PSY240H1 Lecture Notes - Lecture 9: Oppositional Defiant Disorder, Antisocial Personality Disorder, Learning Disability
Lecture 9: Developmental Disorders
March 23, 2016
Overview:
- Risk and Resilience
- Assessment Techniques
- Disorders of Childhood:
o Externalizing/behaviour disorders
o Learning disorders and intellectual disability
o Autism Spectrum
Risk Factors
- Individual
o Genes, teratogens (special kind of risk factor; environmental technically; but
influence before we are born; ie: alcohol from mother during prego) ,
temperament, malnutrition (prior to birth → mothers nutrition → affects fetus
nutrition)
- Family
o Substance use
o unemployment (how it affects the parents → stress → will affect the child→ may
be more impatient)
o poverty (including individual level as well; ie: nutrition; single parent home →
several jobs → not enough monitoring or supervision fro the youth → as older
hang out with wrong crowd or does bad things → no one to teach them wrong
from right)
o mental illness
o domestic violence
- School/Community/Environment
o Inferior education
▪ because of unemployment → bad neighbourhood → bad education
o neighbourhood violence
o peer rejection
▪ interpersonal level
▪ developed disorders such as anxiety, depression
o racisms
o disaster/major stressors
Note: these risk factors are interrelated
Resilience/Protective Factors (buffer against environmental problems)
- Individual
o Temperament
▪ Variations tend to make someone more prone to disorders
▪ Low neuroticism → more resilient against stressors
o physical health
o close bond with primary caregiver
o good school performance
- Family
o Good prenatal
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o Education
o good parenting skills (very important!)
o small family (parents attention is less divided against other siblings)
o financial stability
- School/Community/Environment
o Good teachers/schools
o good neighbourhood
o supportive peers (if you have good connections with friends → help reduce
stressors)
Assessment of Childhood Disorders
- Informants
o Self; parents; family; caregivers; teachers
o Child’s records and previous evaluations (ie: report cards → informative on time
frame)
- Observation
o See that child in action; prove child is having deficits in more than one setting
- Interview (e.g., DISC)
- Questionnaires (e.g., CBCL)
- Tests of intellectual, cognitive, academic functioning (e.g., WISC, WIAT)
o WISC (skill capacity) → capacity for learning; your skills are; what you bring to
the table
o WIAT (achievement test) → what you learn so far
o These two different tests are important because a diagnosis is made only when
there is discrepancies between the capacity and your performance.
o Limitations such as being on your best behaviour is considered.
Externalizing Disorders
- Most are tied together by having common risk factors and vulnerabilities
- Common temperamental – personality correlates
o Poor self-regulation (e.g., low effortful control)**
▪ Unique to externalizing disorders
▪ Self – regulation: have a difficulty inhibiting behaviours
o Negative emotions (e.g. high neuroticism)
Oppositional Defiant Disorder (ODD)
- Recurrent patterns of negativistic, defiant, disobedient, and hostile behaviour
o Happens regularly; very negativistic behaviour; saying no to everything
o Not going to full-blown aggression
- More frequent than typical for child’s age
o Has developmentally inappropriate
- Leads to significant impairment in functioning
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o Ie: causing a lot of trouble at home; fights with parents or siblings; problems at
school (principal office);
- At least 4 symptoms are present for 6 months (DSM 4)
o Lose temper
o Argue with adults
o Actively defy or refusing to confine with an adults wishes
o Deliberately annoy people (more than usual)
o Touchy or easily annoyed by others
o Angry and resentful
o Spiteful or vindictive
▪ Think something is unfair → will get them back
ODD: changes in DSM 5
- Symptoms now grouped into 3 types:
o Angry/irritable mood
o Argumentative defiant behaviour
o Vindictiveness
- More details re: symptom frequency thresholds
o Keep in mind that there is more specific wording added to DSM 5
- Added severity rating
o Not concrete as eating disorder
Conduct Disorder (CD)
- Repetitive and persistent pattern of behaviour in which the basic rights of others or major
age-appropriate societal norms or rules are violated (DSM4/DSM5)
o About major rule violatiosn and violations of society norms
o Not following the rules
o Not the same as ODD
▪ where not following parents wishes
- At least 3 symptoms are present within 1 year
o Aggression to people and animals
▪ Bullying others; starting fights; antagonizing and perpetuating fights; use a
weapon; physical cruelty to animals and people
o Deceitfulness or theft
▪ Break in; robberies; separate from mugging somebody because there is no
face – to – face interaction; shoplifting
▪ Mugging = confrontation (hurting people); shoplifting (hurting the store)
o Destruction of property
o Serious violations of rules
▪ Staying out late (under 13 years old) at least twice
▪ over 13: running away from home or not coming home for a long period
of time
CD Subtypes (DSM4&5)
1. Childhood onset (<10 years)
o Usually male
o Aggression
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Document Summary
Disorders of childhood: externalizing/behaviour disorders, learning disorders and intellectual disability, autism spectrum. Individual: genes, teratogens (special kind of risk factor; environmental technically; but influence before we are born; ie: alcohol from mother during prego) , temperament, malnutrition (prior to birth mothers nutrition affects fetus nutrition) School/community/environment: inferior education, because of unemployment bad neighbourhood bad education, neighbourhood violence, peer rejection interpersonal level, developed disorders such as anxiety, depression, racisms, disaster/major stressors. Individual: temperament, variations tend to make someone more prone to disorders, low neuroticism more resilient against stressors, physical health, close bond with primary caregiver, good school performance. Family: good prenatal, education, good parenting skills (very important!, small family (parents attention is less divided against other siblings, financial stability. School/community/environment: good teachers/schools, good neighbourhood, supportive peers (if you have good connections with friends help reduce stressors) Informants: self; parents; family; caregivers; teachers, child"s records and previous evaluations (ie: report cards informative on time frame)
