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Chapter 6

Chapter 6 Notes PSYC412.docx

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PSYC 412
Melanie Dirks

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Chapter 6 Notes Although the most lethal forms of youth violence in the United States have been steadily decreasing since 1994, the prevalence of other forms of antisocial behavior remains alarmingly high, and the proportion of females involved in violent crimes has increased Based on a survey in the US of  high school students: in 2009 found that about 32% had been in a physical fight in the past year, 18% reported carrying a weapon in the last month, and 8% re- ported being threatened or injured with a weapon on school property. Description of conduct problems •Aggressive behaviors are an adaption to home and neighborhood violence & neglect. •Conduct problem(s) and antisocial behavior(s) are terms used to describe a wide range of age- inappropriate actions and attitudes of a child that violate family expectations, societal norms, and the personal or property rights of others • • The nature, causes, and outcomes of conduct problems in children are wide-ranging, requiring that we consider several different types and pathways. •Children with severe conduct problems usually grow up in extremely unfortunate family  &neighborhood circumstances. •Some children that have conduct problems, do so with a cause. For example a child that stabs  his father after viewing his father rape his mother, is acting out due to the tragic family situation. • many individuals have the following opinions about the nature of youth violence: o Most future offenders can be identified during early childhood. o Child abuse and neglect inevitably lead to violent behavior later in life. o AfricanAmerican and Hispanic youths are more likely to become involved in violence than other racial or ethnic groups. o Getting tough with juvenile offenders by trying them in adult criminal courts reduces the likelihood that they will commit more crimes. o Most violent youths will end up being arrested for a violent crime. o Nothing works with respect to treating or preventing violent behavior. o ALL THEABOVE STATEMENTSARE FALSE Context,Cost and Perspectives Context •Most young people break rules from time to time. •In 2009, about 72% of high school students in the U.S. had consumed alcohol, 46% had smoked cigarettes, and 37% had smoked marijuana. •Very few adolescents (about 6%) refrain from antisocial behavior entirely. •Antisocial behaviors appear and then decline during normal development •About 50% of parents report that their preschoolers steal, lie, disobey, or destroy property, in contrast to 10% of parents who report the same about young adolescents. o This decline partially reflects the parents’ lack of awareness of the trouble their teens may be getting into. •Antisocial behaviors vary in severity, from minor disobedience to fighting. • •Some antisocial behaviors decrease with age (e.g., disobeying at home), whereas others increase with age and opportunity (e.g., hanging around kids who get into trouble). • •Antisocial behaviors are more common in boys than girls during childhood, but this difference narrows in adolescence. • •Longitudinal studies find aggressive acts such as persistent physical fighting to be highly stable, with an average correlation of about 0.70 for measures of these behaviors taken at different times. This makes aggressive behavior about as stable as IQ scores! • Social and Economic Cost • •Although antisocial acts are universal in young people, an early, persistent, and extreme pattern of antisocial behavior occurs in only about 5% of children • •More teenagers in the United States die from fire- arm injuries than from all diseases combined, and they are more than twice as likely as adults to be victims of violence, most often committed by other teens • •The additional public costs per child with conduct problems across the healthcare, juvenile justice, and educational systems are enormous, at least $10,000 or more a year • •The lifetime costs to society for one youth to leave high school for a life of crime and substance abuse has been estimated to be at least two million dollars • Perspectives •These include the legal, psychological, psychiatric, and public health perspectives Legal • Conduct Problems= delinquent or criminal acts •The broad term juvenile delinquency describes children who have broken a law, ranging from sneaking into a movie without paying to homicide. •Legal definitions depend on laws that change over time or differ across locations. Legal definitions exclude antisocial behaviors. •Youths who display antisocial behavior and are apprehended by police may differ from youths who display the same patterns but are not apprehended because of their intelligence or resourcefulness. •The minimum age of criminal responsibility is 12 in most states and provinces, but this has fluctuated over the years in relation to society’s tolerance or intolerance of antisocial behavior in youth. •A legal definition of delinquency may result from one or two isolated acts, whereas a mental health definition usually requires the child to display a persistent pattern of antisocial behavior. Thus, only a subgroup of children who meet a legal definition of delinquency will also meet the definition for a mental disorder Psychological •Conduct problems fall along a continuous dimension of externalizing behavior. which includes a mixture of impulsive, overactive, aggressive, and rule-breaking acts. •The externalizing dimension itself consists of two related but independent sub-dimensions labeled “rule-breaking behavior” and “aggressive behavior” •Two additional independent dimensions of antisocial behavior have been identified: overt– covert and destructive–nondestructive o The overt–covert dimension ranges from overt visible acts such as fighting to covert hidden acts such as lying or stealing. o Children who display overt antisocial behavior tend to be negative, irritable, and resentful in their reactions to hostile situations and to experience higher levels of family conflict. In contrast, those displaying covert