Session Nine (Conduct Disorders) Flashcards
Outline the DSM-5 criteria for a conduct disorder.
- 3/15 Aggressive and/or Rule Violating behaviours (inc. bullying, fire setting, lying to obtain goods, truancy)
- In the last 12 months
- With limited pro-social emotions e.g. lack of remorse, lack of empathy, unconcerned about performance in important activities, shallow affect
What are the 4 types of behaviour looked for when making a diagnosis of Conduct Disorder?
- Aggression (bullying, threatening, intimidating, physical fighting, physically cruel to people or animals)
- Destruction of Property (includes setting fires)
- Deceit and Theft (breaking into houses, lying to obtain goods or favours, stealing without confronting the victim)
- Serious Violation of Rules (staying out all night, running away from home, truant from school)
How prevalent are conduct issues in childhood?
5-10% of children experience early onset and persistent conduct problems.
What is the societal impact of conduct disorders?
- Financial: 70k per youth
- Criminal: Could account for up to 80% of crime within a community
- Prognostic: Majority of adults with antisocial personality disorder had some sort of childhood conduct disorder
Therefore huge area of research at the moment.
What are the 2 types of childhood/adolescent conduct disorders Moffit identified?
Life Course Persistent (aka Childhood onset) group:
Where children are born into difficult families, or with difficult temperaments or into neglect, and quickly learn to use aggression. Once they enter a sociable age they find other similar children and from there behaviour escalates, with criminality and drug use following on quite rapidly.
Adolescent Onset group:
These kids begin to engage in non aggressive delinquent behaviour in their teen years, and are more likely to deliberately breach or reject rules. Often see a surge in delinquent behaviour in adolescence which then calms down as they enter adulthood.
What did Odger’s 2008 study suggest about Moffit’s two groups?
Seemed to confirm their existence, but also showed that a larger group of people who begin delinquent behaviour very young but drop off by ager 15 exists.
Persistent group = 8%
Adolescent group = 12%
Childhood limited = 24%
Low delinquent behaviour = 56%
How commonly do conduct disorders transition into adult behavioural problems, and what has been suggested to explain this?
Under 50% of kids with conduct disorders maintain them into adulthood.
Two theories behind this desistance:
- Transition to internalised types of maladjustment (e.g. depression, anxiety)
- Get better
But little is known about what differentiates these groups, early risk factors are generally similar between the two with perhaps some variations in hyper-activity and parent criminality.
What was ALSPAC?
Avon Longitudinal Study of Parents and Children.
A population based prospective cohort study looking for conduct disorders as well as extensive social and biological data.
14,000 children and their parents recruited and monitored from conception to the age of 15.
What were the findings of the ALSPAC study?
- Supported Offit’s findings about the 3 patterns of conduct disorder behaviour
- Showed that CO kids were less socially typical and more likely to develop anxiety issues, suggest switch to internal maladjustment.
Showed a variety of risk factors were associated with conduct behaviours:
- Temperamental activity level as young at 2 can predict conduct disorders
- Mum reporting she doesn’t enjoy time with the child
- Harsh parenting (hitting)
- Partner cruelty
- Maternal anxiety in pregnancy
All these factors were found most in CO kids, then next most in CL kids, then AO and least in kids not showing these behaviours. Suggests a sort of spectrum.
How might maternal prenatal anxiety affect the developing foetus?
- Cortisol is able to cross the placental barrier
- High levels of maternal cortisol can expose the baby to high levels as well
- Causing a stress response in the offspring
- Leading to…
- Low birth weight
- Neuro, cognitive and emotional developmental delay
- Aggressive behaviour
Outline the programming theory of prenatal response to cortisol?
Some have suggested that the effect of cortisol on a developing foetus is an evolved mechanism to prepare the child for the outside world. Basically if the mother is exposed to high stress during pregnancy, the baby adapts to this environment in the womb so it can come out already adapted to the stressors it will encounter in early life.
How have people interpreted the findings from the ALSPAC study?
- Cortisol, biological effect
- Early experiences have a lasting effect, but only if reinforced or maintained by subsequent events
(this is a slightly more optimistic viewpoint as it suggests potential for early intervention)
What is Epigenetics?
Literally means ‘above the genes’, a second modulation process that affects how and how much a gene gets expressed.
Genetics = hardware Epigenetics = software
What is DNA Methylation?
The addition of a methyl molecule into a DNA base pair (CpG).
CPGs are a Cytosine followed by a Guanine, and exist as islands near genes. These can then become methylated, which reduces the expression of this gene.
Rule of thumb = Methylation stops genes being expressed.
Outline the Meany study into DNA Methylation in rats?
Showed that rats who were shown LESS maternal affection (grooming behaviour) showed LESS methylation at genes associated with the HPA axis meaning these genes were expressed MORE, potentially causing an up regulation of the axis and an increased stress response.
Suggests that experiences in childhood can have biological and genetic effects on our behaviour later in life.
