Lecture 5- ODD/CD Flashcards
What general category of disorders are ODD/CD under?
- Disruptive, Impulse-Control, and Conduct Disorders
- Known as externalizing disorders
What is the DSM5 definition of ODD?
A pattern of angry/irritable mood, argumentative/ defiant
behavior, or vindictiveness lasting at least 6 months, during which at
least 4 of the following are present during interactions with at least
one individual who is not a sibling:
Angry/Irritable mood:
- Often loses temper
- Is often touchy or easily annoyed
- Is often angry and resentful
Argumentative/Defiant behavior:
- Often argues with authority figures or adults
- Often actively defies or refuses to comply with authority figures/adults’ requests or rules
- Often deliberately annoys others
- Often blames others for his/her mistakes or misbehavior
Vindictiveness
-Has been spiteful or vindictive at least twice in the last 6 months
Why does ODD behaviour have to occur outside of the sibling relationship?
Because it is developmentally normal to a certain extent for sibling rivalries and disobedience to occur.
As part of ODD diagnosis what else needs to occur aside just the symptoms?
Impairment: Disturbance in behaviour is associated with distress in the individual or others in his/her immediate social context, or it impacts negatively on social, educational, occupational or other important areas of functioning.
Note: it’s not always the child who experiences discomfort cause often their defiant behaviour gets them what they want in the short term however, it will impair them long term and generally is placing a lot of strain on the family and parents.
What’s important about the timing of ODD symptoms to reach classification of the disorder under the DSM-5?
The behaviors do not occur exclusively during the course of a psychotic, substance use, depressive or bipolar disorder. Also, the criteria are not met for a disruptive mood dysregulation disorder.
What is the DSM5 definition of CD?
A repetitive and persistent pattern of behaviour in which the
basic rights of others, or major age appropriate social norms, or
rules are violated with the presence of at least three of the
following 15 criteria in the last 12 months from any category
below, with least one criterion present in the last 6 months:
Aggression to people and animals
-Often bullies, threatens, or intimidates others
-Often initiates physical fights
-Has used a weapon that can cause serious physical hard to
others (e.g., a bat, brick, broken bottle, knife, gun)
-Has been physically cruel to people
-Has been physically cruel to animals
-Has stolen while confronting a victim (e.g., mugging, purse
snatching, extortion, armed robbery)
-Has forced someone into sexual activity
Destruction of property
-Has deliberately engaged in fire setting with the intention of causing
serious damage
-Has deliberately destroyed others’ property (other than fire setting)
Deceitfulness or theft
-Has broken into someone else’s house, building, or car
-Often lies to obtain goods or favors, or to avoid obligations (i.e, “cons” others)
-Has stolen items of nontrivial value without confronting a victim (e.g., shoplifting, but without breaking and entering; forgery)
Serious violations of rules
-Often stays out at night despite parental prohibitions, beginning before age 13
-Has run away from home overnight at least twice while living in the
parental or parental surrogate home, or once without returning for a
lengthy period
-Is often truant from school, beginning before 13 years of age.
Initially how do people feel when they defy rules as part of CD? How do these feelings develop over time?
- Rush and adrenaline associated so feel a positive emotion initially which serves as a break from the normal negative emotions they feel.
- They then go searching for that positive emotion. But each time they have to do more and more to get the high due to habituation.
Habituation also means they can do more and more harmful things as not a lot of guilt is felt anymore/ they lose empathy.
Like ODD what else is needed other than symptoms to meet criteria for CD?
The disturbance in behavior causes clinically significant impairment
in social, academic, or occupational functioning
What is the link to ASPD (Anti Social Personality Disorder) from CD?
You can’t get diagnosed with a personality disorder such as ASPD until after age 18 and if you met criteria for it that trumps CD. I.e. you would never be deemed as having both CD and ASPD
What are the subtypes of CD?
- Childhood Onset Type: Onset prior to age 10
- Adolescent Onset Type: Absence of any CD criterion prior to age 10
- Unspecified Onset: not enough info available to determine whether symptoms were present before or after age 10
Do you rate CD on serevity?
Yes there is the mild, moderate and severe types
What is the difference between ODD and CD?
- ODD typically emerges 2 – 3 years before CD
- 90% of CD patients used to have ODD before diagnosed CD.
- However, 2/3 of children with ODD do not progress to CD
In other words CD is more severe than ODD typically you won’t get it if you haven’t already met criteria for ODD but not all with ODD end up getting CD.
How do the risk factors of ODD and CD compare?
Similar risk factors (e.g., poverty, family history), though stronger association for CD.
What disorder ODD or CD is required as a precursor to ASPD?
CD
What is the prevalence of life-course CD (child onset) in the normal population, offenders and juvenile crime?
- 3% – 6% of general population (USA)
- 15% of offenders
- ¼ to ½ of juvenile crime
