Week 4 L7 Flashcards
Moderating variable. Of mta results.
- Dichotomous variable of Inattention vs hyperactivity: teratogens group predict excellent vs not responder.
Result: medicationation combined, did better. Vs community 62% to 32% - Parent depression: lower meant 69% good responders. Vs
- Symptom severity: lower levels meant more likely to be excellent responders.
- CHildren high parental depression and severe, higher iq meant better outcome.
Mta results what works for wom for adhd
General conc, for MTA was medication, but is debatable esp. When considering broader functioning,
Thinking of sample:
Young, male, combined type.
Other factors though, like symptom severity, comorbitidity. Parental psychopathology. Cognitive functioning, poverty, ethnicity.
All questions of moderators: variable influence direction and strength between two variables.
Core Features
Age-inappropriate actions and attitudes
Some conduct symptoms normative Arguing
Defiance
May be difficult to draw line in mild cases
Normal late cold good and avian in adolescence.
Violations of societal norms or rights of others Ranging from “talking back” to murder
Several different types and pathways
Subtypes may display other core characteristics
callousness / lack of empathy (early-onset typical)
Oppositional Defiant Disorder (ODD)
Core is negative affect, inability
Age-inappropriateanger/irritability,argumentative/defiant behavior, or vindictiveness
Angry/irritablemood
Often loses temper
Is often touchy or easily annoyed Is often angry or resentful
Argumentative/defiant behavior
Often argues with adults
Often actively defies or refuses to comply with requests from adults or with rules
Often deliberately annoys others
Often blames others for his or her mistakes or misbehavior
Vindictiveness
Has been spiteful or vindictive at least twice in the last 6 months
Diagnostic Criteria
Four of the behaviors are present
Note that child has to be engaging in behavior more than is normative for children of their age and developmental level
Lasts for at least six months
“Exhibited in interaction with at least one person who is not a sibling”
Hard to diagnose in preschoolers,
Aside on sibling agression, can be normative but it can be harmful. Rumors still bad.
Conduct Disorder (CD) More severe than ODD
A repetitive and persistent pattern of violating basic rights of others and/or age-appropriate societal norms or rules, including:
aggression to people and animals
destruction of property
deceitfulness or theft
serious violations of rules
Diagnostic Criteria
3 or more of the behaviors within the past 12 months, with at least one present in the last six months
Note that there are many possible combinations of
symptoms: for all of them see book, (make song?)
Often bullies, threatens or intimidates others, initiates physical fights, truant from school beginning before 13 years of age
Physically cruel to animals, forced someone into sexual activity, used a weapon that can cause serious physical harm
DSM subtypes
Onset
childhood-onset
Onset of at least one symptom before age 10
adolescent-onset
With limited prosocial emotions
Two of the following characteristics persistently over the last 12 months, and in multiple relationships and settings
Lack of remorse or guilt
Callous, lack of empathy
Unconcerned about performance
Shallow or deficient affect
So
With limited prosocial emotions
Callous-unemotional (CU)
When CU is present, CD is earlier onset, aggression is more severe and more instrumental
CU associated with insensitivity to punishment
Conduct Disorder and ODD
In DSM-IV, CD subsumed ODD
In DSM-5, they can be diagnosed at the same time, change in thought.
Assessment
For BehvIcour disorders
Interviews and Checklists
Parents, teachers, youth
CD – youth are an important informant, because behaviors may be hard for other people to see
ODD – not clear how much youth report adds to parent and teacher report
E.g., Brief Child and Family Phone Interview (BCFPI)
Six items related to ODD and CD
Limited Prosocial Emotions
Assessments in development
Clinical Assessment of Prosocial Emotions (CAPE) Semi-structured interview
Need multiple information sources
But need corroborates, as people with disorder often lie. People, data police records.
Preschool hard to determine normative
Also aside on cd not relevant to children, highly unlikely.
What o they look like in small children.
Use assessments like observation.
Assessment for preschoolers
Disruptive Behavior Diagnostic Observation
Schedule (DB-DOS)
Preschoolers interacting in 3 contexts
With an interactive examiner
With a busy examiner
With their parent
“Presses” for disruptive behavior
Compliance: color plastic cutlery sort
Frustration: water guns. Puzzle
Rule-breaking: toy car.
Prevalence, epidemiology
Prevalence
10% for ODD 9% for CD
Cultural and contextual differences
strongly associated with poverty
strongly associated with exposure to violence
“Concerns have been raised that the Conduct Disorder diagnosis may at times be misapplied to individuals in settings where patterns of undesirable behavior are sometimes viewed as protective (e.g., threatening, impoverished, high crime) . . . a Conduct Disorder diagnosis should only be applied when the behavior in question is . . . not simply a reaction to the immediate social context”DSM-IV-TR
Poverty and Disruptive Behavior Disorder
Note on special study Melanie loves
Social causation
Stress of poverty leads to an increase in childhood
psychopathology
Social selection
Families with genetic predisposition drift down towards poverty
Intervention implications
Longitudinal study of epidemiology of childhood psychiatric disorder
Sample included a significant number of Aboriginal people
Significant positive association between poverty and
disruptive behavior
Partway through the study, a casino opened on the reservation
Everyone got a stipend
Everyone got a stipend!!!
Led to four groups
Persistently poor
Ex-poor
Never poor
Newly poor (excluded because of small number)
Natural expirimental, since change income not confounded with self improvement. Great validity.
