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36 Cards in this Set
- Front
- Back
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Conduct Problems |
Related to antisocial behavior - age-inappropriate actions and attitudes that violate family expectations, societal norms, and the personal or property rights of others |
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Delinquency |
legal terms for antisocial behavior - not necessarily considered a mental disorder |
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Externalizing behavior |
Mix of impulsive, overactive, aggressive, and delinquent acts |
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Key Features of Antisocial Behaviors |
- some behaviors decrease with age (e.g. disobeying at home) - some behaviors increase with age and opportunity (e.g. hanging around kids who get into trouble) - more common in boys during childhood |
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Property Violations |
Covert + Destructive - setting fires - stealing - committing vandalism |
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Aggression |
Destructive + Overt - assaulting - fighting - behaving cruelly towards animals and/or people - bullying |
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Status Violations |
Covert + Nondestructive - abusing substances - running away - swearing - breaking rules |
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Oppositional Behavior |
Overt + Nondestructive - being annoying - being defiant - arguing - stubbornness - anger - touchiness |
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Reactive aggression |
engaging in physical violence in response to a threat, frustrating event, or provocation - impulsivity/automaticity - no consideration of alternative responses - mostly seen in younger kids and those with ADHD - also seen in kids with a history of physical abuse and/or bullying |
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Proactive aggression |
Deliberately engaging in an aggressive act to obtain a desired goal - learned through modeling and reinforcement |
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Relational Aggression |
Girls more likely to use relational aggression - purposefully leaving a child out of an activity - getting mad at someone and excluding her from the peer group - telling lies about a person so others won't like him - telling someone you will not like him unless he does what you say |
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ODD Characteristics |
- typically do not regard themselves as angry, oppositional or defiant - view their behavior as a justified response to unreasonable demands or circumstances - may have history of hostile parenting; hard to know which came first |
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ODD: Prevalence, Course & Comorbidities |
- 3-5% - more prevalent in males (prior to adolescence) - first symptoms usually appear in preschool and rarely later than early adolescence - often (but not always) precedes the development of conduct disorder - comorbid with anxiety disorders and major depressive disorder, substance use |
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how does LPE relate to CD? |
- those with LPE are more likely to have childhood-onset, severe, violent and chronic CD |
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Limited Prosocial Emotions |
- traits are relatively stable from late childhood to early adolescence - problems with LPE traits are more strongly related to dysfunctional parenting practices - deficits in fear and distress signals in others (amygdala hyporeactivity) - more heritable |
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Boys and LPE |
- may be less responsibe to parenting intervention via discipline/punishment (equal response for those with and without LPE traits to positive reinforcement |
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Behavior therapy and LPE |
behavior therapy alone is less effective for those with LPE traits (stimulant medication + behavioral therapy seems to help) |
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CD Prevalence |
- 5-10% for boys, 2-4% Prevalence rates rise from childhood to adolescence - more common in boys than in girls - girls tend to use relational aggression - few children with CD receive treatment |
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Key ODD Features |
- argumentativeness - noncompliance with rules and negativism - emotion regulation problems (not included in CD defintion) |
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Distinctions between ODD and CD |
ODD do NOT display: - significant physical aggression - significant destruction of property - pattern of theft and deceit |
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Distinctions between ODD/CD and ADHD |
- individuals with ADHD do not mean to cause harm - ADHD and ODD are often comorbid: when ADHD doesn't follow requests, even when sustained effort and attention are not required, the additional diagnosis may be warranted - comorbid CD and ADHD have worse outcomes |
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Distinctions between ODD/CD and Depressive/Bipolar Disoders |
- ODD/CD do NOT have disturbances of sleep and appetite as is the case with Depressive and Bipolar disorders - energy and activity levels remain constant in CD |
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Assessment: Interview Q's |
1. run-ins with police? circumstances? 2. physical fights? circumstances? frequency? 3. suspended or expelled from school? circumstances? 4. run away from home? overnight? frequency? 5. do you smoke, drink, use drugs? which? frequency and duration? **age 6. sexually active? **age |
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Neurobiological causes of antisocial behavior |
Decreased NTs: - serotonin - dopamine Increased hormones - testosterone Low levels of autonomic arousal - underarousal of HPA axis |
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Why would an underarousal of the HPA axis lead to antisocial behavior? |
- may explain lack of empathy and emotional reactivity to others - limited ability to feel fear and guilt - insensitivity to punishment - less able to experience pleasure, excitement and exhilaration |
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Conduct Problems Caused by Temperament and Psychosocial |
- Difficult temperament - high emotion reactivity - thrill-seeking and recklessness - parents may alternate between overly permissive and angry disciplinary tactics - low parental monitoring - maternal depression, paternal substance abuse - high crime neighborhoods |
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What is one of the best predictors of OD and CDD? |
When parents alternate beween permissive and angry disciplinary tactics - parents may feel powerless |
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Why does high emotional reactivity lead to temperamental conduct problems? |
- don't learn effective emotion regulation skills - parents may have trouble responding sensitively and appropriately -can compromise parent-child interaction quality - children may rely on impulsive decision-making - peer rejection, selective affiliation with deviat peers, deciancy training |
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Cognitive Behavioral Antisocial Bheavior Causes |
- rewards for aggression - hostile attribution bias - may perceive and label their own arousal as anger - focus on positive aspects of aggression and lack of responsiveness to emotional stimuli - social learning (modeling, disinhibition) - reinforcement trap |
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How does a reinforcement trap work? |
Ex/ giving into a tantrum - mother reinforces child's behavior and reinforces her own behavior |
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Parent Management Training |
- teach parents the causes of disruptive behavior problems and how to attend to and praise appropriate behavior immediately and consistently - time out for serious rule violations - structure the environment to help children behave - generalize to other settings |
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Pros of PMT |
Functioning similar to peers without conduct problems for at least 3 years |
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Cons of PMT |
- less effective for parents under high stress - seems to be less effective for adolescents, over whom parents have less control - few clinicians in the community are skilled in PMT |
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Parent-Child Interaction Therapy |
- parents and children attend therapy together - parents develop skills: Praising, Reflecting, Imitating, Describing, Enthusiasm - parents create more realistic expectations for children's behavior - improvements are maintained for at least 1-2 years |
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Multisystematic Treatment |
**Targets family, school, and peers** - therapists works in teams of 3-5 and available 24/7, lasts about 3 months - lowers probability of future offenses +arrests - only available to ~1% of adolescents with serious conduct problems - costly, but not as much as incareceration |
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MST: Family, School, Peers |
Family: help parents effectively interact with and monitor kids, remove obstacles that interfere School: increase parental involvement in education, remove obstacles to academic achievement Peers: limit opportunities for interactions with deviant peers, increase interactions with prosocial youths/new peer networks |
