Conduct Disorder and Oppositional Defiant Disorder Flashcards
Anti-social personality disorder
Pervasive disregard for and violation of rights of others starting by age 15
Wraparound
A framework for organizing services in high-need, mentally ill children involving a number of core values including cultural sensitivity, strength focus, creativity, natural supports, and team approaches
Girls vs boys with CD
Among children with CD, girls tend to have lower intelligence and poorer performance on visuospatial, executive function and academic achievement domains.
Psychopathic traits
Two parts: A callous-unemotional component and an impulsive-antisocial component
Diagnostic criteria for conduct disorder
Persistent, repetitive pattern of behavior that infringes on the basic rights of others or violates major age-appropriate societal norms
Manifests by the presence of at least three symptoms from the following categories in the last 12 months with a least one in the last 6 months:
- Aggression towards people or animals
- Destruction of property
- Deceitfulness or theft
- Serious rule violation
If the patient is older than 18, the criteria for antisocial personality disorder are NOT met.
Ways to get a diagnosis of conduct disorder
Meet the criteria for ASPD, but be younger than 18
Not quite meet the criteria for ASPD despite being older than 18
Oppositional defiant disorder
Characterized by a negative behavior pattern, but offenses do not cause significant harm to others or involve violations of major societal norms
In order to diagnose conduct disorder, symptoms must not only be present during. . .
. . . a manic or depressive episode, or as a reaction to some stressor
In other words, not just secondary to bipolar, MDD, or adjustment disorder.
Disruptive Mood Disregulation Disorder (DMDD)
Diagnosis that describes primary school age children with chronic negative mood and temper outbursts
Validity is still in question, but may represent an extreme and early onset form of oppositional defiant disorder
However, DMDD should be diagnosed instead of ODD when symptoms are particularly severe and negative mood is a predominant feature.
Intermittent explosive disorder
Characterized by impulsive outbursts of anger and aggression
Similar episodes are uncommon in ODD
Many clinicians see __ as a precursor to __, as a precursor to __.
Many clinicians see ODD as a precursor to CD, as a precursor to ASPD.
Treatment of conduct disorder
Very difficult to treat. Requires a multisystem approach (family, education, community) or a wraparound program.
Many patients with CD have comorbid ADHD, which must be identified and treated. Even if the child does not meet full criteria for ADHD, there is evidence that CD is amenable to treatment with stimulants.
No medications are yet approved for treatment of CD, but there is growing evidence that atypical antipsychotics can help control aggression in these patients (particularly risperidone, but also quetiapine, olanzapine, aripiprazole)
