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Chapter 8

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Psychology 2042A/B
Alvin Segal

Psychology 2042A Chapter 8—Conduct Problems  Externalizing: denotes problems that tend to place young people in conflict with others  A distinction has been made between inattention, hyperactivity, and impulsivity on the one hand, and aggression, oppositional behaviors, and more serious conduct problems on the other  Contributed to broad societal concern with levels of violence and crime  Conduct disorder and disruptive behaviour disorder are used to refer to the particular diagnostic grouping that addresses these kinds of difficulties  Delinquency is primarily a legal term used in criminal justice system to describe youth who exhibit conduct problem/antisocial behaviour Juvenile who has committed an index crime or status offense; an index crime is an act that would be illegal for adults as well as for juveniles. A status offense is an act that is illegal only for juveniles.  Preschool age children often hit, kick, or bite other children.  Middle school children engage in various forms of aggression and bullying  Adolescents engage in dangerous behaviours and use illegal substances  Antisocial Personality Disorder: individuals who display a persistent pattern of aggressive and antisocial behaviour after the age of 18. Pervasive pattern of disregard for and violation of the rights of others Pattern must be present since the age of 15, individual did meet, or would have met, the criteria for Conduct Disorder with an onset before 15 years of age.  Oppositional Defiant Disorder is described as a pattern of negativistic, hostile, and defiant behaviour that is developmentally extreme, symptoms must be present for at least 6 months, symptoms contain both emotional and behavioural indicators. These contribute to the prediction of later disruptive/externalizing disorders.  In order to make a diagnosis of ODD the oppositional defiant behaviours and emotional reactions must cause clinically meaningful impairment in the young person’s social or academic functioning  The appropriateness of the ODD diagnosis thus rests on a balance between “overdiagnosing” common problems of children and adolescents as disorders versus ignoring potential serious problems that also may be early precursors of persistent antisocial behaviours  Conduct Disorder represents more seriously aggressive and antisocial behaviours [violence and property damage]  Essential feature of the diagnosis of conduct disorder is a repetitive and persistent pattern of behaviour that violates both the basic rights of others and major age appropriate social norms and symptoms persist for 12 months. Aggression to people and animals, destruction of property, deceitfulness or theft, serious violations of rules; if individual is age 18 years or older, criteria not met for antisocial personality disorder.  Behaviour must cause clinically meaningful impairment in social or academic functioning. There are two subtypes: childhood onset (prior to age 10 years) and adolescent onset  Most research regarding conduct disorder has focused on school age children and adolescents  Current criteria may not be applicable to younger children. Research also suggests that such problem behaviour begins early and persistent problems might be prevented with early intervention  Conduct disorder is more frequently diagnosed in boys  Prevalence is due to bias in the diagnostic criteria  DSM criteria were developed and validated based primarily on male samples  Forms of aggression may be more characteristic of boys  Findings that girls with subclinical levels of conduct disorder symptoms go on to develop clinically significant problems  Evidence suggesting the benefit of conceptualizing externalizing problems in a dimensional rather than categorical manner.  One issue is whether it is appropriate to place the locus of the deviant behaviour entirely within the individual and ignore the social context  Conduct diagnosis should be applied only when the behaviour in question is symptomatic of an underlying dysfunction within the individual and not simply a reaction to the immediate social context.  Clinicians and researchers must be aware of both typical development and the real impact of poverty, stress, and violent communities on the development of antisocial behaviours  An empirically derived syndrome involving aggressive, oppositional, destructive, and antisocial behaviour has been identified in many studies as externalizing  Aggressive behaviour: argues a lot, destroys things, is disobedient, fights  Rule breaking behaviour: breaks rules, lies, steals, truancy  Youths may exhibit one or both types of problems  Research suggests higher degree of heritability for the aggressive than for the rule breaking syndrome  Average scores of the two syndromes decline between ages 4 and 10. After age 10, the scores on the aggressive syndrome continued to decline whereas scores on the rule breaking syndrome increased  Stability (the similarity of a particular individual’s behaviour at two points in time) was higher for aggressive than for rule breaking syndrome.  Some approaches suggest a distinction based on age of onset: a later age of onset or adolescent onset category consisting principally of nonaggressive rule breaking behaviours, and an early onset category that involves these behaviours as well as aggressive behaviours  The salient symptom approach is based on the primary behaviour problem being displayed.  There is support for distinguishing between aggression from other conduct disordered behaviour on the basis of its social impact, correlates, gender differences, and developmental course.  