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Western University
Psychology 2042A/B
Jeff St.Pierre

CH6: CONDUCT PROBLEMS Description of Conduct Problems - Conduct problems & antisocial behaviors: age-inappropriate actions and attitudes of a child that violate family expectations, societal norms, and the personal or property rights to others o Typically grow up in unfortunate family conditions/neighbourhood circumstances Context, Cost and Perspectives Context - Important features of antisocial behavior: o Vary in severity o Some antisocial behaviors decrease with age while others increase o More common in boys than girls in childhood, levels into adolescence Social and Economic Costs - Conduct problems make it the most costly mental health problem in North America - Early, persistent and extreme pattern of antisocial behavior occurs in only about 5% of children o Accounts for over 50% of all crime in U.S - 20% of all mental health $ attributed to crime o $10,000 public cost / child with conduct problems, lifetime = 2 million $ Perspectives - Legal o Juvenile delinquency: children who have broken a law o Mental health definition = display persistent pattern of antisocial behavior - Psychological o Externalizing behavior: mixture of impulsive, overactive, aggressive & rule-breaking acts  Rule-breaking behaviour & aggressive behavior o Overt-cover dimensions: overt = visible (i.e fighting), covert= hidden (i.e lying)  Most children with conduct problems display both overt & covert o Destructive-non-destructive dimension: ranges from acts of cruelty to arguing - Psychiatric o Disruptive behavior disorders: persistent patterns of antisocial behavior, represented by the categories of oppositional defiant disorder (ODD) and conduct disorder (CD) o Categorical (psychiatric): CD /ODD = different patterns of behaviors and outcomes o Dimensional (psychological) o Subclinical levels of symptoms: troubling symptoms too few in number to qualify for categorical diagnosis of CD/ODD - Public Health o Goal: reduce number of injuries and deaths DSM-IV-TR: Defining Features Oppositional Defiant Disorder (ODD) - Oppositional Defiant Disorder (ODD): age inappropriate reoccurring pattern of stubborn, hostile, disobedient and defiant behaviors o Usually appears by age 8 o Extremely negative effects on parent-child interactions o Grouped into: negative affect (angry) & defiance Conduct Disorder (CD) - Conduct Disorder (CD): repetitive and persistent pattern of severe aggressive and antisocial acts that involve inflicting pain/aggression/stealing o Engage in severe antisocial behaviours o Co-occuring problems (i.e ADHD, academic deficiencies) o Families = child-rearing practices (harsh punishment/marital discord/etc) o Feel child is out of control - CD and Age of Onset: o Childhood-onset conduct disorder: display at least one symptom before age 10  More likely boys  Persist in antisocial behavior o Adolescent-onset conduct disorder  Equally boys & girls - CD & ODD o ODD  CD  ODD precursor for CD? No, only 50% with CD have prior ODD diagnosis & most ODD do not progress to severe CD (50% stay ODD)  CD display ODD but ODD no CD Antisocial Personality Disorder (APD) and Psychopathic Features - Antisocial personality disorder (APD): dissocial personality disorder: pervasive pattern of disregard/ violation of rights of others, involvement in illegal behaviors o 40% of CD  APD o APD also display psychopathic feature: patterns of callous, remorseless behavior (menacing)  lack of conscience in children as young as 3-5 yrs o Callous and unemotional (CU) interpersonal style: lacking in guilt, empathy, emotions  Lack of behavioral inhibition Associated Characteristics Cognitive and Verbal Deficits - Conduct problem have normal intelligence but score 8 pts lower in IQ tests o Childhood-onset CD = 15pts lower o ADHD + lowerIQ = CD - Both verbal & family adversity = 4x as much aggressive behavior than only one factor - Cool cognitive executive functioning: attention, planning, inhibition o More characteristic of ADHD - Hot executive functioning: incentives, motivation o More characteristic of CD School and Learning Problems Self-Esteem Deficits - CD may experience high self-esteem = rationalize antisocial conduct Peer Problems - Friendships often based on mutual attraction of antisocial behavior - Underestimate own aggression & negative impact, overestimate amount of aggression directed @ them o Reactive-aggressive children: display hostile attribution bias: more likely to attribute hostility as intent of other children o Proactive-aggressive children: view aggressive actions as positive & value dominance/revenge Family Problems - Types of family disturbance related to problems in children: o General family disturbances: family history of antisocial problems, marital discord, etc o Specific disturbances in parents practices and family functioning: excessive use of harsh discipline - Strongest and most consistent correlates of conduct problems Health-Related Problems - Premature death: 3x higher in boys with CD Accompanying Disorders and Symptoms Attention-Deficit/Hyperactivity Disorder (ADHD) - 50% with CD also have ADHD, why: o Shared predisposing vulnerability (i.e self-regulation) o ADHD may be catalyst for CD o ADHD may lead to childhood onset of CD - However, ADHD & CD are separate disorders, why: o Better fit if CD & ADHD than if combined into one model o CD less likely than ADHD to be associated with cognitive impairments Depression and Anxiety - 50% with conduct problems also have depression/anxiety o ODD not CD, best accounts for the connection between conduct problems and depression - Shy anxiety: protect against conduct problems - Avoidance based on lack of caring: increased risk against conduct problems Prevalence, Gender, And Course Prevalence - Prevalence: ODD > CD in childhood, lvls into adulthood o Lifetime prevalence rates: 12% ODD, 8% CD Gender - Gender differences evident by 2-3 yrs o 2x higher of conduct problems in boys  Disparity increases through middle childhood, narrow in early adolescence, increases in late adolescence o Sex difference in antisocial behavior decreased by 50% over past 50 years Developmental Course and Pathways - General Progression o Earliest in
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