antisocial behavior are less social, more anxious and more suspicious of o The destructive–nondestructive dimension ranges from acts such as cruelty to animals or physical assault to nondestructive behaviors such as arguing or irritability o Figure 6.2, crossing the overt–covert with the destructive–nondestructive dimension results in four categories of conduct problems: (A) covert– destructive, or property violations(Steals,Vandalism,lies); (B) overt–destructive, or aggression(fights,cruel,bullies); (C) covert–nondestructive, or status violations(runaway,swears,truancy,substance use); and (D) overt–nondestructive, or oppositional behavior(Temper,argues,touchy,stubborn). Psychiatric •In DSM-IV-TR, disruptive behavior disorders are persistent patterns of antisocial behavior, represented by the categories of oppositional defiant disorder (ODD) and conduct disorder (CD). •Both categorical (psychiatric) and dimensional (psychological) perspectives have proven validity for the classification of conduct problems in youth. •DSM-5 will likely also include dimensional measures that are sensitive to both the severity of children’s conduct problems and to subclinical levels of symptoms (troubling symptoms too few in number to qualify for a categorical diagnosis of CD or ODD). Public Health •This perspective blends the legal, psychological, and psychiatric perspectives with public health concepts of prevention and intervention. DSM-IV-TR:Defning features Oppositional Defiant Disorder(ODD) •These children display an age- inappropriate recurrent pattern of stubborn, hostile, disobedient, and defiant behaviors •ODD usually appears by age 8, and was included in the DSM to capture early displays of antisocial and aggressive behavior by pre- school and school-age children •Interestingly, recent findings suggest that symptoms of ODD can be grouped into those of negative affect (e.g., angry/irritable mood) and those of defiance (e.g., defiant/headstrong behavior), which differentially predict later emotional and behavioral disorders in early adulthood •In one study, only negative affect predicted later depression, whereas defiance predicted later behavior disorders Conduct Disorder(CD) •Children with conduct disorder display a repetitive and persistent pat- tern of severe aggressive and antisocial acts that involve inflicting pain on others or interfering with rights of others through physical and verbal aggression, stealing, or committing acts of vandalism • They often haveADHD,academic deficiencies & poor relations with peers. •Their families often use child-rearing practices, such as harsh punishment. Age of onset •DSM makes the distinction between youths with an early or late onset of CD. Those with childhood-onset conduct disorder dis- play at least one symptom of the disorder before age 10, whereas those with adolescent-onset conduct disorder do not, o Children diagnosed with childhood-onset CD are more likely to be boys, show more aggressive symptoms, account for a disproportion- ate amount of illegal activity, and persist in their antisocial behavior over time o youths diagnosed with adolescent-onset CD are as likely to be girls as boys and do not display the severity or psychopathology that characterizes the childhood- onset group CD and ODD •There is much overlap between the symptoms of CD and ODD •Symptoms of ODD typically emerge 2 to 3 years before CD symptoms, at about age 6 years for ODD versus age 9 years for CD. •Nearly half of all children with CD have no prior ODD diagnosis, and most children who display ODD do not progress to more severe CD—at least 50% maintain their ODD diagnosis with- out progressing, and another 25% cease to display ODD problems entirely. Antisocial personality Disorder( APD) & Psychopathic Features •(also referred to as dyssocial personality disorder), a pervasive pattern of disregard for, and violation of, the rights of others •In addition to their early CD, adolescents withAPD may also display psychopathic features, which are defined as a pattern of callous, manipulative, deceitful, and remorseless behavior—the more menacing side of human nature •As many as 40% of children with CD developAPD as young adults. •Youths who display psychopathic features appear to be aware that their aggressive behavior will cause others to suffer—but they don’t care when it does. •Children with CD show lack of concern= They display a callous and unemotional (CU) interpersonal style characterized by traits such as lacking in guilt, not showing empathy, not showing emotions. •Children who display CU traits also display a lack of behavioral inhibition as reflected in their preference for novel and perilous activities and a diminished sensitivity to cues for danger and punishment when seeking rewards •It is the callous–unemotional and interpersonal/narcissistic features of psychopathy that can be most reliably distinguished from behaviors consistent with ODD, CD, andADHD. Features associ- ated with impulsivity are more similar to behaviors of children withADHD •Children with CU traits display a greater number and variety of conduct problems, and they have more frequent contact with police and a stronger parental his- tory ofAPD than other children with conduct problems •CU symptoms in childhood are about as stable as ODD and CD symptoms over time, but developmental changes have also been noted, suggesting that these are not unchanging characteristics of the child. •Bart Simpson would qualify for a DSM diagnosis of CD. Associated characteristics Cognitive and Verbal Deficits • Studies found that some children with CD show IQ deficit, this deficit cannot be explained solely by socioeconomic disadvantage,race,or detection by the police. May be due to co- occurrence ofADHD. •Verbal IQ is consistently lower than performance IQ in children with CD, suggesting a specific and pervasive deficit in language. •Verbal deficits are present early in a child’s development, long before the emergence of conduct problems. However, their presence alone does not predict future aggression—family factors are also important. o Children with both verbal deficits and family adversity display 4 times as much aggressive behavior as children with only