PSYC 3342 Lecture Notes - Oppositional Defiant Disorder, Juvenile Delinquency, Conduct Disorder

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6 Feb 2013
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Lecture 3 - Conduct Disorder and Oppositional Defiance Disorder
January 17, 2013
9:24 AM
Description of conduct problems
Conduct problems and antisocial bx described age inappropriate actions/attitudes that violate
family expectation, societal norms or personal or property rights of others
Diversity in disruptive/rule-violating behaviors ranges form annoying minor behavior to serious
antisocial bx
Consider many types, pathways, causes and outcomes
Often associated with unfortunate family and neighborhood circumstances; circumstances do no
excuse the bx but helps us understand it
Context costs and perspective
Context
o Antisocial bx appear and decline during "normal" development
Vary in severity, minor disobedience to fighting
Some antisocial bx decrease with age
Some increase with age and opportunity
More common in boys in childhood but the difference narrows in teens
Kids who are the most physically aggressive in early childhood maintain their relative
standing over time
Social and economic cost
o Conduct problems are the most costly mental health problems In north america
o Earle, persistent, extreme pattern of antisocial bx occurs in 5% of kids; these kids account
for over 50% of crime in the US and 30-50% of clinic referrals
o 20% of mental health expenditures in the US are attributable to crime
o Public costs across healthcare, juvenile justice and educational system are at least $10,000
per child
o Lifetime cost to society per kid who leaves high school for life of crime/drugs about
$2million
Perspectives
o Legal
Juvenile delinquency : kid who has broken the law
Legal definitions result from apprehension and court contact; so they exclude
antisocial bx of very young kid occurring in home or school
Age of responsibilities is 12 in most states and provinces
A subgroup of kids that meet legal definition of delinquency also meet definition of
mental disorder
o Psychological
Conduct problems seen as falling on a continuous dimension of externalizing bx
1 or more SD above the mean : conduct problems
Externalizing bx consisting of related but independent sub-dimensions:
Rule breaking bx
Aggressive bx
Overt/covert(lying) dimension
Destructive/non-destructive dimension
o Psychiatric
Conduct problems viewed as distinct mental disorders based on DSM symptoms
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DSM-iV-TR, conduct problems are described as persistent patterns of antisocial bx
represented by categories of ODD and CD
o Public Health
Blends legal, psychological and psychiatric perspective with public health concepts of
prevention and intervention
Goal: reduce injuries, deaths, personal suffering, and economic costs associated
with youth violence
Cuts across all disciplines
Oppositional Defiant Disorder (ODD)
Age- inappropriate, stubborn, hostile, and defiant bx
Usually appears by age 8
Bx include (have to last at least 6 month and must have at least 4)
o Lose of temper easily
o Argumentative
o Actively defy orders give by authority figures and refuse to comply with requests
o Purposely annoy other ppl
o Blame others for their bx or mistakes
o Touchy - easily annoyed by things
o Anger
o Resentfulness
o Spiteful and vindictive
Many bx are common in young kids, severe/age-inappropriate ODD bx can have extremely
negative effects on parent child interactions
o 75% of preschoolers referred to clinic from low -income families meet the DSM criteria for
ODD
o At high risk for developing secondary problems like mood, anxiety, impulse control disorders
Bx have to be bad enough that it causes problems
Conduct Disorder (CD)
Repetitive, persistent pattern of severe aggressive and antisocial acts that involve inflicting pain
on others or interfering with the rights of others through physical/verbal aggression, stealing or
acts of vandalism
o Severe antisocial bx
o May have co-occurring(comorbid) problems :ADHD, academic deficiencies, poor peer
relations
o Family child -rearing practices may contribute
o Parents feel the kids are out of control and feel helpless to do anything about it
Age of onset: childhood-onset versus adolescent onset CD
o Kids with childhood onset CD display at least one symptom before age of 10
More likely to be boys
More aggressive symptoms
Account for disproportionate amount of illegal activity
Persist in antisocial bx over time
o Adolescent onset CD
Are as likely to be girls as boys
Don’t show the severity or psychopathology of the early onset group
Less likely to commit violent offenses or persist in their antisocial bx over time
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