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Lecture 7

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Hywel Morgan

Monday July 29, 2013 Lecture 7 CONDUCT DISORDER  Disruptive behavioral disorder usually diagnosed in middle childhood (8-10 years old)  Quite common in childhood  There is a theory that CD begins as reactive attachment disorder in infancy o Manifests as CD when reactive disorder goes untreated and the infant can’t make a stable attachment to a primary caregiver  Treatment for reactive attachment disorder  CD (psychiatric term) is often referred to as juvenile delinquency (a legal term)  These children can’t follow the rules and break the law  CD is treatable with family therapy—treating the parents and the child  If CD (research is showing now) goes untreated it goes on to manifest as anti-social personality disorder (treatable but very difficult… but not curable)—lack of empathy and inability to understand another person’s point of view from an empathetic perspective (key symptom) o “What can I get out of you” whether it hurts you or not; feel bad for you but doesn’t really care –sympathy but no empathy  DSM4 – ADHD and CD are under the same category of disruptive disorders o Not surprisingly they tend to be comorbid with each other  ADHD and CD are now separated o CD now goes under a new category “Disruptive Impulse Control and Conduct Disorders” o Reactive attachment disorder, CD, ODD (oppositional defiant disorder), and anti-social personality disorder all go under this new category o Those with ODD are very non compliant, but not quite as serious as CD; will NOT follow rules; they are being defiant & it is interfering with the development and their daily lives o Intermittent explosive disorder is also under this new category  Explosion of anger; spontaneous and sudden explosion of anger which is violent and aggressive o Pyromaniac (setting fire to things) and kleptomania (stealing things) have been moved to DSM 5 as well but have been separated from ADHD CD VS DELINQUENCY  CD is a psychopathology, which requires treatment and is often used interchangeably with the term delinquency … but is incorrect because delinquency is a legal term  A juvenile delinquent is a person who has broken a law and is under the age of 18  All children with CD are delinquent because the very diagnostic requirements of CD is that they break laws & rules that society has established BUT not all juvenile delinquents are conduct disordered  Do all people with CD have to be convicted of a crime? NO o But all juvenile delinquents have because it is the definition of the legal term  Even when the consequences are negative, it’s the attention that is important (even if it’s negative attention)  The root of this psychopathology does seem to be attachment SOME OF THE FOLLOWING BEHAVIOURS USED TO DIAGNOSE CD  There is a better prognosis for CD first diagnosed in middle childhood or adolescence o The earlier the onset the better the prognosis, and the outcome is usually more favorable  Comorbid with ADHD because of the impulsivity  Earlier treatment is better 1 Monday July 29, 2013 Lecture 7 AGGRESSSION TO PEOPLE AND ANIMALS  Aggression towards animals as well which is quite common in younger children with CD  Move from animals to people usually because animals can’t really fight back or say anything  Usually starts with animals, and torment them—such as abuse and torture and may even kill it  They will bully other people and intimidate them  They will initiate physical fights and often use a weapon that will cause serious physical harm o A knife, stone, baseball bat, sticks –much more unsophisticated weapons  Physically cruel to humans and animals and usually steal from a victim while confronting them (assault is the legal term, which is a form of theft) * burglary  Another form of assault is rape or sexual harassment DESTRUCTION OF PROPERTY  Deliberately destroying someone else’s property  Arson is very common in this category as well as vandalism LYING AND STEALING  Deceitfulness  Breaking into someone else’s car or home  Stealing items without confronting the victim  Lying to obtain good, favors, or to avoid obligat
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