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Lecture 17 slides revised

Lecture 17 slides revised - Conduct disorders Conduct...

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Unformatted text preview: Conduct disorders Conduct disorders • Conduct disorder (CD) and oppositional defiant disorder (ODD) • Delinquency, defiance, aggression against peers, theft, losing temper, etc • Behaviors are common (to some degree) in childhood and adolescence Dimensions of behavior: Dimensions of behavior: • • • Severity/intensity Frequency Breadth **Children with CD are beyond the normal range in terms of these dimensions • Costs to society can be large DSM­IV Criteria for CD DSM­IV Criteria for CD • Pattern of Behavior – Repetitive and persistent – Basic rights of others or age­appropriate social norms are violated – 3 or more criteria lasting for 12 months – At least 1 lasting past 6 months CD Categories of Behavior CD Categories of Behavior • Aggression to people and animals • Destruction of property • Deceitfulness or theft – Bullies, fights, rape, armed robbery – Fire setting, other damage – Breaking and entering, stealing, conning – Truancy, running away from home • Serious violations of rules Other CD DSM­IV criteria Other CD DSM­IV criteria • Impairment • If > 18, criteria are not met for ASPD • Subtypes and specifiers • Mild, moderate, severe – Childhood (<10) vs Adolescent onset DSM­IV ODD Criteria DSM­IV ODD Criteria • Pattern of negative, hostile, defiant behavior lasting 6 months, with 4 of the following: – Loses temper, argues with adults – Noncompliance, annoys others – Blames others, touchy or easily annoyed – Angry, resentful, spiteful & vindictive • Impairment; no CD or ASPD Prevalence Prevalence • CD – 2­6% of children – 12% of children – Both are 3­4 times more common in boys • ODD Stability of CD: Stability of CD: • Discipline problems and poor self­ regulation in early childhood are highly predictive of continued problems, especially when associated with inconsistent parenting and high stress • Breadth of problems is also predictive • Age of onset (before age 10 is predictive) • Parent characteristics Course of CP over time: Course of CP over time: • Life course persistent • Adolescent limited Etiological/risk factors: Biological Etiological/risk factors: Biological factors • More questions than answers • Role of genetics strong, but what is being • • • • inherited? Role of testosterone Low physiological arousal Lower levels of serotonin Brain injury or trauma Psychological/personality factors: Psychological/personality factors: • Aggressive children have different ways of processing information • More likely to perceive hostility • Less efficient at thinking of non­violent ways to solve problems • More accepting of aggression Parental/socialization factors: Parental/socialization factors: • Process by which child learns “scripts” for • • • • specific social behaviors, as well as rules that guide interactions Some aggressive acts can be learned Parents’ lack of attention Inconsistent parental discipline Peers can model aggressive behavior Parental/socialization factors: Parental/socialization factors: • Role of poverty/depravation • Role of exposure to violence in the media, on TV and in the movies – Conveys norms that justify behavior – Teaches aggressive scripts – Desensitizes viewers to violence Environmental/situational factors: Environmental/situational factors: • Aversive situations can cause violence and aggression • Alcohol and drug abuse in family • Presence of guns and weapons • Crowds Treatment Treatment • Group therapy, boot camp, incarceration, traditional talk therapy not effective • What does work? – Behavior management training for parents – Problem­solving training – Multisystemic treatment – Teaching skills, working with parents and teachers, tutoring, etc (FastTrack) • Early Prevention ...
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