Overt, confrontational antisocial behaviours e.g. fighting, temper tantrums and covert or concealed antisocial behaviours e.g. fire starting, stealing, truancy  Overt and destructive include aggression, cruelty to animals, fighting, assault, bullying  Overt and non-destructive include stubborn, oppositional, or defiant behaviour  Covert and destructive include lying and property damage  Covert and non-destructive include status offenses such as running away from home and truancy and substance use  Much of the research on conduct disorder has been on male based samples  Boys exhibit significantly higher levels of aggression than do girls  General definition of aggression as intent to hurt or harm others  Children’s aggression would focus on social issues most salient in same gender peer groups  Overt physical or verbal behaviours intended to hurt or harm others  Girls’ attempts to harm others may focus on relational issues—behaviours intended to damage another individual’s feelings or friendships  Relational aggression: includes purposefully leaving a child out of some play or other activity, getting mad at another person and excluding them from peer group, telling a person you will not like them unless they do what you say, saying mean things or lying about someone so that others will not like the person  Relational aggression fits with covert antisocial behaviour and is found from preschool age through adolescence  It is associated with peer rejection, depression, anxiety and feelings of loneliness and isolation  A sole focus on physical aggression might fail to identify aggressive girls  80% of aggressive girls would not have been identified by a definition limited to physical aggression  Violence is typically defined as an extreme form of physical aggression, aggressive acts that cause serious harm to others, such as aggravated assault, rape, robbery, and homicide.  There is the concern regarding youth as perpetrators of violent acts  Rates of violent offenses by juveniles have dropped considerably but an appreciable number of youths are involved in violent behaviour. 15% of arrests for violent crimes involve a juvenile.  The second concern is that young people are frequent victims of violence  Youths chronically exposed to violence may suffer abnormal neurological development and dysregulation in the biological systems that are involved in arousal and managing stress  Young people exposed to violence are at an increased risk for developing aggressive, antisocial, and other externalizing problems as well as internalizing difficulties and somatic symptoms  It is unclear whether there has been a drastic increase in rates of violence in schools, and some of the actions that have been taken had negative effects on young people.  Small percentage of violence occurs on school grounds and spikes at the close of the school day  Programs to reduce violence in schools should do so in a manner that creates a school atmosphere that facilitates the overall development of young people while ensuring their safety  Bullying is characterized by an imbalance of power and involves intentionally and repeatedly causing fear, distress, or harm to someone who has difficulty defending him or her self  Begins to emerge in the preschool years  The scope of the problem is during middle school and beyond th th  Frequency of bullying was higher for 6 graders through 8 graders than among students in the 9 and 10 grades  There is a decrease with age in the percentage of youths who report being bullied  Males were more likely than females to be involved as both perpetrators and victims. Boys are exposed to more direct open attacks than are girls  Girls are more to the subtle form of bullying than to open attacks. Boys may be exposed to this indirect bullying at rates comparable to that of girls  Typical bully is highly aggressive, have a more positive attitude toward violence; being impulsive, strong need to dominate others, having little empathy, being physically stronger than average  The typical victim is more anxious and insecure, cautious, sensitive, quiet, nonaggressive, and suffering from low self esteem, boys are less likely to be physically weaker  Bullying may be part of a more general antisocial, conduct disordered developmental pattern  60% of boys classified as bullies in grades six through nine were convicted of at least one officially registered crime by age 24 and that 35 to 40% of former bullies had three or more convictions by this age  A particular variant of the serotonin transporter (5-HTT) gene is associated with greater risk of emotional disturbance after exposure to stressful events  Victims of bullying experience a variety of negative outcomes, particularly depression and loneliness  Conduct problems are one of the most frequently occurring child and adolescent difficulties  Lifetime prevalence of ODD during childhood and adolescent of 10.2%  Conduct disorders are more commonly diagnosed in boys than in girls  Higher rates of ODD are also reported in boys  An increasing prevalence of conduct disorder with age is often reported for both boys and girls and there is some suggestion that, due to particular risk for girls, in the period around puberty, the gender ratio narrows temporarily in the mid-teens  Ethnic and socioeconomic differences are often reported.  Found no differences in prevalence for the combined problem category. Poverty and the stress of high crime neighbourhoods are thought to increase the risk for conduct- disordered behaviour.  Greater prevalence is reported in urban than in rural environments  Greater delinquency among lower class and minority youths  Children and adolescents who receive one of the disruptive disorder diagnoses also frequently experience other difficulties and receive other diagnoses  If the criteria for both conduct disorder and oppositi
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