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CHCCHchCHap 4Conduct disorders.docx

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Psychology 2042A/B
St Pierre Jeff

Conduct disorders (Professor Scott Wier) The work of Wier - 1995-2000 - Maximum security detention centre - Young offenders aged 16 to 18 (after they are transfer to another place) - Crimes: possession of stolen property, break and entering, car theft, assault, narcotics possession, breach of probation, attempted murder, murder - Sentence range btn: 6 days and 30 months. - The vast majority had a long history with the law Research methods - Qualitative approach - Data collection: content analysis of “journal entries”, the prisoners expressed thought and everything they want to say in the journal (family, violence, drugs, sex, world view/future, racism, friends, freedom, reform, influences of incarceration) - Personal experiences (inmates, guards) - Personal observations (guards, inmates, mental health specialists, administrators) - He made a content analysis of the journal, they wrote a lot about drugs, violence, family. - Provincial school records (available to the prof, he cans look at the history) - Informal interview and conversations with psychologist, social workers, guards - Analysis of previous studies and forensic literature on the topics being studied Conclusions: wier’s work - Personal opinion: many of the 16-18 year old men and women I worked with were beyond rehabilitation BUT efforts short still be taken to reform their destructive ways - Provided our treatment efforts are not naïve; that such efforts take into account the variety of factors that contribute and contributed to how they got where they were, positive change may be possible - Factors: next paragraph - The deleterious affects of incarceration: rehabilitation in prison is severely compromised - The attitudes of the inmates about themselves and one another, in addition to those of correctional officers toward the inmates impaired psychological and behavioural change (make any good improvement). DSM-IV: oppositional defiant disorder - Not a single incident - Consistent pattern, age-inappropriate behaviour - Stubborn, hostile, defiant behaviour - Frequent predictor of unhealthy parent-child relationships (arguing with adult about anything) - Can’t accept to be responsible for something( some else fault not mine) - Irritable - Aggressive toward others - Violating the basic rights of others and/or property - General rejection of societal and cultural norms and rules - E.g.. aggression toward animals; school bully (intimidation), intentional destruction of property order a meal and don’t pay, take a taxi and don’t pay - Security camera in the room, phone call from the staff and they said (your security camera doesn’t work but the good thing is we don’t look anyway). But at the beginning the prof was really freaked out! He met a guy, huge one (steroids) and this men got angry and started to break everything. The professor starts to call but the phone was busy). Finally the prof realised that he can’t work with fear and thinks all the time at their crimes. Childhood versus adolescent onset CD (chronic disorders) - Before the age of 10 - Usually includes some for of aggression - More likely to be boys - Persist over time (long-life) - High correlation between onset CD (childhood CD) and unemployed parents, low SES (socio economics standard), single parents family, multiple partners, abuse - Occurs in both boys and girls with the same level of frequency - Less severe behavioural psychopathology - Less likely to commit violent offenses - Less likely to continue with antisocial behaviour ODD or CD, which is it? - At times they are used interchangeably - CD are usually preceded by ODD (optional defiant disorders) - ODD almost always come before CD, however, the diagnosis of ODD may be missed in the child who is identified with CD - Most children with CD continue to display ODD symptom - Most children who display ODD symptoms, do not progress onto a diagnosis of CD. - The most severe btn ODD and CD is chronic disorder (for children) Conduct disorders and APD - Youths who display symptoms of both ODD and CD are at an elevated risk for a diagnosis of antisocial personality disorder (APD) as adults - Up to 40% of children with CD are diagnosed with APD as adults - Psychopaths: the absence of a conscience, callous acts of deception and manipulation, no sense of remorse, no reflections of what they did. Associated characteristics of CD - ADHD (attention deficit hyperactivity disorder) is the single most frequent comorbid psychiatric/psychological disorder - High rates of poor grades (particularly with language and reading) being held back a grade, specialization ed. Placement, dropouts, suspensions - Childhood CD together with and association of deviant peer group, strong predictor of CD in adolescence. - Family: economically impoverished households and neighbourhoods; single parent households, multiple parent households; parental psychopathology, family history of domestic violence, antisocial family values, incarcerated family members (parents, uncles, aunts, siblings), learning disabilities such as ADHD, the correlation btn this disorder is really significant. Nb: girls are more violent than boys Context, costs and perspectives - Social and economic costs o Conduct problems are the most costly mental health problem in north America o Early, persistent, and extreme pattern of antisocial behavior occurs in about 5% of children; these children account for over 50% of all