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Psychopathology PSYC 340 > ODD and CD > Flashcards

ODD and CD Flashcards

1
Q

internalizing vs externalizing behaviours

A

internalizing:
- focus on inner self, inner directed emotions
- depression, anxiety
externalizing
- behaviours or symptoms that affect others, outer directed B
- ODD, CD
diagnosis requires persistent pattern of B that is:
1. atypical for child’s dev age and dev level
2. severe enough to cause distress to child/others or negatively affected functioning

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2
Q

DSM5 criteria for ODD

A
  1. pattern of angry/irritable mood, argumentative/definant B, or vindictiveness
  2. lasting at least 6 months
  3. > 4 symptoms from any of the above categories exhibited with at least 1 person other than sibling
  4. causes distress in individuals/others in immediate social context, or impairs functioning
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3
Q

DSM5 criteria for ODD: angry/irritable

A
  1. loses temper
  2. is touchy or easily annoyed
  3. angry or resentful
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4
Q

DSM5 criteria for ODD: argumentative/defiant B

A
  1. argues with authority and adults
  2. actively defies/refuses to comply with requests from authority or with rules
  3. deliberately annoys or others
  4. blames others for mistakes/misbehaviours
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5
Q

DSM5 criteria for ODD: vindictiveness

A
  1. spiteful or vindictive
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6
Q

DSM5 criteria for CD

A
  1. repetitive, persistent pattern of antisocial B
  2. > 3 from any following categories
    - aggression to people/animals
    - destruction of property
    - deceitful/theft
    - serious violation of rules
  3. causes significant impairment in social academic or occupational functioning
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7
Q

DSM5 criteria for CD: aggression to people and animals

A
  1. bullies/threatens/intimates
  2. initiates physical fights
  3. used a weapon that can cause harm
  4. physically cruel to people and animals
  5. stolen while confronting victim
  6. forced someone into sex activity
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8
Q

DSM5 criteria for CD: destruction of property

A
  1. deliberately enaged in firesetting with intention to cause damage
  2. deliberately destroyed others’ property
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9
Q

DSM5 criteria for CD: deceitfulness/theft

A
  1. broken into someone’s house/building/car
  2. often lies to obtain good favours or to avoid obligations
  3. stolen items of nontrivial value (e.g. shoplifting)
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10
Q

DSM5 criteria for CD: serious violation of rules

A
  1. stays out at night despite parental prohibition (before 13)
  2. run away from home
  3. truant from school (before 13)
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11
Q

CD specifiers

A
  • onset/course: childhood onset = <10y - teen onset = 10+
  • with limited prosocial emotions (antisocial Bs)
  • prevalence ODD = 3.3%
  • prevalence CD = 3.2%
  • 2-4x higher in males (sex differences emerge by 4y, decrease in adolescence)
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12
Q

CD with limited prosocial emotions

A

at least 2 symptoms in 12 months
1. lack of remorse/guilt
2. callous - lack of empathy
3. unconcerned about performance
4. shallow/deficient affect

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13
Q

developmental course of CD: how does the child’s age/developmental stage impact the presentation of the symptoms

A
  1. frequency + form of disruptive Bs change across development
  2. more overt aggression in preschool + early childhood, more covert in teens
  3. onset: when do symptoms first emerge
  4. continuity vs discontinuity
  5. implications for prognosis
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14
Q

childhood onset of CD characteristics

A
  1. chronic course (perisstent Bs across dev)
  2. predominantly males
  3. more aggressive/violent
  4. more biological risk factors
  5. severe family dysfunction
  6. ADHD
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15
Q

adolescent onset of CD characteristics

A
  1. stronger environmental contribution
  2. socialized
  3. less violent
  4. often do not have ADHD or ODD
  5. more females
  6. many desist but some do not
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16
Q

CU (callous-unemotional) traits impact on CD prognosis

A
  1. more severe conduct problems + extreme antisocial acts
  2. sensation seeking
  3. reduced sensitivity to punishment
  4. more police contact
  5. stronger parental history of APD
  6. response to treatment
  7. more likely to progress to adult APD
  8. poorer longterm outcomes
17
Q

biological view of ODD and CD

A
  1. genetics
    - more genetic influence for CD than ODD, life course persistent pattern, CU traits
    - genotype result in lower MAOA activity - impact fear circuit in amygdala
  2. low fear temperament (strongly linked with CU traits)
  3. neurobiology
    - abnormalities in brain struture/circuits = lower empathy, activation in limbic system
    - reduced autonomic system activity (need for increased stimulation, sensitivity to reward + insensitivity to punishment)
18
Q

psychological view of ODD and CD

A
  1. inconsistent parental discipline + harsh parenting
  2. coercive cycle of parent-child interactions - operant conditioning (powerpoint, slide 18)
  3. behavioural theories
    - modelling + positive reinforcement
  4. cognitive theories
    - hostile attribution bias - mistakenly view neutral B as aggressive/threatning
    - expect favourable outcomes from aggression
    - beliefs that societal normas/expectations do not apply to them
19
Q

social view of ODD and CD

A
  • unpredictability in home and neighbourhood
  • exposure to neighbourhood violence
20
Q

EBT for ODD and CD: children

A

behavioural parenting interventions
- PCIT
- Incredible Years
- triple P

21
Q

EBT for ODD and CD: adolescents

A

combined behavioural therapy + CBT + family therapy
- multisystemic therapy (MST)
- functional family therapy (FFT)

22
Q

behavioural parenting interventions (individual or in groups)

A

goals:
1. teach parent skills to increase desirable Bs, decrease undesirable Bs
2. improve parent-child relationships
skills
1. praise/reward good B
2. consequences for misbehaviour
3. give effective commands
4. set limits

23
Q

functional family therapy

A
  • for teens with delinquent + acting out Bs at risk of institutionalization
  • family based intervention
  • goals:
    1. motivate adolescents/families to decrease negativity in the household
    2. build communication, effective parenting, conflict management skills
  • team of 3-8 therapists with 10-12 families
  • intensive, usually in the home
24
Q

multisystemic therapy

A
  • for teens with serious antisocial/delinquent B
  • goal:
    1. promote responsible B, decrease irresponsible B
    2. prevent out-of-home placement
  • intensive, comprehensive, community based intervention
  • delivered in natural environment, take multiple systems into account
  • frequent contact with therapists
  • techniques:
    1. CBT
    2. parent training
    3. family therapy techniques

Psychopathology PSYC 340 (14 decks)

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