Conduct Problems and Antisocial Behaviour in Young People

Question 1

Define conduct disorder

Answer 1

A repetitive and persistent pattern of antisocial, aggressive, or defiant behaviour with a frequency and severity beyond age appropriate norms that would violate others peoples’ expectations or rights

Question 2

Describe the typical mindset of an individual with conduct disorder

Answer 2

Easily annoyed, angry, resentful, spiteful, vindictive, actively defiant of requests or rules, blameful of others for one’s own mistakes, deliberately annoying to others, argumentative, disconnected from others’ pain

Question 3

Describe the typical behaviour of an individual with conduct disorder

Answer 3

Aggression to people and animals, serious violation of rules (truancy, running away from home, confrontational crime), deceiftulness or theft (shoplifting, burglary, forgery), destruction of property

Question 4

Name the three subtypes of conduct disorder in ICD-10

Answer 4

Conduct disorder confined to the family context, unsocialised context disorder, and socialised conduct disorder

Question 5

State some differential diagnoses of conduct disorder

Answer 5

ADHD, oppositional defiant disorder (ODD), adjustment reaction, mood disorders, autism spectrum disorder

Question 6

State some common comorbidites with conduct disorder

Answer 6

Depression, PTSD, learning disability, autism spectrum disorder, dyslexia

Question 7

Describe the symptoms of early childhood conduct disorder

Answer 7

Defiance of adults’ wishes, disobedience, angry outbursts, physical aggression, destruction of property, blaming others, provocation, arguing

Question 8

Describe the symptoms of later childhood conduct disorder

Answer 8

Swearing, lying, stealing others’ belongings, persistent rule-breaking, physical fights, bullying, animal cruelty, fire-setting

Question 9

Describe the symptoms of adolescent conduct disorder

Answer 9

Cruelty to other people, assault or robbery using force, vandalism, breaking and entering, joyriding, running away from home, truancy, drug and alcohol misuse

Question 10

Define oppositional defiant disorder

Answer 10

Childhood-onset negativistic, defiant, disobedient, provocative, and hostile behaviour towards authority figures lasting at least 6 months

Question 11

How is oppositional defiant disorder differentiated from conduct disorder?

Answer 11

The absence of more severe dissocial or aggressive acts that violate the law or the rights of others

Question 12

State some typical symptoms of oppositional defiant disorder

Answer 12

Loss of temper, arguing with adults, deliberately annoying others, blaming others for one’s own mistakes, active defiance of requests and rules, anger or resentment, easy annoyance

Question 13

Describe the relationship between age of onset and prognosis in ODD and conduct disorder

Answer 13

Younger age of onset indicates a poorer long-term prognosis

Question 14

What percentage of children have a conduct disorder?

Answer 14

2-8%

Question 15

What is the male to female ratio of conduct disorder?

Answer 15

2.5:1

Question 16

Name the 2 strongest predictors of antisocial behaviour in young people

Answer 16

Gender and quality of parenting

Question 17

What percentage of adults with a criminal record had conduct disorder as a child?

Answer 17

Over 90%

Question 18

Name 5 things conduct disorder is a predictor of

Answer 18

Homelessness, difficulties finding work, engaging in early childbearing, dependence on tobacco, alcohol, or drugs, offending and violence, poor parenting practices, mental health issues (anxiety, depression, suicide)

Question 19

State 2 individual factors increasing the risk of conduct disorder

Answer 19

Temperament (callous-unemotional traits), developmental problems (e.g. autism spectrum disorder, learning disability), hyperactivity, difficulties with friends and school

Question 20

State 2 familial factors increasing the risk of conduct disorder

Answer 20

Parental approach (poor supervision, erratic and harsh discipline, parental disharmony, abuse), parent-child attachment difficulties, witnessing domestic violence

Question 21

State 2 social factors increasing the risk of conduct disorder

Answer 21

Lower socio-economic class, neighbourhood (inner city, overcrowding, high crime and unemployment), school (low teacher satisfaction, deviant peer groups)

Question 22

Name the diagnostic questionnaire used to diagnose conduct disorder

Answer 22

Structured Assessment of Violence and Risk in Youth (SAVRY)

Question 23

Name the historical risk factors assessed by the SAVRY

Answer 23

History of violence, non-violent offending, past interventional failures, self-harm or suicide attempts, exposure to violence at home, childhood maltreatment, parent or caregiver criminality, poor school achievement

Question 24

Name the social risk factors assessed by the SAVRY

Answer 24

Peer delinquency, peer rejection, stress and poor coping, poor parental management, lack of personal or social support, community disorganisation

Question 25

Name the individual risk factors assessed by the SAVRY

Answer 25

Negative attitudes, risk taking or impulsivity, substance use, anger management problems, lack of remorse or empathy, poor compliance, low interest in or commitment to school

Question 26

Name the protective factors assessed by the SAVRY

Answer 26

Prosocial environment, strong social support, strong attachment and bonds, positive attitude towards intervention and authority, strong commitment to school, resilient personality traits

Question 27

State some interventions for conduct disorder

Answer 27

School interventions, parenting programs, cognitive problem-solving and skills training, multi-systemic therapy

Question 28

What do parenting programs for conduct disorder teach?

Answer 28

They promote play and good times between children and parents, as well as the importance of praise and recognition for good behaviour with clearly expressed expectations and consistent and calm consequences for misbehaviour

Question 29

State the focuses of CBT for anger management

Answer 29

Stopping and thinking in challenging situations, recognising one’s own emotional state, recognising and defining problems, developing alternative responses, anticipating consequences, crediting oneself for staying in control, reviewing actions afterwards