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Chapter 6

psy341 - chapter 6 conduct disorders.doc

Course Code
Ross Hetherington

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Chapter 6: Conduct Problems
- increased substantial in the past 25 years
- affects males and females, all social classes, all family types
- most lethal forms decreasing in US since 1994
-Conduct and antisocial problems – 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
Context, Costs, and Perspectives
- many young people admit to antisocial acts—i.e. alcohol, smoking, drugs
oadolescences excessively conventional, trusting, anxious, and socially
incompetent, ill-adjusted
- antisocial behaviour rises and then falls in development
oboth parents and teens describe antisocial behaviour decreasing with age
- antisocial behaviour
ovary in severity—minor disobedience to fighting
osome decrease, others increase with age and opportunity
omore common in boys during childhood but difference narrows in
- most physical aggression is during childhood
Social and Economic Costs
- 5% of children have extreme pattern of antisocial behaviour and account for 50% of
all crime in the US and 30-50% clinical referral
- 20% of all mental health expenditures in the US attributable to crime
- More teens in US die from fire-arm injuries than all diseases; twice as likely to be
victim of violence compared to adults
- legal
ojuvenile delinquency – children who have broken a law
laws change over time and differ across locations
oofficial vs self-reported delinquency
ominimum age of responsibility in most states and provinces is 12
oadaptations to hostile environment—carrying weapon for self-defence?
Reaction to environment vs mental health?
Latter requires persistent pattern of antisocial behaviour
- psychological

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oexternalizing behaviour – continuous dimension which includes a mixture
of impulsive, overactive, aggressive, and rule-breaking acts
conduct problems usually one standard deviation above mean
two subdivisions
rule-breaking behaviour
orunning away, setting fires, stealing, skipping school,
alcohol and drugs, vandalism
ofighting, destructiveness, disobedience, showing off,
being defiant, threatening others, disruptive at school
otwo independent dimensions of antisocial behaviour (see Fig 6.2; pg 157)
overt-covert ranges from over visible acts (i.e. fighting) to covert,
hidden acts (lying, stealing)
ochildren tend to be negative, irritable, and resentful
in reactions to hostile situations
oexperience higher levels of family conflict
oless social, more anxious, and more suspicious of
ofamilies provide little support
most children exhibit both
children in frequent conflict with authority show most severe
family dysfunction and poorest long-term outcome
destructive-nondestructive dimension ranges from acts such as
cruelty to animals or physical assault to non-destructive behaviours
such as arguing or irritability
cross the two for the following
covert-destructive (property violations)
overt-destructive (aggression)
ohigh risk for later psychiatric problems and
impairment in functioning
covert-nondestructive (status violations)
overt-nondestructive (oppositional behaviour)
- psychiatric
oDSM-IV-TR: disruptive behaviour disorders – persistent patterns of
antisocial behaviour (ODD and CD)
oAntisocial personality disorder
- public health
oblends legal, psychological, psychiatric perspectives
oprevention and intervention
ogoal to reduce injuries, deaths, personal suffering, and economic cost of
youth violence

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DSM-IV-TR: Defining Features
Oppositional Defiant Disorder (ODD)
- age-inappropriate recurrent pattern of stubborn, hostile, and defiant behaviour
(tantrums, arguing)
- usually appears by age 8
- early display of antisocial and aggressive behaviour by preschool and school age
- negative parent-teacher interactions
- 75% of low-income clinic-referred preschoolers
- Substantial risk for secondary mood, anxiety, and impulse-control disorders
Conduct Disorder (CD)
- repetitive and persistent pattern 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
- co-occurring problems—ADHD, academic deficiencies, poor relations with peers
- families often use child-rearing practices that contribute to problem
- parents feel children out of control
- age of onset makes a difference in diagnosis
ochildhood-onset conduct disorder – display at least one symptom before
age 10
more likely boys
show more aggressive symptoms
account for disproportionate amount of illegal activity
persistent in antisocial behaviour over time
oadolescent-onset conduct
both girls and boys equally likely
do not display severity or psychopathology of the childhood-onset
less likely to commit violent offenses or persistent in antisocial
behaviour as they age
- relationships with ODD
oCD and ODD symptoms overlap—separate disorders? Or same underlying
oODD symptoms emerge 2-3 years before ODD (age 6 vs 9)—ODD
precursor to CD?
oBUT most children with ODD do not progress to CD (50% maintain ODD,
25% cease entirely)
ODD extreme developmental variation?
Not necessarily leading to CD
onew cases of CD almost always preceeded by ODD
onearly all children with CD continue to display ODD
- relationship with antisocial personality disorder
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