?

Answer 17

They found that adopted children who were adopted from antisocial biological fathers were more likely to develop ODD/CD over children who were adopted from fathers who did not have antisocial fathers.

Question 18

What did Dick et al., 2005 conclude from twin studies?

Answer 18

Dick et al., concluded that it was genetic influences not environmental factors that predicted future CD/ODD diagnosis. Some genetics overlapped for CDD and OD but not all.

Question 19

What are some family predisposing factors for ODD/CD?

Answer 19

Large family size
Parental discord
Substance abusing parents
Excessive conflict within family
Maternal Responsiveness
Low infant fearfulness

Question 20

What did Frick and Brocki, 2019 say about family function?

Answer 20

Maternal responsiveness & infant low fearfulness in infants one year old predicted later conduct problems in insecurely attached infants. Showing attachment formed during infancy is basis for later social behaviour.

Question 21

What neurobiological structures did Matthys et al., 2013 say were related to ODD and CD?

Answer 21

Reward processing, Cognitive control and Punishment processing

Question 22

Who coined the developmental model for ODD?

Answer 22

Loeber et al. (2000)

Question 23

Why is Loeber et al a developmental model?

Answer 23

Becasue it is non stagnent and has multiple pathways and components that can cause the same outcome. ie CD can cause substance abuse or substance absue could be casued by CD. ADHD is said to cause both CD and ODD but at differnet arts of developement. ODD can casue Depression which then in turn could cause CD or substance abuse and so on.

Question 24

What are the three original developmental pathways theorized by Loeber (1993)?

Answer 24

Overt Pathway, Covert pathway and Authority conflict pathway

Question 25

What is the overt pathway?

Answer 25

A developmental pathway theorized by Loeber, 1993, to explain ODD. States that the patient starts with minor agression and progresses to physical fighting and then violence such as rape and attacks.

Question 26

What is the covert pathway?

Answer 26

A developmental pathway theorized by Loeber, 1993, to explain ODD. States that the patient, before age 15, begins with minor covert behaviours, such as shoplifting, and progesses to property damage to delinquency.

Question 27

What is the authority conflict pathway?

Answer 27

A developmental pathway theorized by Loeber, 1993, to explain ODD. States that the patient, before age 12, begins with behaviour such as stubborness to defiance of authority & finally to authority avoidance e.g. truancy.

Question 28

What is the Child and adolescent disposition scale?

Answer 28

A parent rated scale used to test for behaviour problems ie ODD.

Question 29

Who coined the Child and adolescent disposition scale?

Answer 29

Lahey et al., 2010

Question 30

What does the Child and adolescence disposition scale test for?

Answer 30

• Sympathetic response to others
• Negative emotional response to threat, frustration and loss
• Positive response to novelty and risk

Question 31

Who talks about family based intervention for ODD and CD?

Answer 31

Prinstein et al, 2019

Question 32

What is the key focus of family based intervention for CD and ODD?

Answer 32

Refocusing from preoccupation with conduct problem behaviour to emphasis on prosocial goals. Content usually includes psychoeducation on prosocial goals. It is primarily with parents and less child-therapist contact.

Question 33

What are the eight steps of homebased intrvention for ODD and CD?

Answer 33

• Psychoeducation
• Observation and monitoring
• Reinforcement of prosocial behaviour
• Simple effective commands
• Discipline unacceptable behaviour
• Supervision monitoring
• Generalization to other environments
• Communication strategies

Question 34

Who talks about child skills in treatment for ODD and CD?

Answer 34

Prinstein et al. 2019

Question 35

What is the point of child skills training?

Answer 35

Teaching children with ODD and CD, who have social behaviour defecits, social skills.