Unit 7 Impulse Control Chapter 21 Flashcards
What is Impulse Disorder
◦ Characterized by aggressive behaviors and emotions.
◦ Problems relating to others in socially acceptable ways results in lack of healthy relationships.
◦ Can lead to isolation
◦ Recognizing and treating aggressive and
impulsive behaviors while a person is young can prevent further problems ad avoid interactions with criminal justice system.
What is Oppositional Defiant Disorder
-least severe
-can outgrow
-shows remorse
-mainly emotional dysfunction , DOES NOT VIOLATE RIGHTS OF OTHERS
NO MEDICATION
Behavior exceeds the boundaries of what is
socially acceptable
◦ Impacts emotions and behaviors
◦ The child is seen as difficult/defiant
◦ Extremely difficult to attend school, form
friendships or be a functioning member of
the family
◦ Show preference to large rewards but little
attention to increasing penalties
◦ Untreated the child may grow out of it
Risk factors for ODD
Risk Factors
◦ Insecure attachment
◦ Chaotic caregiving or harsh neglectful families
◦ Child abuse
◦ Lack of Structure
TX for ODD
Treatment
◦ Target needs of child and family
◦ Help child manage anger, improve problem
solving develop techniques to reduce
impulsivity and improve social interactions
◦ Parent training, group therapy, CBT, anger
management
◦ Medications – managing comorbidities and anger/aggression
What is Conduct Disorder
VIOLATES RIGHTS OF OTHERS
“THEY WILL VERBALIZE DOING IT AGAIN”
Persistent pattern of behaviors where the rights of others are violated, and societal norms/rules are disregarded.
◦ Abnormally aggressive, initiates Fights, bullies, coerces others into activities against their will, intimidate and hurt
others.
◦ Associated with parental rejection, neglect, harsh discipline
◦ Crave excitement and do not worry about consequences like others
◦ The subset with conduct disorder referred to as callous and unemotional (especially dangerous)
-PRONE TO GO TO JAIL INITITE FIGHTS
◦ Callousness – may be a predictor for future antisocial personality disorder-NO REMORSE
◦ Treatment
◦ Most successful tx includes parental involvement. If parents have antisocial traits, less likely to participate
Which disorder can children grow out of if untreated?
A. Oppositional Defiant Disorder
B. Conduct Disorder
Conflict with authority and adults
◦ Emotional Dysregulation
◦ Chronic Negative Mood
◦ Temper Outburst
◦ Left untreated – child may grow out of it
REMORSE IS PRESENT
Which disorder can children progessively get worse if left untreated?
A. Oppositional Defiant Disorder
B. Conduct Disorder
B. Conduct Disorder
NO REMORSE, INITIATES FIGHTS, AGGRESSIVE
◦ Conflict with authority and adults
◦ More severe than Oppositional Defiant
◦ Aggression toward people/animals, theft,
deceit, destruction of property (abnormally
aggressive)
◦ Callousness
◦ Untreated can develop into Antisocial
Personality disorder as an adult
Conduct Disorder is cHILDHOOD ASSESSMENT AND S/S
Childhood-onset
◦ Before age 10
◦ Little concern for others, no remorse
◦ “he deserved it”
◦ Project a strong image but actually low self-
esteem
◦ Likely persist through adolescence and
without intensive treatment may develop into
antisocial personality disorder
Conduct Disorder-Adolescent assessment ans s/s
Adolescent-onset
◦ No sx before age of
◦ Act out through sexual behaviors, substance
use, or risk-taking behaviors
◦ Girls tend to lie, be truant, run away, abuse
substances and engage in promiscuity
Intermittent Explosive Disorder (IED)
Inability to control aggressive behaviors
◦ Aggression can be verbal or physical and targeted toward other people, animals, property or even themselves
◦ Anything can trigger
◦ Pattern of going from rage to remorse (Tension, explosive behavior and aggression, release, remorse)
◦ Can lead to interpersonal relationship problems
◦ Physical health – HTN, diabetes
◦ May experience other emotions more strongly than most individuals.
◦ The main problem is emotion regulation
◦ Higher than normal inflammatory markers
◦ Higher levels of testosterone
◦ Exposure to violence at a young age, childhood sexual or physical abuse
RAGE THEN REMORSE
MONITOR FOR SUICIDAL IDEATION
QUICK TO GET ANGRY FOR NO REASON
-losing video game
-damages property
-lashes out at opposite baseball team
-rages
Best treatment for IED-Intermittent Explosive Disorder
Treatment:
Psychotherapy combined
with Pharmacological Tx =
Best results
Interventions for Impulse control disorders
◦ Promote a climate of safety for the patient and for others
◦ Establish rapport with the patient
◦ Self limits and expectations
◦ Consistently follow through with consequences of rule-breaking
◦ Provide structure and boundaries\Provide activities and opportunities for achievement of goals to promote a sense
of purpose
◦ Tx with individual, group and family therapy
◦ Need consistency and structure – teach family consistent limits
◦ Pharmacological – Tx aggression and other comorbidities
◦ Multiple types of therapy
