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Lecture 7

PSY341H5 Lecture 7: 7. Conduct disordersPremium

11 pages48 viewsSpring 2018

Department
Psychology
Course Code
PSY341H5
Professor
Aitken Madison
Lecture
7

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PSY341: Lecture 7: Abnormal psychology Child Disorders: Conduct Problems
Questions from last class
- Brain development and ADHD
o Is maturation of the cerebellum also delayed in children/adolescents with ADHD?
~5 year delay in prefrontal cortex
Cerebellum may be associated with ADHD
There are sex differences too (more males tend to have this disorder)
Questions from midterms
- The severity of an intellectual disability is determined based on:
a. Age of onset
b. Adaptive functioning (in DSM 5)
looks act conceptual, social and practical domains
c. Intellectual ability (this was previously based on intellectual ability in DSM 4)
Why was there a change IQ sores do’t tell hat soeoe eeds ad hat
support they need
d. All of the above
- The Ontario Child Health Study used parent, teacher, and self-ratings of symptoms of conduct
disorder, attention-deficit/hyperactivity disorder (ADHD), emotional disorder, and somatization
within the past 6 months. This methodology could be used to determine:
a. Heritability
b. Incidence rates (number of new cases in a given time)
c. Prevalence rates (number of individuals meeting diagnostic criteria for specific
disorders within a given time period)
do’t kow if the perso had this issue eerge i the last 6 oths, just kow
that they experienced it in that time
d. Risk factors
- Children and adolescents with specific learning disorder (any subtype) tend to have relatively
lower ___________ and ___________ scores on the Wechsler Intelligence Scales for
Children (WISC), compared to their other WISC scores.
a. Verbal comprehension; processing speed
b. Perceptual reasoning; Working memory
c. Working memory; processing speed
d. Working memory; Verbal comprehension
- in WISC visual spatial, fluid reasoning and verbal comprehension =higher order reasoning
skills. The WM and processing speed are underlying factors
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Page 2 of 11
Conduct problems
- Parents are often at odd with their kids and it can be hurtful and challenging for them (the child
can verbally or physically abuse them = negative relation of parent with child)
- DSM 5: disruptive, impulse control and conduct disorders
o Often are co-morbid and referred together. Terms can be used interchangeably
o The box on the right are non diagnostic terms
- Disruptive behavior disorders as a health problem
o Common and concerning
The most common:
Childhood mental health problem
Reason children access mental health services
Associated with negative long-term outcomes: (followed people into adulthood)
Increased risk for crime
Substance abuse
Mental health problems
Problems in intimate partner relationships
Has also led to increased mortality
o Followed them from their 1st birthday
Dutch study (1.92 million individuals (9495 with
disruptive behavior disorders)
Other associated factors
SES, risky behaviour, drug use, other diagnosis
What else should be considered
The authors controlled for:
Parental psychiatric disorders
Gender
Age
Calendar time
Maternal and paternal age at birth
Parental education
Parental employment status
Comorbidity (ADHD, substance use disorders)
Taking all this to consider, there is a higher
mortality rate (2.7 times more mortality)
0
5
10
15
DBD No diagnosis
Mortality Rate per 10,000
Person-Years
3.19
2.57
0
1
2
3
4
Crude MRR Adjusted MRR
Mortality Rate Ratios (DBD vs. Not)
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Page 3 of 11
Economic burden of severe conduct problems
What would you estimate the cost savings to society would be of
saving one high-risk youth from a life of crime?
o To save them its about $2.6 to 5.9 million
o Iludes life of rie, lo produtiity, iareratio…..
o This is basically the people with the most severe risk factor
- Diagnostic criteria
o Oppositional defiant disorder (ODD)
These are the 3 domains and have 4 symptoms from any category (not a
spectrum disorder)
Other considerations
Behaviour has to happen in interactions with 1+ person(s) who is not a
sibling
Must distinguish from normal limits of behaviour developmental level,
gender, and culture:
o Frequency:
<5 years old: Behaviour occurs most days
≥5 years old: Behaiour ours at least oe/eek
o Intensity (how extreme are the episodes (i.e. tantrums) and
how long it takes to recover)
Not exclusively during psychotic, substance use, or depressive disorder.
Not disruptive mood dysregulation disorder.
o Conduct disorders
Repetitive and persistent pattern of behavior in which the basic rights of others
or major age- appropriate societal norms are violated
More severe
Domains
Aggression to people and animals
o Bullies, threatens, intimidates
o Initiates physical fights
o Used a weapon that can cause serious physical harm to others
o Physically cruel to people
o Physically cruel to animals
o Stolen while confronting a victim
o Forced sexual activity
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