Disruptive, Impulse, Conduct Disorders Flashcards
(26 cards)
Oppositional defiant disorder general description
Persistent pattern of hostile, angry, argumentative, and defiant behaviors, more than typical for age/developmental status, causing significant impairment.
Diagnostic criteria for oppositional defiant disorder
- More days than not for 6 months if < 5 years old
- At least once per week for 6 months if 5 years or older
- Must exhibit at least 4 symptoms in an interaction with a non-sibling
- Cross-situational experiences indicate greater severity
Signs/symptoms of ODD
1) Angry/Irritable mood
2) Argumentative/defiant: argues with authorities, defies requests for compliance, deliberately annoys others, blames others
3) Vindictiveness: at least 2x within past 6 months
Risk factors of ODD
marital discord, poor parenting practices/inconsistent limit setting, low family cohesion, parental mental disorder or substance abuse
Usual onset of ODD
6-8 yo
Most common comorbidity of ODD
ADHD
- also associated with anxiety, depression, learning or communication disorder
Oppositional Defiance Disorder treatment
- Referral to psych for eval (psychotherapy, +/-CBT)
- Parent management training, peer training
- Meds used in treating other disorders (ADHD, depression, anxiety) sometimes helpful
How is Disruptive Mood Dysregulation different than ODD?
- Baseline irritable mood
- Reckless aggression against people, animals, property (more physical)
Intermittent Explosive Disorder
recurrent episodes of inability to control aggressive impulses
Intermittent Explosive Disorder is not diagnosable before age ____.
6 yo
Intermittent Explosive Disorder diagnostic criteria
verbal or physical aggression occurring 2x/week for 3 months
OR
3 outbursts involving damage, destruction, or injury
Onset of IED
abrupt
peaks in adolescence
IED treatment
- Refer for psychotherapy and pharm tx
- CBT sometimes helpful
Symptom groupings of Conduct Disorder
at least 3 in the past year, and at least 1 in the past 6 months:
- Aggressive behavior that threatens or causes bodily harm to animals or other people
- Nonaggressive behavior that results in property damage or loss
- Theft or deceitfulness
- Significant breaches of rules and regulations
Words that describe a person with conduct disorder?
bully, fighter, cruel, runaway, con people, thief, sexual predators
Comorbidities with conduct disorder
ODD, ADHD, mood, anxiety, cognitive disability, substance use
40% of children diagnosed with conduct disorder develop _______ as adults.
antisocial personality disorder
General description of conduct disorder
- Persistent and recurrent behavior that violates accepted age-appropriate rules or societal norms
- Patterns present in multiple environments
- Not just a childhood diagnosis
Conduct disorder treatment
Recognize comorbid psychiatric disorders- ODD, ADHD, IED, depression…
Therapeutic interventions:
- Parent management
- Problem-solving skills
- Multisystem therapies
- Difficult to choose meds because symptoms are generally vague -> refer
pyromania signs/symptoms
- deliberate and purposeful fire-setting
- tension ro affective arousal preceding act
- fascination with fire
- pleasure, gratification, or relief when setting
- no monetary gain, expression of ideology, no criminal intentions
How is arson different than pyromania?
An arsonist has criminal motivation or feelings of revenge
Pyromania is a psych disorder of fire obsession
Treatment of pyromania
- Medications not approved
- Impulse control drugs may help (opioid antagonists, topiramate, SSRIs, and lithium)
- Fire Safety Education and CBT show good results in kids
Definition of kleptomania
inability to resist repetitive urges to steal specific items
signs/sx’s of kleptomania
- increasing sense of tension before act
- pleasure, gratification, or relief with theft
- not an expression of anger, vengeance, or for personal gain