crime in the US and approximately 30-50% of clinic referrals o As much as 20% of mental health expenditures in the US are attributable to crime o Public costs across healthcare, juvenile justice and educational systems are a tleast 10000$ a year per child o Lifetime cost to society per child who leaves high school for life of crime and substance abuse is estimated to be at least $2 million Myth buster Adolescence is inevitably a time of turmoil??? - 1 st paragraph of text G Stanley hall “a time of storm and stress” 1904 Anna Freud “to be normal during the adolescent period is by itself abnormal” (1958) Based on AMERICAN data, there is an increase in conflicts with parents, taking more risks, and mood changes. However, the majority of youth, most surveys in countries around the world, report general happiness in their home. In contrast to the US data given in the text, what percentage of youth were charged with a criminal code offence in Canada in 2011? Between 5-6 % (actually decreasing) Self-esteem deficits - Low self-esteem is not the primary cause of conduct problems o Instead problems are related to inflated instable and or tentative view of self - Youths with conduct problems may experience high self-esteem that over time permits them to rationalize their antisocial conduct. Peer problems - Young children with conduct problems display poor social skills and verbal and physical aggression toward peers. - Often rejected by peers, although some are popular o Children rejected in primary grades are five times more likely to display conduct problems as teens o Some become bullies o Often form friendships with other antisocial peers  Predictive of conduct problems during adolescence o Underestimate own aggression and its negative impact, and overestimate others aggression toward them o Reactive-aggressive children display hostile attributional bias: attribute negative intent to others o Proactive-aggressive view their aggressive action as positive - Rejection and acceptation by peer! Do you feel connected to your community, to your school? If we arrived to connect you, it’s perfect, plus you become disconnected and more the risks goes up. - Booth camp: 0 empirical evidence that they were an effective treatment. Family problems - Family problems are among the strongest and most consistent correlated of conduct problems o General family disturbances (e.g. parental mental health problems, family history of antisocial behavior, marital discord, etc.) o Specific disturbances in parenting practices and family functioning (e.g. excessive use of harsh discipline, lack of supervision, lack of emotional support/involvement, etc.) o High levels of conflict are common in the family, especially between siblings o Lack of family cohesion and emotional support o Deficient parenting practices o Parental social-cognitive deficits - Bad mixed btn hard and jelly fish. Parents who want order in the house and outside they don’t care. Accompanying disorders and symptoms - Attention-deficit/hyperactivity disorder (ADHD) o More than 50% of children with CD also have ADHD o Possible reasons for overlap:  A shared predisposing vulnerability may lead to both ADHD and CD  ADHD may be a catalyst for CD  ADHD may lead to childhood onset of CD o Research suggests that CD and ADHD are distinct disorders - Depression and anxiety: o About 50% of children with conduct problems also have a diagnosis of depression or anxiety  ODD best accounts for the connection between conduct problems and depression  Poor adult outcomes for boys with combined conduct and internalizing problems  Girls with CD develop depressive or anxiety disorder by early adulthood  Males and females: increasing severity of antisocial behavior is associated with increasing severity of depression and anxiety  Anxiety may serve as protective factor to inhibit aggression - The fact that children have disorder increase the risk to act bad in adulthood or even be a juvenile delinquent. Depression high overlap with children with disorders. More you suffer of disorder and more you are excluded for the society. Prevalence, Gender, and course - Prevalence o ODD more prevalent than CD during childhood: by adolescence, prevalence is equal o Lifetime prevalence rates  12% for ODD (13% for males, 11% for females=  8% for CD (9% for males, 11% for females o Prevalence estimates for CD and ODD across cultures are similar, but most comparisons have been made between Western countries rather than between Western and non-Western countries Gender - Gender differences are evident by 2-3 years of age o During childhood, rates of conduct problems are about 2-4 times higher in boys o Boys have earlier age of onset and greater persistence o Gender disparity increases through middle childhood, narrows in early adolescence, and increases again in late adolescence, when male delinquent behavior peaks o Early symptoms for girls are sexual misbehaviours o Boys remain more violence-prone over their lifespan o Sex differences in antisocial behavior have decreased by more than 50% over the past 50 years - Aggression continues in preschool years. - Boys starts higher than girls. - Concern because tend to be less differences btn gender Adult outcomes - 50% of active offenders decrease by early 20s, and 85% decrease by late 20s - Adult outcomes depend on type and variety of conduct problems, in addition to the number and combination of risk factors in child, family and community - Negative adult outcomes, especially for those on the LCP path o Male: crimina
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