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PSYC 3342 (5)
Lecture

Ch. 6 Conduct Problemsecture 3.docx

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Department
psychology
Course Code
PSYC 3342
Professor
valeriedare

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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  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  Lasts for a period of years and then settles back down  CD and ODD have much overlap of symptoms o Although most cases of CD are preceded by ODD and most kids with CD continue to display ODD symptoms, most kids with ODD do not progress to more severe CD  CD and Antisocial Personality disorder o APD: pervasive pattern of disregard for and violation of the rights of others; involvement in multiple illegal bx o As many as 40% of kids with CD later develop APD o Adults with APD may display psychopathy; a pattern of callous, manipulative, deceitful, remorseless behavior o Signs of lack of conscience occur in some kids as young as 3-5 years o Subgroups of kids with cd are at risk for extreme antisocial and aggressive acts; display callous and unemotional interpersonal style Associated characteristics (CD)  Cognitive and verbal deficits o Although most kids with conduct problems have normal IQ, they score nearly 8 points lower than peers o Greater deficit for kid with the childhood onset o Verbal IQ consistently lower than performance IQ o Deficits present before conduct problems and may increase risk o Deficits in executive functioning related to failure to consider future implications of their bx and its impact on others  May be due to co-occuring ADHD  School and learning problems o Underachievement, grade retention, special ed placement, dropout, suspension and expulsion o Common factor may underlie both conduct problem s and school difficulties o SES disadvantage o Early language deficits may cause communication difficulties, which may increase conduct problems in school o Relationship between conduct problems and underachievement is firmly established by teens  Self-esteem deficits o Low self-esteem is not the primary cause of conduct problems  Instead problems are related to inflated and unstable and/or tentative view of self  Peer problems o Verbal and physical aggression towards peer; poor social skills o Often rejected by peers although some are popular  Kids rejected in primary grades are 5 times more likely to display conduct problems as teens  Some become bullies  Often form friendships with other antisocial peers  Underestimate own aggression, overestimate others' aggression towards them;  Reactive-aggressive kids display hostile attributional bias; attribute negative intent to others  Proactive-aggressive kids view their aggressive actions as positive  Family problems o General family disturbances (eg mental health problems, family history of antisocial bx, marital discord, etc) o Specific disturbances in parenting practices and family functi
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