one factor •It is important to keep in mind that the relation- ship between different cognitive/verbal deficits and antisocial behavior may vary for specific types of antisocial behaviors. For example, one study found that verbal abilities were negatively related to physical aggression, but positively associated with theft, and that inductive reasoning was negatively associated with increases in theft across adolescence •Children with conduct problems rarely consider the future consequences of their behavior or its impact on others. o They fail to inhibit their impulsive behavior, keep social values or future rewards in mind, or adapt their actions to changing circumstances. This pattern suggests deficits in executive functions similar to those of children withADHD. •The types of executive functioning deficits experienced by children with ODD and CD may differ from those experienced by children withADHD o For example, Rubia has made the distinction between cool (as in temperature, not as in Lady Gaga) cognitive executive functions, such as attention, working memory, planning, and inhibition, and hot executive functions that involve incentives and motivation. o Both cool and hot executive functions are associated with distinct but interconnected brain networks. Cool executive function deficits are thought to be more characteristic of children withADHD, whereas hot executive function deficits are more characteristic of children with conduct problems. School and Learning Problems •Children with conduct problems display many schooldifficulties, including academic underachievement, graderetention, special education placement, dropout, suspension, and expulsion Self-esteem Deficits • Children with Conduct problems have an inflated, unstable and/or tentative view of self, which overtime permits them to rationalize their antisocial conduct. Peer Problems •Young children with conduct problems display verbal and physical aggression toward other children & poor social skills. •Involvement with antisocial peers becomes increasingly stable during childhood and supports the transition to adolescent criminal acts such as stealing, truancy, or substance abuse •Unfortunately, many well-intentioned programs such as group therapy, summer programs, or boot camps tend to create groups for youth with con- duct problems—the very situation that may produce the most damage. •Aggressive children also show distortions in how they think about social situations. o reactive–aggressive children (those showing an angry, defensive response to frustration or provocation) dis- play a hostile attributional bias, which means they are more likely to attribute hostile and mean-spirited intent to other children, especially when the intentions of others are unclear (e.g., when another child accidentally bumps into a reactive–aggressive child, they are likely to think the other child did it on purpose). o proactive–aggressive children (those who use aggressive behavior deliberately to obtain a desired goal) are more likely to view their aggressive actions as positive and to value social goals of dominance and revenge rather than affiliation •Box 6.3 Bullies and their victims: o Bullying occurs when one or more children intentionally and repeatedly expose another child who cannot readily defend himself or herself to negative actions. o In 2007, about 32% of students age 12–18 reported having been bullied at school o Interestingly, in one study, youths with a particular genotype (involving the se- rotonin transporter 5-HTT gene) were found to be less likely to suffer adverse effects following bullying victimization—another example of G x E interaction Family Problems •Family problems are among the strongest and most consistent correlates of conduct problems •Two types of family disturbances are related to these problems in children: o General family disturbances include parental mental health problems, a family history of antisocial behavior, marital discord, family instability, limited resources, and antisocial family values. o Specific disturbances in parenting practices and family functioning include excessive use of harsh discipline, lack of supervision, lack of emotional sup- port and involvement, and parental disagreement about discipline. Health-Related Problems •Young people with persistent conduct problems en- gage in many behaviors that place them at high risk for personal injuries, illnesses, overdoses from drug abuse, sexually transmitted diseases, substance abuse, and physical problems as adults •Rates of premature death (before age 30) due to various causes are 3 to 4 times higher in boys with conduct problems than in boys without these problems (contrary to popular belief, it’s not only the good that die young!) •The evidence indicates that conduct problems during childhood are a risk factor for adolescent and adult substance abuse, and this relationship is mediated by drug use and delinquency during early and late adolescence Accompanying Disorders and Symptoms •Most children with conduct disorder also haveAHD, depression and anxiety. Attention-Deficit/Hyperactivity Disorder (ADHD) •More than 50% of children with CD also haveADHD •Possible reasons for this overlap: o Ashared predisposing vulnerability such as impulsivity, poor self-regulation, or temperament may lead to bothADHD and CD. o ADHD may be a catalyst for CD by contributing to its persistence and escalation to more severe forms, particularly when shaped by ineffective parenting emotional reactions and behaviors. o ADHD may lead to childhood onset of CD, which is a strong predictor of continuing problems. •Two lines of research suggest that CD &ADHD are distinct: 1. CD and ADHD consistently provides a better fit to the data than a model based on only a single disorder 2. CD is less likely thanADHD to be associated with cognitive impairments, neurodevelopmental abnormalities, inattentiveness in the classroom, and higher rates of accidental injuries Depression & Anxiety • •About 50% of youths with conduct problems also receive a diagnosis of depression or anxiety • •Recent evidence suggests that it is ODD and not CD that best account
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