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Child Health > CAMHS 2 - Conduct Disorder > Flashcards

CAMHS 2 - Conduct Disorder Flashcards

1
Q

What is conduct disorder?

A

A repetitive and persistent pattern of behaviour in which the basic rights of others or major age appropriate norms/rules are violated

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2
Q

What is conduct disorder sometimes called in younger children?

A

Oppositional Defiant Disorder (ODD)

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3
Q

What is conduct disorder classified as?

A

A behaviour disorder = second most common group of mental health disorders in children and teens (5%)

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4
Q

What is needed to diagnose conduct disorder?

A

Presence of three or more of the criteria in the past 12 months with at least one of the criteria in the past 6 months

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5
Q

What are the diagnostic criteria for conduct disorder?

A

Aggression to people or animals
Destruction of property
Deceitfulness or theft
Serious violation of rules

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6
Q

What are some types of aggression found in conduct disorder?

A

Often threatens, bullies or intimidates others
Has been physically cruel to other people or animals
Often initiates fights
Has used a weapon that can cause serious harm
Has stolen while confronting a victim
Has forced someone into sexual activity

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7
Q

What is classed as destruction of property when diagnosing conduct disorder?

A

Deliberately destroyed other people’s property or has engaged in fire-setting

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8
Q

What are some ways deceitfulness and theft may manifest?

A

Has broken into someone’s home, building or car

Lies to obtain goods or favours or to avoid obligations

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9
Q

What is the consequence of conduct disorder?

A

Serious impairment in social, academic or occupational function

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10
Q

What are some areas affected in someone’s life by conduct disorder?

A

School and family
Criminality and mental health co-morbidity
Health, Social or Criminal justice system involvement

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11
Q

What are the types of conduct disorder?

A

Mild, moderate and severe

Severe may be unsocialised or socialised

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12
Q

Where is mild to moderate conduct disorder restricted to?

A

The family environment

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13
Q

What does unsocialised severe conduct disorder present as?

A

Predominantly violent behaviour and more likely to be dealt with in the criminal justice system

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14
Q

How does socialised severe conduct disorder present?

A

More covert antisocial acts or have better ability at avoiding the involvement of the criminal justice system

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15
Q

What are some co-morbidities of conduct disorder?

A

Attachment difficulties (RAD), ADHD, depression, substance misuse, deviant sexual behaviour, reading and other learning difficulties (30%)

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16
Q

What difficulties make up the triad that characterises ADHD?

A

Inattention, hyperactivity and impulsivity

17
Q

What are the impairing symptoms of ADHD that relate to self-regulation?

A

Developmentally inappropriate, impaired functioning, pervasive across setting, longstanding from age 5

18
Q

What causes ADHD?

A

Multifactorial = involves genetic and environmental factors

19
Q

How does ADHD run in families?

A

Shows familial clustering both in and across generations
60% increased risk in children with parents with ADHD
15% increased risk in siblings of children with ADHD
Hyperactivity tends to aggregate in families

20
Q

Why is it possible to misdiagnose ADHD in children with conduct disorder?

A

The conditions present the similarly and are also highly co-morbid

21
Q

How are simple ADHD and ADHD with co-morbid conduct disorder different?

A

Distinct subtypes = both have same short term response to stimulant medication but children with ADHD and CD have higher rates of antisocial personality as adults

22
Q

What causes conduct disorder?

A 
Genetics = some evidence as per twin studies
Brain injury (intrauterine or post natal)
Environmental
23
Q

What are some environmental causes of conduct disorder?

A

Individual child problem = difficult temperament, clash of parental and child temperament
Parental and family circumstances are strong predictors

24
Q

What is the link between brain injury and antisocial behaviour?

A

Antisocial behaviour is more common in children with neurological conditions

25
Q

What is the responsibility of the family when raising a child?

A

Role of the family is to rear and socialise a child so that it develops normally

26
Q

Why may families struggle to meet the need of a child to socialise?

A

Parents with mental illness or intellectual difficulties
Drug/alcohol problems or domestic violence
Single parent families

27
Q

What are some intra-familiar predictors of antisocial behaviour?

A

Lack of house rules (no set routine) and supervision
Lack of clarity as to how children should behave
Lack of effective contingencies
Lack of techniques to deal with crises/resolve conflict

28
Q

What is a lack of effective contingencies in a family setting?

A

Inconsistent responses to undesired behaviour with failure to follow through on consequences or rewards

29
Q

Why is anger common in children with conduct disorder?

A

Protective response to painful feelings (easier to be angry)

Can give adolescents a sense of identity

30
Q

Why are things like stealing and destructive behaviour a natural progression from anger?

A

Anger cause adrenaline rush in brain in body that makes young people feel powerful and alive = more serious aggressive behaviour has the same response

31
Q

How are children with conduct disorder that have no co-morbid disorders treated?

A

Parent/Foster training = children under age 11
Child focused programmes = children aged 9-14
Multimodal interventions = young people aged 11-17

32
Q

What are child focused programmes?

A

Social and cognitive problem solving programmes

33
Q

What are multimodal interventions?

A

Multisystemic therapy providing intensive support to the young person and their family

34
Q

How is medication used to treat conduct disorder?

A

Not first line = may help with impulsivity and aggressive behaviour in extreme cases

35
Q

What are some medications used to treat co-morbid conditions of conduct disorder?

A 
ADHD = stimulant medication
Depression = SSRIs
36
Q

What is an example of a medication used to treat conduct disorder?

A

Risperidone = atypical antipsychotic

Child Health (27 decks)

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