10/18 Conduct Disorders - Upadhyay Flashcards Preview

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Flashcards in 10/18 Conduct Disorders - Upadhyay Deck (11):
1

disruptive, impulse control, conduct disorders

 

common feature

5 types

all display impaired self-regulation

  • intermittent explosive disorder
  • pyromania
  • kleptomania
  • oppositional defiant disorder (ODD)
  • conduct disorder

2

intermittent explosive disorder

  • recurrent behavioral outbursts represting failiure to control aggressive impulses, manifested as:
  1. verbal aggression or physical aggrssion towards others/animals/property
    • occuring avg 2x/wk for 3 mo
    • aggression does not result in damage/destruction of property or physical injury to victum
  2. behavioral outbursts
    • damage/destruction of prop or physical assault involving physical injuries
    • 3 episodes within 12mo period
  • aggression in ourburts is grossly out of proportion
  • outbursts not premeditated
  • outbursts cause impairment in occupational/interpersonal fx, personal distress, or have financial/legal conseqs
  • age at least 6yo
  • outbursts not better explained by another disorder

 

 

3

intermittend explosive disorder

SSRI

mood stabiliziers

2gen antipsychotics

 

CBT

  • helps identify stressors that trigger outbursts → pts can then recognize and defuse situation
  • aims to help pts understand that they are resp for consequences of actions

4

pyromania

deliberate and purposeful fire-setting on multiple ocasions

  • tension/arousal before act
  • fascination/curiosity with act
  • pleasure/gratification from act

5

kleptomania

recurrent failure to resist impulses to steal objects that are not needed for personal use or their monetary value

  • tension before act
  • pleasure/gratification at time of act/after act

6

other addiction/compulsive behaviors

 

  • internet addiction
  • compulsive shoppingi

internet addiction: excessive or poorly controlled comp use → impairment or distress

  • urges to use
  • tension/arousal before
  • depressed/guilty after spending too much time

compulsive shopping: irresistible urge to buy items that are unneeded or unwanted

  • often young women

7

tx for compulsive behavior

SSRIs!

8

oppositional defiant disorder

 

symptoms (3 categories)

specifiers

criteria for 5/below and 5+

comorbidities

recurrent pattern of at least 4sx for 6months

  • angry/irritable mood
    • losing temper, touchiness, easily annoyed, angry, resentful
  • argumentative/defiant behavior
    • arguing with auth figures, refusal to comply with rules/requests, blaming others for mistakes/misbehavior
  • vindictiveness
    • spiteful/vindictive >2x in past 6mo

specifier: mild (1 setting), moderate (2 settings), severe (3 settings)

  • behaviors lead to distress in individ or others in immediate social context or negatively impact important area of fx

 

5yo and under: most days for 6mo

5yo+: once a week for 6mo

 

comorbidities: ADHD, conduct disorder

  • assoc with incr risk of suicide

9

ODD treatment

tx targeting both child and family

  • family tx essential bc parents need help understanding/managing child
  • combo of psychotx and medication
    • social skills training
    • cognitive problem solving training

 

10

conduct disorder

 

4 categories: 15sx within

criteria for dx

specifiers

repetitive and persistent behavior pattern in which basic rights of others or major age-approp social norms or rules violated

  1. aggressive conduct to people/animals
    • bullies, threatens, intimidates others
    • initiates fights
    • used a weapon that can cause serious physical harm
    • physically cruel to ppl
    • physically cruel to animals
    • forced another into sexual activity
    • stolen during confrontation
  2. destruction of property
    • deliberately engaged in fire setting
    • deliberately destroyed property of others
  3. deceitfulness or theft
    • broken into house/car
    • lies to obtain goods/favors or to avoid obligation
    • stonel items of nontrivial value without confrontation
  4. serious rule violations (runaway, truancy)
    • stays out at night despite parental prohibition
    • run away from home overnight at least 2x
    • often truant

sx must cause impairment in social/academic fx

three or more sx present in 12mo, at least 1 in 6mo

specifiers: 

  • onset
    • childhood onset type (prior to 10)
    • adolescent onset type (no sx before 10)
    • unspecified
  • limited prosocial emotions (2 or more)
    • lack of remorse/guilt
    • callous - lack of empathy
    • unconcerned about performance
    • shallow or deficient affect
  • severity
    • mild (minor harm to others)
    • moderate
    • severe

11

tx for conduct disorder

very difficult to treat

mild cases may respond to psychotherapy

consider: meds to reduce anger, irritability, mood issues

treat comorbidities

family tx essential

  • parents need help understanding, managing, supervising, monitoring children/adolescents with other team members